1. 1 Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 1 CHAPTER 7 AN OVERVIEW OF ICD-10-CM

2. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 2 ICD-10-CM ICD-10-CM scheduled to replace ICD-9-CMICD-10-CM scheduled to replace ICD-9-CM Target implementation date October 1, 2013Target implementation date October 1, 2013

3. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 3 Improvements in ICD-10-CM More relevant ambulatory and managed care encounter codesMore relevant ambulatory and managed care encounter codes Expanded injury codesExpanded injury codes Combination diagnosis/symptom codesCombination diagnosis/symptom codes Up to 7 charactersUp to 7 characters(Cont’d…)

4. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 4 Improvements (…Cont’d) Updated diabetes codesUpdated diabetes codes Greater overall specificityGreater overall specificity

5. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 5 ICD-10-CM Structure 21 Chapters21 Chapters V and E codes incorporated into code setV and E codes incorporated into code set Addition of chapters forAddition of chapters for –Eye and Adnexa –Ear and Mastoid Process

6. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 6 GEMs Files ICD-9-CM code mapped to new ICD-10- CM codeICD-9-CM code mapped to new ICD-10- CM code Figure: 7.1 GEMs mapping files I-9 to I-10 (Courtesy U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.) (Courtesy U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.)

7. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 7 GEMs File, Cont’d ICD-10-CM code mapped to new ICD-9- CM codeICD-10-CM code mapped to new ICD-9- CM code GEMS mapping files I-10 to I-9 (Courtesy U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.)

8. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 8 GEMs Flag (Column 3) Three types of flagsThree types of flags –Approximate Direct match from I-9 to I-10Direct match from I-9 to I-10 Flags: 00000 and 10000Flags: 00000 and 10000 –No Map No diagnosis code availableNo diagnosis code available –Combination Requires a combination of codes to map from one system to anotherRequires a combination of codes to map from one system to another

9. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 9 Index Main terms and subtermsMain terms and subterms Figure: 7.9 ICD-10-CM Index (From Buck CJ: 2010 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2010, Saunders.)

10. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 10 ICD-10-CM Chapters Chapter 1 Certain Infectious and Parasitic Diseases (A00–B99)Chapter 1 Certain Infectious and Parasitic Diseases (A00–B99) Chapter 2 Neoplasms (C00–D49)Chapter 2 Neoplasms (C00–D49) Chapter 3 Disease of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism (D50–D89)Chapter 3 Disease of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism (D50–D89) Chapter 4 Endocrine, Nutritional, and Metabolic Diseases (E00–E90)Chapter 4 Endocrine, Nutritional, and Metabolic Diseases (E00–E90) Chapter 5 Mental and Behavioral Disorders (F01–F99)Chapter 5 Mental and Behavioral Disorders (F01–F99) Chapter 6 Diseases of the Nervous System (G00–G99)Chapter 6 Diseases of the Nervous System (G00–G99) Chapter 7 Diseases of the Eye and Adnexa (H00-H59)Chapter 7 Diseases of the Eye and Adnexa (H00-H59) Chapter 8 Diseases of the Ear and Mastoid Process (H60–H95)Chapter 8 Diseases of the Ear and Mastoid Process (H60–H95) Chapter 9 Diseases of the Circulatory System (I00–I99)Chapter 9 Diseases of the Circulatory System (I00–I99) Chapter 10 Diseases of the Respiratory System (J00–J99)Chapter 10 Diseases of the Respiratory System (J00–J99) Chapter 11 Diseases of the Digestive System (K00–K94)Chapter 11 Diseases of the Digestive System (K00–K94) Chapter 12 Diseases of the Skin and Subcutaneous Tissue (L00–L99)Chapter 12 Diseases of the Skin and Subcutaneous Tissue (L00–L99) Chapter 13 Diseases of the Musculoskeletal System and Connective Tissue (M00–M99)Chapter 13 Diseases of the Musculoskeletal System and Connective Tissue (M00–M99) Chapter 14 Diseases of the Genitourinary System (N00–N99)Chapter 14 Diseases of the Genitourinary System (N00–N99) Chapter 15 Pregnancy, Childbirth, and the Puerperium (O00–O99)Chapter 15 Pregnancy, Childbirth, and the Puerperium (O00–O99) Chapter 16 Certain Conditions Originating in the Perinatal Period (P00–P96)Chapter 16 Certain Conditions Originating in the Perinatal Period (P00–P96) Chapter 17 Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q00–Q99)Chapter 17 Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q00–Q99) Chapter 18 Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00–R99)Chapter 18 Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00–R99) Chapter 19 Injury, Poisoning, and Certain Other Consequences of External Causes (S00–T88)Chapter 19 Injury, Poisoning, and Certain Other Consequences of External Causes (S00–T88) Chapter 20 External Causes of Morbidity (V01–Y99)Chapter 20 External Causes of Morbidity (V01–Y99) Chapter 21 Factors Influencing Health Status and Contact with Health Services (Z00–Z99 )Chapter 21 Factors Influencing Health Status and Contact with Health Services (Z00–Z99 )

11. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 11 Tabular Each section begins with unique letter and codes arranged in numerical orderEach section begins with unique letter and codes arranged in numerical order ICD-10-CM Tabular, R codes. (Modified from Buck CJ: 2010 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2010, Saunders.) Figure: 7.10

12. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 12 Official Instructional Notations IncludesIncludes –Define or give examples of category content Figure: 7.11 Includes notation. (From Buck CJ: 2010 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2010, Saunders.)

13. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 13 Excludes1 Exclude1 = Not Coded HereExclude1 = Not Coded Here Figure: 7.12 Excludes1 notation in I-10. (From Buck CJ: 2010 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2010, Saunders.)

14. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 14 Excludes2 Excludes2 = Not Included HereExcludes2 = Not Included Here Figure: 7.13 Excludes2 notation. (From Buck CJ: 2010 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2010, Saunders.)

15. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 15 Code First/Use Additional Code Code First/Use Additional = Etiology/Manifestation Paired CodesCode First/Use Additional = Etiology/Manifestation Paired Codes Figure: 7.14 I-10 Tabular, Code first notation. (From Buck CJ: 2010 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2010, Saunders.)

16. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 16 Code Also Code Also = More than 1 code requiredCode Also = More than 1 code required Figure: 7.16 I-10 Tabular, Code also notation (From Buck CJ: 2010 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2010, Saunders.)

17. Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 17 7th Character and Placeholder x Codes <6 characters that have a 7th character requirement, x is placeholderCodes <6 characters that have a 7th character requirement, x is placeholder Figure: 7.17 x as the placeholder. (From Buck CJ: 2010 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2010, Saunders.)

18. 18 Copyright © 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 18 Conclusion CHAPTER 7 AN OVERVIEW OF ICD-10-CM