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Chapter 2

Chapter 2. Overview – ICD-9-CM Part 2. A Word of Caution About the Alphabetic Index (Section I, Vol. 2). Some words in Index do not appear in Tabular—saves space Exact word may not be in code Tabular description But found in Alphabetic Index

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Chapter 2

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  1. Chapter 2 Overview – ICD-9-CM Part 2

  2. A Word of Caution About the Alphabetic Index (Section I, Vol. 2) Some words in Index do not appear in Tabular—saves space Exact word may not be in code Tabular description But found in Alphabetic Index That is why you must locate term in Index and then locate Tabular (follow where Index directs)

  3. Section 2, Table of Drugs and Chemicals Drug name placedalphabetically on left under heading “Substance” (Cont’d…) Modified from Buck CJ: 2010 ICD-9-CM, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2010, Saunders.

  4. Table of Drugs and Chemicals First column: “Poisoning” code for substance involved, wrong substance given or taken First-listed before manifestation condition (Cont’d…) Modified from Buck CJ: 2010 ICD-9-CM, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2010, Saunders.

  5. Table of Drugs and Chemicals (…Cont’d) E codes identify how poisoning occurred Example: If analgesics poisoning occurred by accident, E850.9 Correct order poisoning 3 codes required: Identify agent analgesic 965.9 Condition—coma 780.01 Accidental poison E850.9 Correct order adverse effect 2 codes required Condition—coma 780.01 Therapeutic E935.9

  6. Table of Drugs and Chemicals: Headings Accident: Unintentional Therapeutic: Correct dosage, correctly administered, with adverse effects (example, allergic reaction) Suicide attempt: (must be documented) Assault: Intentionally inflicted by another person Undetermined: Unknown intent

  7. E Codes (E800-E999) Supplementary Classification of External Causes of Injury and Poisoning Alpha-numerical designations for injuries and poisonings (Cont’d…)

  8. E Codes (E800-E999) (…Cont’d) Provides additional information about external causes Never a principal (inpatient) diagnosis Separate E codeindex Locate the E Code index in your ICD-9-CM now

  9. Index to External Causes: Example Main terms are type of accident (Collision) Subterms are circumstances of the accident (motor vehicle) Modified from Buck CJ: 2010 ICD-9-CM, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2010, Saunders.

  10. Volume 2, Neoplasm In Volume 2, Index, locate Neoplasm Table under the alphabetic entry “N” Do not reference Neoplasm table when diagnostic statement states “mass” From Buck CJ: 2010 ICD-9-CM, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2010, Saunders.

  11. Abbreviations • NEC: Not elsewhere classifiable • No more specific code exists • NOS: Not otherwise specified • Unspecified in documentation

  12. [ ] Brackets • Enclose synonyms, alternative wording, or explanatory phrases • Used to identify manifestation codes • Helpful, additional information • Can affect code • Found only Tabular List (001.0-999.9)

  13. Volume 2, Etiology and Manifestation of Disease Etiology =cause of disease Manifestation = symptom Etiology + Manifestation = Combination codes

  14. Combination Code Modified from Buck CJ: 2010 ICD-9-CM, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2010, Saunders.

  15. Multiple Coding No combination code, useindividualcode(s) in this order 250.4x 581.81 Modified from Buck CJ: 2010 ICD-9-CM, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2010, Saunders.

  16. Volume 2, Notes • Define terms • Give further coding instructions • Example: Index: “Melanoma,” • Note: “Except where otherwise indicated….” (Cont’d…)

  17. Figure: 2.13 From Buck CJ: 2010 ICD-9-CM, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2010, Saunders. Volume 2, Notes • Mandatory fifth digits also appear as notes (one reason to never code from Index) (…Cont’d)

  18. Volume 2, Eponyms • Disease or syndrome named for person • Example: • Arnold-Chiari (see also Spina bifida) • Sturge-Weber • Prader-Willi

  19. Chapter 2 Conclusion – Overview ICD-9-CM Part 2

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