Endocrine ICD-10-CM
ICd-10-CM Coding Guidelines
Blood and Blood Forming Organs
Secondary diagnoses
Coding Conventions
100
When looking up the code for Amyloidosis, what type of excludes note is there? What is it telling you?
It excludes Alzheimers- Excludes 2
100
How many sections are in the coding gudelines for blood and blood forming organs?
Zero
100
Sarcoidosis of the skin
D86.3
100
Malia comes to the hospital preoperatively to have labs and a check xray done because she is going to have a d&c due to a missed abortion. What are the codes here?
Z01.812, Z01.811, O02.1
100
What does code also mean in the ICD-10-CM codebook mean?
“Code also” note A “code also” note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. The sequencing depends on the circumstances of the encounter.
200
Under chapter notes- what is the note explain for Ehlers-Danlos syndrome?
Exludes 1- NOT CODED HERE- go to Q79.6-
200
What do the guidelines tell us about complicatioons due to an insulin pump?
Complications due to insulin pump malfunction (a) Underdose of insulin due to insulin pump failure An underdose of insulin due to an insulin pump failure should be assigned to a code from subcategory T85.6, Mechanical complication of other specified internal and external prosthetic devices, implants and grafts, that specifies the type of pump malfunction, as the principal or first-listed code, followed by code T38.3X6-, Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs. Additional codes for the type of diabetes mellitus and any associated complications due to the underdosing should also be assigned. (b) Overdose of insulin due to insulin pump failure The principal or first-listed code for an encounter due to an insulin pump malfunction resulting in an overdose of insulin, should also be T85.6-, Mechanical complication of other specified internal and external prosthetic devices, implants and grafts, followed by code T38.3X1-, Poisoning by insulin and oral hypoglycem
200
accidental puncture/laceration of spleen when performing a procdure on the spleen
D78.11
200
Aylin visits her primary physiican to discuss an ongoing stomach problem that she has had for a few weeks. He dagnoses her with gastritis and prescribes medication. She also listed on her problem list coming in that she has chronic fatigue that is managed by a sleep specialist and is also planning on running a marathon soon. What can we code?
gastritis
200
What does the word and mean in the ICD-10-CM book mean?
“And” The word “and” should be interpreted to mean either “and” or “or” when it appears in a title. For example, cases of “tuberculosis of bones”, “tuberculosis of joints” and “tuberculosis of bones and joints” are classified to subcategory A18.0, Tuberculosis of bones and joints
300
Code for Tauri disease- what other disoders group here?
E74.09
Other glycogen storage disease
Andersen disease
Hers disease
Tauri disease
Glycogen storage disease, types 0, IV, VI-XI
Liver phosphorylase deficiency
Muscle phosphofructokinase deficiency
300
Can we code Covid-19 as an OP if the final dx is suspected Covid-19 since we are treating the patient as though they have it? Why or why not.
No
300
torsion of spleen
D73.5
300
What clinical tests would help a coder decide if a diagnosis can be picked up?
Labs
Xrays
neurological-EEG
cardiological- EKG
300
What does etiolological condition mean versus manafestation?
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD?10-CM has a coding convention that requires the underlying condition be sequenced first, if applicable, followed by the manifestation. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation
400
Barth syndrome- code and what other notes are you to follow here?
E78.71
Excludes 1: Niemann-Pick disease type C (E75.242)
400
How do we code a patient if they are in receiving chemo for a primary malginancy of their right lung?
Encounter for chemo
Primary malignancy
400
ABLA
D62
400
Clyde has presented to the ED for a finger laceration. He also has diabetes for which he is non-compliant with his medications. He is also prone to blood clots and is on a blood thinner. He has had labs run to look at his clotting factor, his A1C (diabetes measurement) during this visit along with having his finger sutured. He was also counseled on getting his diabetes in order and got an insulin drip. Further, he has a family hisory of glaucoma and stroke. What should we code for?
Finger lac
diabetes
noncompliance
hx blood clots
longer term use of anticoagulation meds
400
Difference between excludes 1 and excludes 2. Where do we find he edits on these?
A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
500
Other disorders of iron metablolism: code and what note are you to follow?
E89.19
Use additional code, if applicable, for idiopathic pulmonary hemosiderosis (J84.03)
500
Bonus question
How do you feel so far? What is confusing and what can I go over that will help?
500
Warm autoimmune hemolytic anemia
D59.11
500
What are the criteria to code a secondary dx?
For reporting purposes, the definition for “other diagnoses” is interpreted as additional conditions that affect patient care in terms of requiring: clinical evaluation; or therapeutic treatment; or diagnostic procedures; or extended length of hospital stay; or increased nursing care and/or monitoring.
500
What is a placeholder character? Give an example.
The ICD-10-CM utilizes a placeholder character “X”. The “X” is used as a placeholder at certain codes to allow for future expansion. An example of this is at the poisoning, adverse effect and underdosing codes, categories T36-T50.
Where a placeholder exists, the X must be used in order for the code to be considered a valid code.