Discussion wk 3 response 1

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CHAPTER 6

CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)

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Diseases of Digestive System, Chapter 11

K00-K95

Unspecified GI hemorrhage, K92.2

Combination codes with hemorrhage

Example: K57.21, Diverticulitis of large intestine with perforation and abscess with bleeding

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The categories are sequenced in a manner that follows the path of the digestive system from the mouth to the anus, beginning with disorders of the teeth.

For a hemorrhage to be reported active bleeding is not necessary; however, documentation must support the fact that active bleeding has occurred.

Diseases of the Skin and Subcutaneous Tissue, Chapter 12

L00-L99

Also codes to report conditions of the:

Nails

Sweat glands

Hair

Hair follicles

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Chapter 12 describes diseases or conditions of the Integumentary System.

Does the integumentary system only include the skin? (No)

What else is included in the integumentary system? (glands, nails, hair and hair follicles)

What are the two glands that are covered in the integumentary system? (sweat and sebaceous)

Infections

Using additional code before L00 directs coder to report the infection with B95-B97

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If there isn’t a combination code to describe the diagnosis (cellulitis) and cause (staph infection), then both of these diagnoses would be coded out to fully describe the condition.

Pressure Ulcers

Stage 1: erythema (redness) of skin

Stage 2: partial loss of skin (epidermis or dermis)

Stage 3: full thickness loss of skin (up to but not through fascia)

Stage 4: full thickness loss (extensive destruction and necrosis)

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Pressure ulcers develop when the circulation is decreased to that area of the body.

Pressure ulcers are graded and reported based on:

Depth of the ulcer

Categorized in stages

Diseases of the Musculoskeletal System and Connective Tissue, Chapter 13

M00-M99

Most codes specify:

Site: Location on the body

Laterality: Right, left, unilateral, bilateral

Some codes include “multiple sites” such as:

M15.-, Polyosteoarthritis including multiple sites

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Chapter 13 describes diseases or conditions of the bone, joints, and muscles.

A medical dictionary will always be a handy tool to use when there are medical terms that you may not know. For example, dorsopathies.

Infectious Arthropathies

M00-M02

Direct infections

Invades synovial tissue

Invades the joint

Invasive organism has been identified

Indirect infections

Reactive: Microbial infection identified but not in joint

Postinfective: Microbial antigen present, but not constant and no evidence of multiplication

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Pathological Fractures

Also known as (AKA): Spontaneous fracture

Fracture reported in addition to underlying condition responsible for fracture

Never assign a code for a traumatic fracture and pathological fracture of same bone

7th character indicates treatment plans, such as A for initial

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The 7th character A (initial encounter) is assigned as long as the patient is receiving active treatment for the fracture.

Other 7th characters:

D (subsequent) is assigned when all active treatment is completed

G, K, and P are assigned subsequent, nonroutine encounters

S is assigned for a sequela

Osteoporosis

M80 and M81

Systemic condition that affects bones

Fracture sustained with trauma that would not usually cause a fracture

Site is not a component of codes

Category M80, Osteoporosis with current pathological fracture

Age and other osteoporosis codes

Category M81, Osteoporosis without current pathological fracture

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Osteoporosis is a systemic condition

Meaning all bones of the musculoskeletal system are affected.

Male genitalia (N40-N53)

Female genitalia (N70-N98)

Breast (N60-N65)

Urinary System (N00-N39)

Kidney stones are most common disorder reported from this chapter

N20, Calculus of kidney and ureter

Diseases of the Genitourinary System, Chapter 14

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Osteoporosis is a systemic condition

Meaning all bones of the musculoskeletal system are affected.

Conclusion CHAPTER 6

CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)

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