An overview of ICD-10 coding for medical physicians by Advanced Billing Consultants.

1. ICD-10 Overview
Prepared by Advanced Billing Consultants
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2.  Minimum of 3, maximum of 7 characters
 6th and 7th are not optional if required
 X may serve as a place holder for 4th and 5th
character for future use
 Example of X place holder: other specified
spondylopathies, cervical region is
M48.8X2
Code Structure
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3.  Represent the category
 1st: Capital Letter (any except U)
 2nd: number
 3rd: number
 Example: The category for pain, not elsewhere
classified is
G89
Characters 1-3
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4.  Represent the etiology, anatomical site,
severity, or other clinical detail
 Can be number or letter- capital or lowercase
Characters 4-6
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5.  For obstetrics, musculoskeletal injuries, and
external causes of morbidity
 encounter type, or extension, stages,
LT/RT/bilateral/unspecified
 OR:
 A: initial
 D: subsequent
 S: Sequela (complications)
Character 7
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6.  Collapsed vertebra, not elsewhere classified is M48.50-
M48.58, but it requires a 7th digit
 A= initial encounter for fracture
 B= subsequent encounter for fracture with routine healing
 G= subsequent encounter for fracture with delayed healing
 S= sequela of fracture
 Correct diagnoses for the initial encounter for collapsed
vertebra not elsewhere classified, site unspecified is:
M48.50A
Example Character 7
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7.  Excludes1: the two codes cannot be billed
together
 Excludes2: both codes can be used
Excludes Notes
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8.  Many ICD-10 require additional diagnosis
codes
Additional Codes Required
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9.  “in diseases classified elsewhere”= a
manifestation code
 Can never be listed first
 May say: “use additional code” or “code first”
 Again, can never be listed first
 Code in brackets means it must be coded
also, and second
Etiology/Manifestation Codes
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10. 1. Certain Infectious and Parasitic Diseases (A00-B99)
2. Neoplasms (C00-D49)
3. Disease of the blood and blood-forming organs and certain disorders
involving the immune mechanism (D50-D89)
4. Endocrine, Nutritional, and Metabolic Diseases (E00-E89)
5. Mental, Behavioral, and Neurodevelopmental Disorders (F01-F99)
6. Chronic pain syndrome (G89)
7. Diseases of the Eye and Adnexa
8. Diseases of the Ear and Mastoid Process (H60-H95) **not yet used
9. Diseases of Circulatory System (100-199)
10. Diseases of Respiratory System (J00-J99)
11. Diseases of Digestive System (K00-K95) **not yet used
Chapters
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11. 12. Diseases of the Skin and Subcutaneous Tissue (L00-L99)
13. Diseases of Musculoskeletal System and Connective Tissue (M00-M99)
14. Diseases of Genitourinary System (N00-N99)
15. Pregnancy, Childbirth (O00-O9A)
16. Certain Conditions Originating in the Prenatal Period (P00-P96)
17. Congenital malformations, deformations and chromosomal abnormalities
(Q00-Q99)
18. Symptoms, signs, and abnormal clinical and laboratory findings (R00-R99)
19. Injury, Poisoning, and Certain other Consequences of External Causes
(S00-T88)
20. External Causes of Morbidity (V00-Y99)
21. Factors Influencing Health Status and Contact with Health Services (Z00-
Z99) ***The new V-codes***
Chapters Cont’d
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12.  Use ICD-10 for DOS 10/1/2015 and forward.
 Continue use of ICD-9 for DOS 9/30/15 and
before (even for corrected claims)
Date Transition
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13.  Many software systems provide crosswalks and
conversions at the encounter or charge entry
level. Ensure you have the most recent
updates for your system.
 Specialty specific cheat sheets can be
purchased from many vendors
 AAPC offers a free ICD-9 to ICD-10 conversion
tool at: https://www.aapc.com/icd-10/codes/
Conversions and Crosswalks
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14.  We appreciate any feedback. Please contact
us at info@abcbilling.net
Thank You!
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