What is a valid
ICD -10 code?
THIS APPLIES TO AMBULATORY PRACTICES ONLY:
ICD-10-CM is composed of codes with 3, 4, 5, 6 or 7 characters. Codes with three characters are included in ICD-10-CM as the heading of a category of codes that may be further subdivided by the use of fourth, fifth, sixth or seventh characters to provide greater specificity.
A three-character code is to be used only if it is not further subdivided.
While diagnosis coding to the correct level of specificity is the goal for allclaims, for 12 months after ICD -10 implementation, if a valid ICD -10 code from the right family is submitted, Medicare will process and not audit valid ICD
-10 codes
Example provided by CMS is C81 (Hodgkin’s lymphoma) – which by itself is not a valid code.
Examples of valid codes within category C81 contain 5 characters, such as:
C81.00 Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site
C81.03 Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal
lymph nodes
C81.10 Nodular sclerosis classical Hodgkin lymphoma, unspecified site
C81.90 Hodgkin lymphoma, unspecified, unspecified site
During the 12 month after ICD -10 implementation, using any one of the valid codes for Hodgkin’s lymphoma (C81.00, C81.03, C81.10 or C81.90) would not be cause for an audit under the recently announced flexibilities.
Comments
Post a Comment