Coding Transition Tip Sheet ICD-9 to ICD-10
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1 Coding Transition Tip Sheet ICD-9 to ICD-9 Consists of three to five digits Consists of three to seven digits First digit numeric or alpha (E or V codes) First character always alpha (all letters used except U) 2 nd, 3 rd, 4 th and 5 th digits numeric 2 nd digits numeric 3 rd through 7 th alpha or numeric Decimal after first 3 digits Decimal after first 3 digits Placeholder Character Placeholder Character The uses a placeholder character X. The X is used as a placeholder for certain codes to allow for future expansion. Where a placeholder exists, the X must be used in order for the code to be considered a valid code. T37.0x1A - poisoning by sulfamides, accidental (unintentional), initial encounter A nonprofit independent licensee of the Blue Cross Blue Shield Association
2 7 th Characters ICD-9 codes are only 5 characters 7 th Characters Certain categories have applicable 7 th characters. The applicable 7 th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7 th character must always be the 7 th character in the data field. If a code that requires a 7 th character is not 6 characters, a placeholder X must be used to fill in the empty characters. O65.OXX1 - Obstructed labor due to deformed pelvis, fetus 1 Alphabetic Index Abbreviations This abbreviation in the index represents other specified. condition, the Index directs the coder to the other specified code in the Tabular List. Alphabetical Index Cataract Specified NEC Tabular List Other cataract Alphabetic Index Abbreviations This abbreviation in the index represents other specified. condition, the Index directs the coder to the other specified code in the Tabular List. Alphabetical Index Cataract Specified NEC H26.8 Tabular List H Other specified cataract
3 Tabular Abbreviations This abbreviation in the Tabular List represents other specified. condition the Tabular List includes an NEC entry under a code to identify the code as the other specified code. NOS Not otherwise specified This abbreviation is the equivalent of unspecified. Tabular List Heart failure, unspecified Cardiac failure NOS Heart failure NOS Myocardial failure NOS Tabular Abbreviations This abbreviation in the Tabular List represents other specified. condition the Tabular List includes an NEC entry under a code to identify the code as the other specified code. NOS Not otherwise specified This abbreviation is the equivalent of unspecified. Tabular List I Heart failure, unspecified Biventricular (heart) failure NOS Cardiac, heart or myocardial failure NOS Congestive heart disease Congestive heart failure NOS Right ventricular failure (secondary to left heart failure) Disorders of the Immune Mechanism Are included with Endocrine, Nutritional and Metabolic Diseases Disorders of the Immune Mechanics Are included with Diseases of the Blood and Blood-Forming Organs There is a single chapter for Diseases of the Nervous System and Sense Organs. The chapter for Diseases of the Nervous System and Sense Organs has been separated into three chapters.
4 Excludes An excludes note under a code indicates that the terms excluded from the code are to be coded elsewhere. In some cases, the codes for the excluded terms should not be used in conjunction with the code from which it is excluded. An example of this is a congenital condition excluded from an acquired form of the same condition. The congenital and acquired codes should not be used together. In other cases, the excluded terms may be used together with an excluded code. Category: Spina bifida Excludes: Spina bifida occulta (756.17) Excludes 1 A type 1 excludes note is a pure excludes note. It means NOT CODED HERE An excludes 1 note indicates that the code excluded should never be used at the same time as the code above the excludes 1 note. An excludes 1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. Category: Q05 - Spina bifida Excludes 1: Arnold-Chiari syndrome, type II - (Q07.0). Spina bifida occulta (Q76.0) Excludes 2 Excludes 2 A type 2 excludes note represents Not included here An excludes 2 note indicates that the condition excluded is not part of the condition represented by the code; however, a patient may have both conditions at the same time. When an excludes 2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate. Category: I70 Atherosclerosis Code: I70.2X - atherosclerosis of native arteries of the extremities Excludes 2: atherosclerosis of bypass graft of extremities (I70.30-I70.79)
5 Code Also Code Also A code also note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. Category: N39 Other disorders of urinary system Code: N39.4X Other specified urinary incontinence Code also any associated overactive bladder (N32.81) Default Codes Default Codes A code listed next to a main term in the Alphabetic Index is referred to as a default code. The default code represents that condition that is most commonly associated with the main term, or is the unspecified code for the condition. If a condition is documented in a medical record (for example, appendicitis) without any additional information, such as acute or chronic, the default code should be assigned. Hemiplegia/hemiparesis and monoplegia. When the affected side is specified, but documentation doesn t indicate if it s the dominant or non-dominant side, and a default code is not included in the classification, the following guidelines should be followed: When the left side is affected, the default is non-dominant. When the right side is affected, the default is dominant.
6 Contains E codes and V codes Does not separate E codes and V codes There are 17 Chapters There are 21 Chapters Some are classified by body or organ, while others are classified by etiology or nature of the disease process Chapter 5 Mental Disorders ( ) Chapter 5 Mental and Behavioral Disorders (F01-F99) There are more subchapters, categories and subcategories Chapter 17 Injury and Poisoning ( ) Classified by type of injury Chapter 19 Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88) ***Injuries classified by anatomical site, beginning at the head and ending at the ankle*** ***New terminology, outdated terminology in ICD-9*** E Code Chapter Supplementary Classification of External Causes of Injury and Poisoning (E800-E999) Chapter 20 External Causes of Morbidity (V01-Y99) Injury/health condition classified by: cause, intent and location Activity at time of event Status (military or civilian)
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