ICD-10 If the provider merely indicates accelerated, benign, or malignant hypertension, that translates to an unspecified code, I10. For patients returning for regular treatment, the medical record must reflect the status of the disease and the impact on other organ systems to ensure proper reimbursement. Heart failure must be documented as “acute,” “chronic,” or “acute on chronic” and must specify whether it is systolic or diastolic congestive heart failure. Codes demonstrating this concept THe JOuRNaL OF THe HeaLTHCaRe BILLINg aND maNagemeNT assOCIaTION 39 appear below: • I50.30 Diastolic congestive heart failure • I50.31 acute diastolic congestive heart failure • I50.32 Chronic diastolic congestive heart failure • I50.33 Chronic on acute congestive heart failure • 150.40 Combined with systolic congestive heart failure • 150.41 acute congestive heart failure • 150.43 acute on chronic congestive heart failure It is also important for physicians and coders to understand that the documentation related to terms such as “decompensation” and “exacerbation” indicate an acute condition. If a combination code exists for the condition the patient is experiencing, it is important to use that code rather than separately reporting two or more codes. If a patient has a “methicillin Resistant staphylococcus aureus, mRsa, infection due to sepsis,” use a41.02 to indicate both sepsis and mRsa. similarly, if the patient has “Pneumonia due to mRsa,” use J15.212 rather than reporting mRsa and either sepsis or pneumonia separately. always review the notes and instructions that appear with each category of codes to ensure you have the correct number of digits, whether there are any codes included or excluded, or whether additional codes need to be reported. Coding for asthma demonstrates these suggestions clearly. If you review the information for the base code for the category of asthma, J45, you are provided with a list of inclusions such as allergic asthma and idiosyncratic asthma. The coder is also instructed to report an additional code for “exposure to environmental tobacco smoke,” Z77.22. exclusions are listed as well, such as “asthma with chronic obstructive pulmonary disease,” J44.9, to guide the coder in the final ICD-10 code selection. Lastly, next to each code, a red box lists the number of required digits. The tabular section of the code book is a great resource that enables accuracy in coding. enroll in a coding course to prepare for updating coding credentials for ICD-10. subsequently, medical office staff need to begin reviewing provider documentation to determine whether it will support identification of an ICD-10 code. Become an active member of a coding organization, ask questions, and collaborate with colleagues. Take one or two encounters per week and review the code book to select the ICD-10 codes. Following this advice will ensure that when October 1, 2014 arrives, the concepts will be clear and the transition will be a smooth one. Coding and compliance have been a primary focus of the various positions that Valerie has held over the course of her career. She is an AHIMA certified trainer for ICD-10 CM and ICD-10 PCS and participates in their Ambassador program for ICD-10. Currently, Valerie is the ICD-10 quality assurance manager at the Hospital for Special Surgery in New York. ICD-10 will become effective on October 1, 2014. Have you utilized the HBMA resources to begin training staff and clients? TIME IS RUNNING OUT. A Few Ways to Obtain CHBME Credits Attend HBMA conferences Take the quiz in Billing Purchase videos by module from the Executive Summit (located at the website)
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