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Coding Update 2006

Coding Update 2006. Primary Care Conference March 29, 2006. ICD-9-CM. International Classification of Diseases - 9 th Edition - Clinical Modification ICD-10 already in use internationally 2009 for USA ??. ICD-9-CM Coding Guidelines. National Center for Health Statistics website

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Coding Update 2006

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  1. Coding Update 2006 Primary Care Conference March 29, 2006

  2. ICD-9-CM • International Classification of Diseases - 9th Edition - Clinical Modification • ICD-10 already in use internationally • 2009 for USA ??

  3. ICD-9-CM Coding Guidelines National Center for Health Statistics website http://www.cdc.gov/nchs/icd9.htm Coding Clinic – issued quarterly by American Hospital Association

  4. Diagnosis Code Tips Do not code diagnoses documented as rule out (R/O), probable, suspected, or consistent with…

  5. Abnormal findings Findings, abnormal, w/o diagnosis • Positive PPD • Prolonged bleeding time • Electrocardiogram • Liver function tests

  6. Signs & Symptoms • Fever • Dysuria • Wheezing • Fatigue • Knee pain

  7. ICD arranged by Condition • Bronchitis • Pain • Sprain • Bursitis • Cellulitis

  8. Site or Type • Pain, • ankle • knee • Arthritis • inflammatory • fingers • multiple sites

  9. Malignancy coding • Locate code by histological type; (eg melanoma, astrocytoma) • Code as malignancy as long as it is still being treated • Code as a history of malignancy once active treatment has ended

  10. Neoplasms Neoplasm Table • Primary • Secondary • Ca in situ • Benign • Uncertain Behavior • Unspecified

  11. Unknown primary malignancy Assign code 199.1 for unknown primary, if still actively treated

  12. Diabetes – compound coding If using a fourth digit to describe complication – code also the complication as a secondary code

  13. Diabetes Mellitus – 4th digits 250.0x = w/o mention of complication 250.1x = w/ketoacidosis 250.2x = w/hyperosmolarity 250.3x = w/other coma 250.4x = w/renal manifestations

  14. Diabetes Mellitus – 4th digit 250.5x = w/ophthalmic manifestations 250.6x = w/neurologic manifestations 250.7x = w/peripheral circulatory disorders 250.8x = w/other specified manifestations 250.9x = w/unspecified complications

  15. Diabetes – 5th digit • 0 type II or unspecified, not uncontrolled • 1 type I, not uncontrolled • 2 type II or unspecified, uncontrolled • 3 type I, uncontrolled

  16. Nursing Facility Codes • Skilled Nursing (SNF) • Intermediate Care (ICF) • Long Term Care (LTCF) • Psychiatric Residential Treatment Center

  17. Nursing Facility Services • Three levels of service for admissions • Four levels for subsequent care • Comprehensive annual assessment

  18. Domiciliary, Rest Home or Custodial Care services • Section revised to better capture care provided in these settings • Increasing number of patients with complex diseases (eg, Alzheimer patients)

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