INTRODUCTION TO ICD-10-CM LATEST UPDATE

INTRODUCTION TO ICD-10-CM LATEST UPDATE Main terms Represent diseases, conditions, symptoms, nouns, and adjectives in the Alphabetic Index. are set in boldface and listed in alphabetic order. Nonessential modifiers A term or a series of terms that appear in parentheses following a main term or subterm has no effect on the selection of the codes listed for that main term. Default code The code listed next to a main term in the Alphabetic Index Placeholder character Used when a code has less than six characters and a seventh character is required NOS The equivalent of "unspecified" NEC The equivalent of "other specified" Square brackets Used in the Tabular List to enclose synonyms, abbreviations, alternative wordings, or explanatory phrases. The terms within the brackets are presented for informational purposes. Parentheses Used to enclose supplementary words or explanatory information that may or may not be present in the statement of a diagnosis Colon Used in the Tabular List after an incomplete term that needs one or more additional terms in order to be assigned to a particular code Excludes1 Indicates that the conditions listed after it cannot ever be used at the same time as the code above the code. A patient can't have both conditions at the same time. Exception when two conditions are unrelated. Excludes2 Indicates that two codes are applied when both conditions are present And Means "and" or "or" when it appears in a code title Structure of ICD-10-CM Codes Three (3) to seven (7) characters in length, The first character is alpha (all letters except U are used), The second character is numeric, Characters 3-7 are alpha or numeric, Code uses a decimal after the first three characters, Code uses dummy placeholder "x", Alpha characters are not case sensitive, Some examples of codes include: P09 S32.010A O9A.211 M1A.0111 subterm Indented beneath the main term, etiology code should always be reported first). The ICD-10-CM Tabular List divided into 21 chapters. subdivided subchapters (blocks) that contain three character categories and form the foundation of the code. categories urther subdivided into four- or five-character subcategories ICD-10-CM codes must be used to the highest number of characters available or to the highest level of specificity. When the code contains fewer than seven characters, the placeholder "X" must be used to fill in the empty character(s). What are the four reporting options for POA? A code used to identify the place where an injury occurred. This code describes the physical location or place where the event occurred, not the patient's activity at the time of the event. A data element required on the CMS 1450 claim form or the Uniform Bill-04 to be linked with all ICD-10-CM diagnosis codes according to present on- admission reporting guidelines. The purpose of the POA indicator is to differentiate between conditions that were present in the patient at the time of admission and the conditions that develop during the inpatient stay How would you code a congenital malformation that has been corrected?