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ICD 10 Codes -International Classification of Disease 10th edition
-2015
-diagnosis codes
-describe individual's disease or medical condition; physicians and trained billers determine
these codes
ICD 10 Structure C.E.A.S.E
-Category: 1-3
-Etiology, Anatomic Site, Severity/other clinical detail: 4-6
-Extension: 7 (initial or subsequent encounter, laterality (LR), other clinical detail (ex: weeks
gestation)
more characters=more likely you get paid
Category 1-3
general disease code; family code
not billable when more characters exist
, specificity Be very specific
Not billable if you only include first 3 characters; claim will be rejected
5 character minimum
Diabetes E10: T1D
E11: T2D
E11 ex NOT BILLABLE as need GREATER SPECIFICITY:
E11.4 = T2 DM w/ neurological complications
BILLABLE (5 characters!)
• E11.40 = T2 DM with diabetic neuropathy, unspecified
• E11.41 = T2 DM with diabetic mono-neuropathy
• E11.42 = T2 DM with diabetic poly-neuropathy
• E11.49 = T2 DM with other diabetic neurological complication
E10.62 Type 1 diabetes mellitus with skin complications