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January 23, 2014

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ICD-10 is coming in 250 Days!

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Glasgow Coma scale

Glasgow Coma scale ICD-10 codes will provide information on measurement scales that could not be reported with ICD-9-CM. The Glasgow Coma Scale includes three tests used to report criteria such as open eyes, verbal responses and motor responses. When individual scores for these three items are documented, ICD-10-CM codes would be assigned and reported.

Combination codes

You might have heard that ICD-10 combines codes, but what does that mean ? A distinguishing feature of ICD-10 is that it includes “combination codes.” These allow a physician to describe multiple diagnoses by using only 1 code or to describe a diagnosis with its complication. This reduces the number of codes needed while still providing detailed information. For example, in ICD-9 the codes for type 2 Diabetes with Retinopathy are: 250.5, diabetes with ophthalmic manifestations, and 362.01-362.07, retinopathy. In comparison, the ICD-10 codes describing type 2 Diabetes with Retinopathy are several. For example: E11.32: Type 2 diabetes with mild nonproliferative diabetic retinopathy. Much more straightforward.

SIRS is gone

Quandary or Conundrum In ICD-10, there will no longer be a code for SIRS occurring due to an infectious process. The only references to SIRS in the ICD-10-CM Official Guidelines for Coding and Reporting are those specifically related to SIRS due to a non-infectious process . There are instructional notes in ICD-10-CM that instruct to code the underlying condition first , which means that the underlying condition should be sequenced before the SIRS code. In the ICD-10-CM world, in order to accurately reflect the severity of illness and risk of mortality for patients who present with a localized infection, SIRS, and a clinical picture of sepsis, the provider must document sepsis as a diagnosis. As a reminder, Bacteremia is the presence of bacteria in the blood as evidenced by a positive blood culture. (not always associated with Sepsis!). Basically, it's only a lab finding. Septicemia can be found classified under the code for sepsis ( ...

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Sam Antonios MD, FACP, FHM - Opinions here do not necessarily reflect the opinions of Via Christi

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