🧠 ICD-10 Basics
How many characters can an ICD-10-CM code have?
ICD-10-CM codes range from three to seven characters, allowing flexibility for detailed classification.
indicates conditions that should never be coded together as they are mutually exclusive diagnoses in ICD-10.
Excludes1
`What chapter includes codes for infectious and parasitic diseases?
Chapter 1, codes A00–B99
What is the principal diagnosis for a SNF admission following a resolved hospital condition?
The condition being actively treated in the SNF, not the resolved hospital diagnosis
What does “NEC” stand for and when is it used?
Not Elsewhere Classified” — used when no specific code exists for a documented condition.
What is the 7th Character for Subsequent Encounter?
D
True or False: You can assign a code based solely on the diagnosis name without documentation.
FALSE
Necessity of Documentation
Accurate coding requires thoroughclinical documentation to supportdiagnosis and treatment details.
Compliance with Standards
Following coding standards ensureslegal compliance and maintains integrityin medical billing.
Fraud Prevention
Proper documentation preventsfraudulent or inaccurate billing,protecting both providers and patients.
What chapter covers endocrine, nutritional, and metabolic diseases?
Chapter 4, codes E00–E89.
A resident is discharged from the hospital with a diagnosis of pneumonia. Upon admission to the SNF, the pneumonia has resolved and is no longer being treated. Should the SNF code pneumonia as the principal diagnosis?
No. Resolved diagnoses should not be coded in the SNF setting. The principal diagnosis should reflect the condition that is actively being treated and responsible for the skilled services provided in the SNF. If the hospital condition is resolved, the SNF must query the physician to determine the appropriate principal diagnosis for the SNF stay.
What does “NOS” mean in ICD-10-CM?
“Not Otherwise Specified” — used when documentation lacks specificity.
What does the letter “X” represent in ICD-10 coding?
The letter 'X' acts as a placeholder to complete the required character length in ICD-10 codes when data is missing.
What does “code first” mean in sequencing?
Code first is a sequencing instruction to code anunderlying condition before its manifestation.
What code category is used for diabetes mellitus with complications?
E10–E13, depending on type and cause.
What codes should be assigned for a resident admitted after colectomy due to Crohn’s disease with a colostomy? Identify Primary X
Z48.815-ENCOUNTER FOR SURGICAL AFTERCARE FOLLOWING SURGERY ON THE DIGESTIVE SYSTEM
Z43.3-ENCOUNTER FOR ATTENTION TO COLOSTOMY
Z90.49- ACQUIRED ABSENCE OF OTHER SPECIFIED PARTS OF DIGESTIVE TRACT,
K50.911- CROHN'S DISEASE, UNSPECIFIED, WITH RECTAL BLEEDING
Z79.52 - LONG TERM (CURRENT) USE OF SYSTEMIC STEROIDS
What is the purpose of “Includes” notes?
To further define or give examples of the content of a category.
ICD-10 stands for?
International Classification of Diseases, Tenth Revision
What does the “With” or “In” convention mean in ICD-10-CM?
It implies a cause-and-effect relationship between two conditions, even without explicit provider documentation.
What chapter includes neoplasms and how are they organized?
Chapter 2, codes C00–D49; organized by site and behavior (e.g., malignant, benign).
What is the coding guidance for resolved diagnoses?
Do not code resolved diagnoses unless they are still part of the care plan.
What does the “Code Also” note indicate?
That two codes may be needed to fully describe a condition, but it does not indicate sequencing.
This part of an ICD-10-CM code identifies the general category of the disease or condition
ICD-10-CM, the first three characters of a code represent the category, which describes the general type of disease, condition, or injury. For example:
• J45 – Asthma
• E11 – Type 2 diabetes mellitus
When should a combination code be used?
Combination codes represent multiple conditions or related manifestations with a single code to simplify documentation and coding.
What is the correct sequencing when coding anemia associated with a neoplasm?
Code the neoplasm first, followed by D63.0 for anemia in neoplastic disease.
How do you code a principal diagnosis when the acute condition is resolved and not being treated?
Query the MD to determine the reason for skilled services and code accordingly.
When assigning ICD-10-CM codes, how should a coder interpret the instructional notes “Code First” and “Use Additional Code” in the context of etiology/manifestation coding, and what is the consequence of ignoring these notes?
“Code First” notes appear at manifestation codes and instruct the coder to sequence the underlying etiology first. “Use Additional Code” notes appear at etiology codes and indicate that a secondary code is needed to describe the manifestation. Ignoring these notes can result in incorrect sequencing, denial of claims, and failure to accurately reflect the clinical picture of the patient