ICD-9-CM to ICD-10-CM Resource Guide

Transcription

1 Prescription Drug Monitoring and Toxicology ICD-9-CM to ICD-10-CM Resource Guide Provided as a service of Quest Diagnostics ICD-9-CM to ICD-10-CM Resource Guide 1

2 Disclaimer This list is intended to assist ordering physicians in providing ICD-9 and ICD-10 Diagnosis Codes as required by Medicare and other Insurers. It includes the diagnosis narratives and the codes that are most commonly submitted for toxicology and pain management tests orders, but is not a complete list. The list was compiled from the ICD-9-CM 2012 book and the ICD-10-CM 2015 book. The responsibility for correct coding belongs to the ordering physician. ICD-9-CM and ICD-10-CM books should be used as a complete reference. ICD-9-CM to ICD-10-CM Resource Guide 2

3 Table of Contents Information on the ICD-10 Transition 4 Pain Management: Top Mappings 5 Addiction Medicine: Top Mappings 11 ICD-9-CM to ICD-10-CM Resource Guide 3

4 The ICD-10 Transition: An Introduction Beginning October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. To accommodate the ICD-10 code structure, the transaction standards used for electronic healthcare claims, Version 4010/4010A, must be upgraded to Version About ICD-10 ICD-10-CM/PCS (International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System) consists of two parts: 1. ICD-10-CM for diagnosis coding 2. ICD-10-PCS for inpatient procedure coding ICD-10-CM is for use in all U.S. healthcare settings. Diagnosis coding under ICD-10-CM uses 3 to 7 digits instead of the 3 to 5 digits used with ICD-9-CM, but the format of the code sets is similar. ICD-10-PCS is for use in U.S. inpatient hospital settings only. ICD-10-PCS uses 7 alphanumeric digits instead of the 3 or 4 numeric digits used under ICD-9-CM procedure coding. Coding under ICD-10-PCS is much more specific and substantially different from ICD-9-CM procedure coding. The transition to ICD-10 occurred because ICD-9 produces limited data about patients medical conditions and hospital inpatient procedures. ICD-9 is over 30 years old, has outdated terms, and is inconsistent with current medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full. IMPORTANT NOTE Your facility must have to provide the new ICD-10 codes to Quest Diagnostics with each specimen beginning in October Due to the high specificity of ICD-10, Quest Diagnostics will be unable to translate many former ICD-9 codes to ICD-10 codes. ICD-9-CM to ICD-10-CM Resource Guide 4

5 Pain Management Top Mappings Anxiety State Opioid Type Dependence Abuse F41.9 Anxiety F11.20 Opioid Dependence F Opioid Dependence w/ Intoxication F Opioid Dependence w/ Intoxication Delirium F Opioid Dependence w/ Intoxication w/ Perceptual Disturbance F Opioid Dependence w/ Intoxication F11.23 Opioid Dependence w/ Withdrawal F11.24 Opioid Dependence w/ Opioid-Induced Mood F Opioid Dependence w/ Induced Psychotic w/ Delusions F Opioid Dependence w/ Induced Psychotic w/ Hallucinations F Opioid Dependence w/ Opioid-Induced Psychotic F Opioid Dependence w/ Opioid-Induced Sexual Dysfunction F Opioid Dependence w/ Opioid-Induced Sleep F Opioid Dependence w/ Other Opioid-Induced F11.29 Opioid Dependence w/ Opioid-Induced Opioid Type Dependence Continuous Abuse Drug Dependence Abuse Drug Dependence Continuous Abuse F11.20 Opioid Dependence F19.20 Other Psychoactive Substance Dependence F19.20 Other Psychoactive Substance Dependence Other Chronic Pain G89.28 Other Chronic Post Procedural Pain Chronic Pain Syndrome G89.4 Chronic Pain Syndrome ICD-9-CM to ICD-10-CM Resource Guide 5

6 Pain Management Top Mappings Pain In Joint Shoulder Region M Pain In Right Shoulder M Pain In Left Shoulder M Pain In Shoulder Pain In Joint Lower Leg M Pain In Right Knee M Pain In Left Knee M Pain In Knee Cervical Spondylosis w/o Myelopathy M47.21 Other Spondylosis Radiculopathy OA-AX M47.22 Other Spondylosis w/ Radiculopathy Cervical Region M47.23 Other Spondylosis w/ Radiculopathy Cervicothoracic M Spondylosis w/o Myelopathy/ Radiculopathy OA-AX Region M Spondylosis w/o Myelopathy/ Radiculopathy Cervical Region M Spondylosis w/o Myelopathy/ Radiculopathy Cervicothoracic Region M Other Spondylosis OA-AX Region M Other Spondylosis Cervical Region M Other Spondylosis Cervicothoracic Region Lumbosacral Spondylosis w/o Myelopathy M47.26 Other Spondylosis w/ Radiculopathy Lumbar Region M47.27 Other Spondylosis w/ Radiculopathy Lumbosacral Region M47.28 Other Spondylosis Radiculopathy Sacral & Sacrococcygeal M Spondylosis w/o Myelopathy/ Radiculopathy Lumbar Region M Spondylosis w/o Myelopathy/ Radiculopathy Lumbosacral Region M Spondylosis w/o Myelopathy/ Radiculopathy Sacral & Sacrococcygeal Region M Other Spondylosis Lumbar Region M Other Spondylosis Lumbosacral Region M Other Spondylosis Sacral & Sacrococcygeal Region ICD-9-CM to ICD-10-CM Resource Guide 6

7 Pain Management Top Mappings Displacement Lumbar Intervertebral Disc w/o Myelopathy M51.26 Other Intervertebral Disc Displacement Lumbar Region M51.27 Other Intervertebral Disc Displacement Lumbosacral Region Degeneration Of Cervical Intervertebral Disc M50.30 Other Cervical Disc Degeneration Cervical Region M50.31 Other Cervical Disc Degeneration OA-AX Region M50.32 Other Cervical Disc Degeneration Mid-Cervical Region M50.33 Other Cervical Disc Degeneration Cervicothoracic Region Degeneration Lumbar/Lumbosacral Intervertebral Disc M51.36 Other Intervertebral Disc Degeneration Lumbar Region M51.37 Other Intervertebral Disc Degeneration Lumbosacral Region Postlaminectomy Syndrome Lumbar Region M96.1 Postlaminectomy Syndrome NEC Cervicalgia M54.2 Cervicalgia Brachial Neuritis Or Radiculitis NOS M50.10 Cervical Disc w/ Radiculopathy Cervical Region M50.11 Cervical Disc w/ Radiculopathy OA-AX Region M50.12 Cervical Disc w/ Radiculopathy Mid-Cervical Region M50.13 Cervical Disc Radiculopathy Cervicothoracic Region M54.11 Radiculopathy OA-AX Region M54.12 Radiculopathy Cervical Region M54.13 Radiculopathy Cervicothoracic Region Lumbago M54.5 Low Back Pain Thoracic/Lumbosacral Neuritis/Radiculitis M51.14 Intervertebral Disc w/ Radiculopathy Thoracic M51.15 IV Disc w/ Radiculopathy Thoracolumbar Region M51.16 Intervertebral Disc w/ Radiculopathy Lumbar Region ICD-9-CM to ICD-10-CM Resource Guide 7

8 Pain Management Top Mappings Thoracic/Lumbosacral Neuritis/Radiculitis (Continued) M51.17 IV Disc w/ Radiculopathy Lumbosacral Region M54.14 Radiculopathy Thoracic Region M54.15 Radiculopathy Thoracolumbar Region M54.16 Radiculopathy Lumbar Region M54.17 Radiculopathy Lumbosacral Region Backache M54.89 Other Dorsalgia M54.9 Dorsalgia Myalgia And Myositis M60.80 Other Myositis Site M Other Myositis Right Shoulder M Other Myositis Left Shoulder M Other Myositis Shoulder M Other Myositis Right Upper Arm M Other Myositis Left Upper Arm M Other Myositis Upper Arm M Other Myositis Right Forearm M Other Myositis Left Forearm M Other Myositis Forearm M Other Myositis Right Hand M Other Myositis Left Hand M Other Myositis Hand M Other Myositis Right Thigh M Other Myositis Left Thigh M Other Myositis Thigh M Other Myositis Right Lower Leg M Other Myositis Left Lower Leg M Other Myositis Lower Leg M Other Myositis Right Ankle And Foot M Other Myositis Left Ankle And Foot M Other Myositis Ankle And Foot M60.88 Other Myositis Other Site M60.89 Other Myositis Multiple Sites M60.9 Other Myositis ICD-9-CM to ICD-10-CM Resource Guide 8

9 Pain Management Top Mappings Myalgia And Myositis (Continued) M79.1 Myalgia M79.7 Fibromyalgia Pain In Soft Tissues Of Limb M Pain In Right Arm M Pain In Left Arm M Pain In Arm M Pain In Right Leg M Pain In Left Leg M Pain In Leg M Pain In Limb M Pain In Right Upper Arm M Pain In Left Upper Arm M Pain In Upper Arm M Pain In Right Forearm M Pain In Left Forearm M Pain In Forearm M Pain In Right Hand M Pain In Left Hand M Pain In Hand M Pain In Right Finger(s) M Pain In Left Finger(s) M Pain in Finger(s) M Pain In Right Thigh M Pain In Left Thigh M Pain In Thigh M Pain In Right Lower Leg M Pain in Left Lower Leg M Pain In Lower Leg M Pain In Right Foot M Pain In Left Foot M Pain In Foot M Pain In Right Toe(s) M Pain In Left Toe(s) M Pain In Toe(s) ICD-9-CM to ICD-10-CM Resource Guide 9

10 Pain Management Top Mappings Headache G44.1 Vascular headache, not elsewhere classified Lumbar Sprain And Strain R51 S33.5xxA Headache Sprain Ligaments Lumbar Spine Initial Encounter V58.69 Encounter For Long-Term Use Of Other Medications Z79.3 Long-Term Current Use Of Hormonal Contraceptives Z Long-Term Current Use Of Opiate Analgesic Z Other Long-Term Current Drug Therapy V58.83 Encounter For Therapeutic Drug Monitoring Drug-Induced Mental Z51.81 Encounter For Therapeutic Drug Level Monitoring F10.19 Alcohol Abuse w/ Alcohol-Induced ICD-9-CM to ICD-10-CM Resource Guide 10

11 Addiction Medicine Top Mappings F10.29 Alcohol Dependence w/ Alcohol-Induced F11.19 Opioid Abuse w/ Opioid-Induced F11.29 Opioid Dependence w/ Opioid-Induced F11.90 Opioid Use F11.99 Opioid Use w/ Opioid-Induced F12.19 Cannabis Abuse w/ Cannabis-Induced F12.29 Cannabis Dependence w/ Cannabis-Induced F12.99 Cannabis Use w/ Cannabis-Induced F13.19 Sedative Hypnotic/Anxiolytic Abuse w/ Induced F13.29 Sedative Hypnotic/Anxiolytic Dependence w/ Induced F13.90 Sedative Hypnotic/Anxiolytic Use F13.99 Sedative Hypnotic/Anxiolytic Use w/ Induced F14.19 Cocaine Abuse w/ Cocaine-Induced F14.29 Cocaine Dependence w/ Cocaine-Induced F14.90 Cocaine Use F14.99 Cocaine Use w/ Cocaine-Induced F15.19 Other Stimulant Abuse w/ Induced Drug-Induced Mental (Continued) F15.29 Other Stimulant Dependence w/ Induced ICD-9-CM to ICD-10-CM Resource Guide 11

12 Addiction Medicine Top Mappings F15.90 Other Stimulant Use F15.99 Other Stimulant Use w/ Induced F16.19 Hallucinogen Abuse w/ Induced F16.29 Hallucinogen Dependence w/ Induced F16.90 Hallucinogen Use F16.99 Hallucinogen Use w/ Induced F Nicotine Dependence w/ Nicotine-Induced F Nicotine Dependence Cigarettes w/ Nicotine-Induced F Nicotine Dependence Chew Tobacco w/ Nicotene-Induced F Nicotine Dependence Other Tobacco Product w/ Induced F18.19 Inhalant Abuse w/ Inhalant-Induced F18.29 Inhalant Dependence w/ Inhalant-Induced F18.99 Inhalant Use w/ Inhalant-Induced F19.19 Other Psychoactive Substance Abuse w/ Induced F19.29 Other Psychoactive Substance Dependence w/ Induced F19.90 Other Psychoactive Substance Use F19.99 Other Psychoactive Substance Use w/ Induced Paranoid Schizophrenia Condition Schizoaffective F20.0 Paranoid Schizophrenia F25.0 Schizoaffective Bipolar Type ICD-9-CM to ICD-10-CM Resource Guide 12

13 Addiction Medicine Top Mappings F25.1 Schizoaffective Depressive Type F25.8 Other Schizoaffective s F25.9 Schizoaffective Major Depressive Affective Recurrent Episode Moderate Degree Major Depressive Recurrent Episode Severe w/o Psychotic Behavior Bipolar F33.1 Major Depressive Recurrent Moderate F33.2 Major Depressive Recurrent Severe w/o Pyschotic F31.9 Bipolar Episodic Mood F39 Mood Affective Generalized Anxiety Acute Alcoholic Intoxication In Alcoholism Drinking Behavior F41.1 Generalized Anxiety F Alcohol Dependence w/ Intoxication F Alcohol Dependence w/ Intoxication Other & Alcohol Dependence Drunkenness Other & Alcohol Dependence Continuous Drunkenness Other & Alcohol Dependence Remission Opioid Type Dependence Abuse F10.20 Alcohol Dependence F10.20 Alcohol Dependence F10.21 Alcohol Dependence In Remission F11.20 Opioid Dependence F Opioid Dependence w/ Intoxication Delirium F Opioid Dependence w/ Intoxication w/ Perceptual Disturbance Opioid Type Dependence Abuse (Continued) F Opioid Dependence w/ Intoxication F11.23 Opioid Dependence w/ Withdrawal ICD-9-CM to ICD-10-CM Resource Guide 13

14 Addiction Medicine Top Mappings F11.24 Opioid Dependence w/ Opioid-Induced Mood F Opioid Dependence w/ Induced Psychotic w/delusions F Opioid Dependence w/ Induced Psychotic w/ Hallucinations F Opioid Dependence w/ Opioid-Induced Psychotic F Opioid Dependence w/ Opioid-Induced Sexual Dysfunction F Opioid Dependence w/ Opioid-Induced Sleep F Opioid Dependence w/ Other Opioid-Induced F11.29 Opioid Dependence w/ Opioid-Induced Opioid Type Dependence Continuous Abuse Opioid Type Dependence Episodic Abuse Opioid Type Dependence In Remission Sedative Hypnotic/ Anxiolytic Dependence F11.20 Opioid Dependence F11.20 Opioid Dependence F11.21 Opioid Dependence In Remission F13.20 Sedative Hypnotic/Anxiolytic Dependence F Sedative Hypnotic/Anxiolytic Dependence w/ Intoxication F Sedative Hypnotic/Anxiolytic Dependence w/ Intoxication Delirium F Sedative Hypnotic/Anxiolytic Dependence w/ Intoxication F Sedative Hypnotic/Anxiolytic Dependence w/ Withdrawal F Sedative Hypnotic/Anxiolytic Dependence w/ Withdrawal Delirium F Sedative Hypnotic/Anxiolytic Dependence w/ Withdrawal w/ Perceptual Disturbance Sedative Hypnotic/ Anxiolytic Dependence (Continued) F Sedative Hypnotic/Anxiolytic Dependence w/ Withdrawal ICD-9-CM to ICD-10-CM Resource Guide 14

15 Addiction Medicine Top Mappings F13.24 Sedative Hypnotic/Anxiolytic Dependence w/ Induced Mood F Sedative Hypnotic/Anxiolytic Dependence Induced Psychotic Delusions F Sedative Hypnotic/Anxiolytic Dependence Induced Psychotic Hallucinations F Sedative Hypnotic/Anxiolytic Dependence Induced Psychotic F13.26 Sedative Hypnotic/Anxiolytic Dependence Induced Persisting Amnestic F13.27 Sedative Hypnotic/Anxiolytic Dependence Induced Persisting Dementia F Sedative Hypnotic/Anxiolytic Dependence Induced Anxiety F Sedative Hypnotic/Anxiolytic Dependence w/ Induced Sexual Dysfunction F Sedative Hypnotic/Anxiolytic Dependence w/ Induced Sleep F Sedative Hypnotic/Anxiolytic Dependence w/ Other Induced F13.29 Sedative Hypnotic/Anxiolytic Dependence w/ Induced Cocaine Dependence Abuse F14.20 Cocaine Dependence F Cocaine Dependence w/ Intoxication F Cocaine Dependence w/ Intoxication Delirium F Cocaine Dependence w/ Intoxication w/ Perceptual Disturbance F Cocaine Dependence w/ Intoxication F14.23 Cocaine Dependence w/ Withdrawal Cocaine Dependence Abuse (Continued) F14.24 Cocaine Dependence w/ Cocaine-Induced Mood ICD-9-CM to ICD-10-CM Resource Guide 15

16 Addiction Medicine Top Mappings F Cocaine Dependence w/ Induced Psychotic w/ Delusions F Cocaine Dependence w/ Induced Psychotic w/ Hallucinations F Cocaine Dependence w/ Cocaine-Induced Psychotic F Cocaine Dependence w/ Cocaine-Induced Anxiety F Cocaine Dependence w/ Cocaine-Induced Sexual Dysfunction F Cocaine Dependence w/ Cocaine-Induced Sleep F Cocaine Dependence w/ Other Cocaine-Induced F14.29 Cocaine Dependence w/ Cocaine-Induced Cannabis Dependence Abuse F12.20 Cannabis Dependence F Cannabis Dependence w/ Intoxication F Cannabis Dependence w/ Intoxication Delirium F Cannabis Dependence w/ Intoxication w/ Perceptual Distance F Cannabis Dependence w/ Intoxication F Cannabis Dependence w/ Psychotic w/ Delusions F Cannabis Dependence w/ Psychotic w/ Hallucinations F Cannabis Dependence W/ Psychotic F Cannabis Dependence w/ Cannabis-Induced Anxiety F Cannabis Dependence w/ Other Cannabis-Induced F12.29 Cannabis Dependence w/ Cannabis-Induced Cannabis Dependence Continuous Abuse F12.20 Cannabis Dependence ICD-9-CM to ICD-10-CM Resource Guide 16

17 Addiction Medicine Top Mappings Amphetamine & Other Psychostimulant Dependence Abuse F15.20 Other Stimulant Dependence F Other Stimulant Dependence w/ Intoxication F Other Stimulant Dependence w/ Intoxication Delirium F Other Stimulant Dependence Intoxication w/ Perceptual Disturbance F Other Stimulant Dependence w/ Intoxication F15.23 Other Stimulant Dependence w/ Withdrawal F15.24 Other Stimulant Dependence w/ Induced Mood F Other Stimulant Dependence w/ Induced Psychotic w/ Delusions F Other Stimulant Dependence Induced Psychotic w/ Hallucinations F Other Stimulant Dependence w/ Induced Psychotic F Other Stimulant Dependence w/ Induced Anxiety F Other Stimulant Dependence w/ Induced Sexual Dysfunction F Other Stimulant Dependence w/ Induced Sleep F Other Stimulant Dependence w/ Other Induced F15.29 Other Stimulant Dependence w/ Induced Hallucinogen Dependence Abuse F16.20 Hallucinogen Dependence F Hallucinogen Dependence w/ Intoxication F Hallucinogen Dependence w/ Intoxication w/ Delirium F Hallucinogen Dependence w/ Intoxication ICD-9-CM to ICD-10-CM Resource Guide 17

18 Addiction Medicine Top Mappings Hallucinogen Dependence Abuse (Continued) F16.24 Hallucinogen Dependence w/ Hallucinogen-Induced Mood F Hallucinogen Dependence w/ Psychotic w/ Delusions F Hallucinogen Dependence w/ Psychotic w/ Hallucinations F Hallucinogen Dependence w/ Psychotic F Hallucinogen Dependence w/ Anxiety F Hallucinogen Dependence w/ Hallucinogen Persisting Perception F Hallucinogen Dependence w/ Other Hallucinogen-Induced F16.29 Hallucinogen Dependence w/ Hallucinogen-Induced Other Specified Drug Dependence In Remission F18.21 Inhalant Dependence In Remission F19.21 Other Psychoactive Substance Dependence In Remission Combinations Of Opioid Type Drug w/ Any Other Drug Dependence Use Combinations Of Drug Dependence Excluding Opioid Drug Abuse Drug Dependence Abuse Nondependent Alcohol Abuse Drunkenness F19.20 Other Psychoactive Substance Dependence F19.20 Other Psychoactive Substance Dependence F19.20 Other Psychoactive Substance Dependence F10.10 Alcohol Abuse F Alcohol Abuse w/ Intoxication Nondependent Tobacco Use F Nicotine Dependence F Nicotine Dependence In Remission ICD-9-CM to ICD-10-CM Resource Guide 18

19 Addiction Medicine Top Mappings Nondependent Tobacco Use (Continued) F Nicotine Dependence Cigarettes F Nicotine Dependence Cigarettes In Remission F Nicotine Dependence Chewing Tobacco F Nicotine Dependence Chewing Tobacco In Remission F Nicotine Dependence Other Tobacco Product F Nicotine Dependence Other Tobacco Product In Remission Nondependent Cannabis Abuse Nondependent Sedative Hypnotic/Anxiolytic Abuse Patient Use F12.10 Cannabis Abuse F13.10 Sedative Hypnotic Or Anxiolytic Abuse F Sedative/Hypnotic/Anxiolytic Abuse w/ Intoxication F13.90 Sedative Hypnotic Or Anxiolytic Abuse Nondependent Opioid Abuse F11.10 Opioid Abuse F Opioid Abuse w/ Intoxication F Opioid Abuse w/ Intoxication Nondependent Cocaine Abuse F14.10 Cocaine Abuse F Cocaine Abuse w/ Intoxication Nondependent Amphetamine/ Related Acting Sympathomimetic Abuse Patient Use F15.10 Other Stimulant Abuse F Other Stimulant Abuse w/ Intoxication F15.90 Other Stimulant Use ICD-9-CM to ICD-10-CM Resource Guide 19

20 Addiction Medicine Top Mappings Other Mixed/ Nondependent Drug Abuse F18.10 Inhalant Abuse F55.0 Abuse Of Antacids F55.1 Abuse Of Herbal Or Folk Remedies F55.2 Abuse Of Laxatives F55.3 Abuse Of Steroids Or Hormones F55.4 Abuse Of Vitamins F55.8 Abuse Of Other Non-Psychoactive Substances Post-Traumatic Stress F43.10 Post-Traumatic Stress F43.11 Post-Traumatic Stress Acute F43.12 Post-Traumatic Stress Chronic 311 Depressive NEC Attention Deficit Of Childhood w/o Hyperactivity F32.9 Major Depressive Single Episode F90.0 Attention-Deficit Hyperactivity Predominantly Inattentive Type F90.9 Attention-Deficit Hyperactivity Type Attention Deficit Of Childhood w/ Hyperactivity F90.0 Attention-Deficit Hyperactivity Predominantly Inattentive Type F90.1 Attention-Deficit Hyperactivity Predominantly Hyperactive Type F90.2 Attention-Deficit Hyperactivity Combined Type F90.8 Attention-Deficit Hyperactivity Other Type V71.09 Observation Of Other Suspected Mental Condition V71.9 Observation For Suspected Condition Z03.89 Encounter For Observation Other Suspected Diseases & Conditions Ruled Out Z04.9 Encounter For Examination And Observation For Reason ICD-9-CM to ICD-10-CM Resource Guide 20

21 QuestDiagnostics.com 3 Giralda Farms Madison, NJ USA Quest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics. All third party marks - and - are the property of their respective owners Quest Diagnostics Incorporated. All rights reserved. MI /2015