ICD10 CM Training Pediatrics ICD10 CM Compliance Dates

ICD-10 CM Training Pediatrics

ICD-10 -CM Compliance Dates • ICD-10 -CM will be valid for dates of service on or after October 1, 2015 – Outpatient dates of service of October 1, 2015 and beyond. – Inpatient hospital service claims, is effective for dates of discharge after September 30, 2015

Covered and Non-Covered Entities • Covered Entities – Everyone covered by the Health Insurance Portability Accountability Act (HIPAA) • Non-Covered Entities – Worker’s Compensation – Auto Insurance – Non covered HIPAA entities are exempt but are encouraged to adapt the new code set

ICD-10 Code Structure • 21 Chapters • Alpha-numeric codes; not case-sensitive – Codes begin with Alpha letter, A-Z, excluding U – Common errors • I verses 1 • O verses 0 • “x” Placeholder • 3 to 7 characters – Decimal following 3 rd character

ICD-10 Code Structure • Placeholder “x” – Used for future expansion of a code – Fills in empty characters when a 6 th and/or 7 th character apply – The placeholder may be used in different scenarios but should never serve as the final character. Example: W 19. XXXA Unspecified fall, Initial Encounter

ICD-10 Code Structure • 7 th Character – Provides specified information regarding the clinical visit – Is required for certain categories and must be reported in the seventh position – May be alpha or numeric – Has different meanings depending on the coding category

ICD-10 Code Structure • Laterality – Some ICD-10 -CM codes indicate laterality, specifying whether the condition occurs on the left, right or is bilateral. – If no bilateral code is provided and the condition is bilateral, assign separate codes for both the left and right side. – If the side is not identified in the medical record, assign the code for the unspecified side. OGCR section 1. B. 13

ICD-10 Code Structure • “Other” Codes – Codes titled “other” or “other specified” are for use when the information in the medical record provides detail for which a specific code does not exist. • “Unspecified” Codes – Codes titled “unspecified” are for use when the information in the medical record is insufficient to assign a more specific code. OGCR section 1. A. 9. a. b

ICD-10 Structure • Excludes Notes – Excludes 1 • • A type 1 Excludes note is a pure excludes note It means “NOT CODED HERE” The code excluded should never be used at the same time When two conditions cannot occur together – Excludes 2 • Represents “Not included here” • The condition excluded is not part of the condition represented by the code • It is acceptable to use both the code and the excluded code together, when appropriate OGCR section 1. A. 12. a. b

ICD-10 Code Structure • “Code First” and “Use Additional Code” – ICD-10 has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. – These instructional notes indicate the proper sequencing order of the codes. OGCR section 1. A. 13 • The “-” indicates there additional reporting options

ICD-9 -CM to ICD-10 -CM Conversion Utility (GEMs) in e. CW From top tool bar • Billing • ICD-9 -CM to ICD-10 -CM Conversion Utility (GEMs)

ICD-9 -CM to ICD-10 -CM Conversion Utility (GEMs) in e. CW • Type in ICD-9 -CM Code • Select- Map to ICD-10 -CM • ICD-10 -CM Code will appear – IF code is not a one-to-to conversion, modifier selections will appear to narrow search.

IMO/Smart Search IMO is a registered trademark for Intelligent Medical Objects. • Integrates software in the practice management systems to allow for a quick search of medical terms and codes. • Allows for a search using physician verbiage, partial terms or ICD codes. • System integrates with e. CW Smart Search is the result of IMO functionality within a practice management system. • Is available at no cost • Is found in the assessment section of the progress note • Allows easier search of codes (ICD-9 to ICD-10)

Most Common Diagnosis Codes

Routine Infant or Child Health Examination ICD-9 Code ICD-10 Code Description Excludes 1 V 20. 2 Z 00. 129 Encounter for routine child health examination without abnormal findings • Encounter for routine child health examination NOS • Encounter for development testing of infant or child • Health check (routine) for child over 28 days old • Encounter for routine child health examination with abnormal findings • Use additional code to identify abnormal findings • V 20. 2 Z 00. 121 • • Excludes 2 Health check for child under 29 days old (Z 00. 11 -) Health supervision of foundling or other health infant or child (Z 76. 1 Z 76. 2) Newborn health examination (Z 00. 11 -) N/A

Well Examination Documentation Tips • Identify routine health check – Adult – Child – Newborn • Under 8 days old • 8 -28 days old • Identify presence/absence of abnormal findings – Without abnormal findings • Use an additional code for any abnormal findings

Encounter for examination of ears and hearing ICD-9 Code ICD-10 Code Description Excludes 1 V 72. 19 Z 01. 10 Encounter for examination of ears and hearing without abnormal findings • • encounter for examination for administrative purposes (Z 02. -) encounter for examination for suspected conditions, proven not to exist (Z 03. -) encounter for laboratory and radiologic examinations as a component of general medical examinations(Z 00. 0 -) encounter for laboratory, radiologic and imaging examinations for sign(s) and symptom(s) - code to thesign(s) or symptom(s) Excludes 2 N/A There are more specific code choice selections below: Z 01. 110 Encounter for hearing examination following failed hearing screening Z 01. 118 Encounter for examination of ears and hearing with other abnormal findings Use additional code to identify abnormal findings

Examination of ears and hearing Documentation Tips • Identify presence/absence of abnormal findings – Without abnormal findings • Use an additional code for any abnormal findings • Identify previous failed hearing screening • Z 01 codes are not to be used if the examination is for diagnosis of a suspected condition or for treatment purposes. • During a routine exam, should a diagnosis or condition be discovered, it should be coded as an additional code. • Pre-existing and chronic conditions and history codes may also be included as additional codes as long as the examination is for administrative purposes and not focused on any particular condition.

Encounter for examination of eyes and vision ICD-9 Code ICD-10 Code Description Excludes 1 V 72. 0 Z 01. 00 Encounter for examination of eyes and vision without abnormal findings • Encounter for examination of eyes and vision NOS • • • Z 01. 01 Encounter for examination of eyes and vision with abnormal findings Use additional code to identify abnormal findings encounter for examination for administrative purposes (Z 02. -) encounter for examination for suspected conditions, proven not to exist (Z 03. -) encounter for laboratory and radiologic examinations as a component of general medical examinations(Z 00. 0 -) encounter for laboratory, radiologic and imaging examinations for sign(s) and symptom(s) - code to the sign(s) or symptom(s) Excludes 2 • screening examinations (Z 11 -Z 13)

Examination of eye Documentation Tips • Identify presence/absence of abnormal findings – Without abnormal findings Use an additional code for any abnormal findings Identify high risk medication Identify diabetes and diabetes retinopathy Z 01 codes are not to be used if the examination is for diagnosis of a suspected condition or for treatment purposes. • During a routine exam, should a diagnosis or condition be discovered, it should be coded as an additional code. • Pre-existing and chronic conditions and history codes may also be included as additional codes as long as the examination is for administrative purposes and not focused on any particular condition. • •

Asthma ICD-9 Code ICD-10 Code Description Excludes 1 493. 00, 493. 10 J 45. 20 Mild intermittent asthma, uncomplicated or NOS • 493. 01, 493. 11 J 45. 22 Mild intermittent asthma with status asthmaticus N/A 493. 02, 493. 12 J 45. 21 Mild intermittent asthma with (acute) exacerbation N/A 493. 82 J 45. 991 Cough variant asthma N/A 493. 90 J 45. 909 J 45. 998 Unspecified asthma, uncomplicated Other asthma N/A 493. 91 J 45. 902 Unspecified asthma with status asthmaticus • bronchitis due to chemicals, gases, fumes and vapors (J 68. 0) • cystic fibrosis (E 84. -) 493. 92 J 45. 901 Unspecified asthma with (acute) exacerbation • bronchitis due to chemicals, gases, fumes and vapors (J 68. 0) cystic fibrosis (E 84. -) bronchitis due to chemicals, gases, fumes and vapors (J 68. 0) Excludes 2 • cystic fibrosis (E 84. -)

Asthma Severity Chart INTERMITTENT MILD PERSISTENT MODERATE PERSISTENT SEVERE PERSISTENT SYMPTOMS 2 or less days per week More than 2 days per week Daily Throughout the day NIGHTIME AWAKENINGS 2 x’s per month or less 3 – 4 x’s per month More than once per week but not nightly Nightly RESCUE INHALER USE 2 or less days per week More than 2 days per week, but not daily Daily Several times per day INTERFERENCE WITH NORMAL ACTIVITY None Minor limitation Some limitation Extremely limited LUNG FUNCTION FEVI>80% predicted and normal between exacerbations FEV 1>80% predicted FEV 1 60 – 80% predicted FEV 1 less than 60% predicted

Asthma Documentation Tips • Identify – Severity • Mild intermittent • Mild persistent • Moderate persistent • Severe persistent • Unspecified – Complication • With acute exacerbation • With status asthmaticus • Uncomplicated – Due to • Allergies • Fumes • When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e. g. tracheobronchitis to bronchitis in J 40). Use additional code, where applicable, to identify: – exposure to environmental tobacco smoke (Z 77. 22) – exposure to tobacco smoke in the perinatal period (P 96. 81) – history of tobacco use (Z 87. 891) – occupational exposure to environmental tobacco smoke (Z 57. 31) – tobacco dependence (F 17. -) – tobacco use (Z 72. 0) •

Undiagnosed Cardiac Murmurs ICD-9 Code ICD-10 Code Description Excludes 1 785. 2 R 01. 1 Cardiac murmur, unspecified • Applicable to: • Cardiac bruit NOS • Heart murmur NOS cardiac murmurs and sounds originating in the perinatal period (P 29. 8) There are more specific code choice selections R 01. 0 Benign and innocent cardiac murmurs Functional cardiac murmur R 01. 2 Other cardiac sounds Cardiac dullness, increased or decreased Precordial friction Excludes 2 N/A

IMO Smart Search

Documentation Tips • R 00 -R 99 codes that describe symptoms and signs are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider. • R 00 -R 99 codes for signs and symptoms may be reported in addition to a related definitive diagnosis when the sign or symptom is not routinely associated with that diagnosis, such as the various signs and symptoms associated with complex syndromes. The definitive diagnosis code should be sequenced before the symptom code. • R 01. 0 – undiagnosed cardiac murmur

Acute upper respiratory infection, unspecified ICD-9 Code ICD-10 Code Description Excludes 1 465. 9 J 06. 9 Acute upper respiratory infection, unspecified • Applicable To: • Upper respiratory disease, acute • Upper respiratory infection NOS • acute respiratory infection NOS (J 22) streptococcal pharyngitis (J 02. 0) Use additional code, where applicable, to identify: • exposure to environmental tobacco smoke (Z 77. 22) • exposure to tobacco smoke in the perinatal period (P 96. 81) • history of tobacco use (Z 87. 891) • occupational exposure to environmental tobacco smoke (Z 57. 31) • tobacco dependence (F 17. -) • tobacco use (Z 72. 0) Excludes 2 N/A

Otitis media, unspecified ICD-9 Code ICD-10 Code Description Excludes 1 Excludes 2 382. 9 H 66. 90 Otitis media, unspecified ear • Otitis media NOS • Acute otitis media NOS • Chronic otitis media NOS N/A Use additional code for any associated perforated tympanic membrane (H 72. -) There are more specific code choice selections 382. 9 H 66. 91 Otitis media, unspecified, right ear 382. 9 H 66. 92 Otitis media, unspecified, left ear 382. 9 H 66. 93 Otitis media, unspecified, bilateral

Documentation Tips • • • Otitis Media Type – Laterality – Chronicity – Recurrence – Spontaneous tympanic membrane rupture – Suppurative otitis media location Use an external cause code following the code for the ear condition, if applicable, to identify the cause of the ear condition Use additional code to identify: – exposure to environmental tobacco smoke (Z 77. 22) – exposure to tobacco smoke in the perinatal period (P 96. 81) – history of tobacco use (Z 87. 891) – occupational exposure to environmental tobacco smoke (Z 57. 31) – tobacco dependence (F 17. -) – tobacco use (Z 72. 0)

Acute pharyngitis, unspecified ICD-9 Code ICD-10 Code Description Excludes 1 462 J 02. 9 Acute pharyngitis, unspecified • Applicable To: • Gangrenous pharyngitis (acute) • Infective pharyngitis (acute) NOS • Pharyngitis (acute) NOS • Sore throat (acute) NOS • Suppurative pharyngitis (acute) • Ulcerative pharyngitis (acute) • • • acute laryngopharyngitis (J 06. 0) peritonsillar abscess (J 36) pharyngeal abscess (J 39. 1) retropharyngeal abscess (J 39. 0) There are more code choices below: J 02. 0 Streptococcal pharyngitis J 02. 8 Acute pharyngitis due to other specified organism • Use additional code (B 95 -B 97) to identify infectious agent Use additional code, where applicable, to identify: • exposure to environmental tobacco smoke (Z 77. 22) • exposure to tobacco smoke in the perinatal period (P 96. 81) • history of tobacco use (Z 87. 891) • occupational exposure to environmental tobacco smoke (Z 57. 31) • tobacco dependence (F 17. -) • tobacco use (Z 72. 0 Excludes 2 • chronic pharyngitis (J 31. 2)

Acute pharyngitis, unspecified Documentation Tips • Type of pharyngitis • Identify infectious agent – Streptococcus – Other organism • Identify acute or chronic. Chronic pharyngitis code J 31. 2 • When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e. g. tracheobronchitis to bronchitis in J 40).

Cystic fibrosis ICD-9 Code ICD-10 Code Description Excludes 1 Excludes 2 277. 00 E 84. 9 Cystic fibrosis, unspecified N/A Includes: mucoviscidosis There are more specific code choice selections below: E 84. 0 Cystic fibrosis with pulmonary manifestations Use additional code to identify any infectious organism present, such as: Pseudomonas (B 96. 5) E 84. 11 Meconium ileus in cystic fibrosis Excludes 1: meconium ileus not due to cystic fibrosis (P 76. 0) E 84. 19 Cystic fibrosis with other intestinal manifestations Distal intestinal obstruction syndrome E 84. 8 Cystic fibrosis with other manifestations

Documentation Tips Identify: • Anatomical site • Manifestations (e. g. bronchopneumonia)

Acute lymphoblastic leukemia not having achieved remission ICD-9 Code ICD-10 Code Description Excludes 1 204. 00 C 91. 00 Acute lymphoblastic leukemia not having achieved remission • personal history of leukemia (Z 85. 6) Excludes 2 N/A Applicable to: • Acute lymphoblastic leukemia with failed remission • Acute lymphoblastic leukemia NOS There are more specific code choice selections below: C 91. 01 Acute lymphoblastic leukemia, in remission C 91. 02 Acute lymphoblastic leukemia, in relapse

Documentation Tips • Code C 91. 0 should only be used for T-cell and B-cell precursor leukemia • Identify: – In remission – In relapse – Achieved remission

Type 1 diabetes mellitus without complications ICD-9 Code ICD-10 Code Description Excludes 1 250. 01 E 10. 9 Type 1 diabetes mellitus without complications • Applicable to: • brittle diabetes (mellitus) • diabetes (mellitus) due to autoimmune process • diabetes (mellitus) due to immune mediated pancreatic islet betacell destruction • idiopathic diabetes (mellitus) • juvenile onset diabetes (mellitus) • ketosis-prone diabetes (mellitus) • • diabetes mellitus due to underlying condition (E 08. -) drug or chemical induced diabetes mellitus (E 09. -) gestational diabetes (O 24. 4 -) hyperglycemia NOS (R 73. 9) neonatal diabetes mellitus (P 70. 2) postpancreatectomy diabetes mellitus (E 13. -) postprocedural diabetes mellitus (E 13. -) secondary diabetes mellitus NEC (E 13. -) type 2 diabetes mellitus (E 11. -) Excludes 2 N/A

Diabetes Documentation Tips Diabetes is a chronic condition that requires multi-specialty management. • The documentation should indicate relevant details regarding the management of each case as it relates to the services rendered or actions taken to coordinate the patients care. • The HPI, at a minimal, should include some indication of the historical timeline or duration of the illness, levels as it relates to the date of service, manifestations or impairments associated with the condition and effectiveness of current medication regimen. • The examination should notate any physical signs related to the diabetic conditions. (Ulcers, nails, edema, discoloration, sensitivity to touch)

Diabetes Documentation Tips • Indicate Type • Indicate additional conditions, manifestations, or complications • • Cataract Circulatory complication Foot ulcer Gastroparesis • Notate causal relationships (due to, with, secondary) • State due to drugs or chemicals

Malignant neoplasm of adrenal gland ICD-9 Code ICD-10 Code Description Excludes 1 Excludes 2 194. 0 C 74. 90 Malignant neoplasm of adrenal gland N/A There are more specific code choice selections below: C 74. 00 Malignant neoplasm of cortex of unspecified adrenal gland C 74. 01 Malignant neoplasm of cortex of right adrenal gland C 74. 02 Malignant neoplasm of cortex of left adrenal gland C 74. 10 Malignant neoplasm of medulla of unspecified adrenal gland C 74. 11 Malignant neoplasm of medulla of right adrenal gland C 74. 12 Malignant neoplasm of medulla of left adrenal gland C 74. 91 Malignant neoplasm of unspecified part of right adrenal gland C 74. 92 Malignant neoplasm of unspecified part of left adrenal gland

Documentation Tips • Identify: – Laterality – Type • Symptoms, signs, and ill-defined conditions listed in Chapter 18 (R 00 -R 99) characteristic of, or associated with, an existing primary or secondary site malignancy cannot be used to replace the malignancy as principal or firstlisted diagnosis, regardless of the number of admissions or encounters for treatment and care of the neoplasm.

Encounter for screening for respiratory tuberculosis ICD-9 Code ICD-10 Code Description Excludes 1 V 74. 1 Z 11. 1 Encounter for screening for respiratory tuberculosis • examinations related to pregnancy and reproduction (Z 30 Z 36, Z 39. -) Excludes 2 N/A

Documentation Tips • The testing of a person to rule out or confirm a suspected diagnosis because the patient has some sing or symptom is a diagnostic examination, NOT A SCREENING. • Should a condition be discovered during a screening then the code for the condition may be assigned as an additional diagnosis. • Nonspecific abnormal findings disclosed at the time of these examinations are classified to categories R 70 -R 94.

Cough ICD-9 Code ICD-10 Code Description Excludes 1 786. 2 R 05 Cough • • Cough with hemorrhage (R 04. 2) Smoker’s Cough (J 41. 0) Excludes 2 N/A

Cough Documentation Tips • Symptom Codes – Codes that describe symptoms and signs are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider. • Use of a symptom code with a definitive diagnosis code – Codes for signs and symptoms may be reported in addition to a related definitive diagnosis when the sign or symptom is not routinely associated with that diagnosis code. • Signs or symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.

Contact with and (suspected) exposure to tuberculosis ICD-9 Code ICD-10 Code Description Excludes 1 V 01. 1 R 01. 1 Contact with and (suspected) exposure to tuberculosis • • carrier of infectious disease (Z 22. -) diagnosed current infectious or parasitic disease see Alphabetic Index Excludes 2 • personal history of infectious and parasitic diseases (Z 86. 1 -)

Documentation Tips • Category Z 20 indicates contact with, and suspected exposure to, communicable diseases. These codes are for patients who do not show any sign or symptom of a disease but are suspected to have been exposed to it by close personal contact with an infected individual or are in an area where a disease is epidemic. • Contact/exposure codes may be used as a first-listed code to explain an encounter for testing, or, more commonly, as a secondary code to identify a potential risk.

Clearinghouse Testing • Group. One will submit ICD-10 CM test batch to Clearinghouse prior to October 1, 2015 • Update all e. CW ICD-10 settings to be effective on October 1, 2015

Monitor Claims On October 01, 2015 we will monitor claims for date of service rules • Outpatient claims cannot have crossover dates • Outpatient claims will be coded according to date of service • Inpatient facility claims will be coded per date of discharge We will monitor claims to resolve any unanticipated problems with the submission process

Claim Denial and Management • We will monitor for claim denials • We will monitor editing trends for ICD-10 Coding guidelines • We will provide feedback to the physicians regarding supporting documentation requirements • We will monitor WC or Liability carriers for published rules on use of ICD-9 or ICD-10 code sets

Client Responsibilities • Client will need to update in e. CW – – Templates Order Sets Superbills Favorites • Future Orders in e. CW – Remove ICD-9 code add ICD-10 code

https: //my. eclinicalworks. com/e. CRM/jsp/index. jsp • • Knowledge Documents & Videos ICD-10 Information ICD-10 Videos – View videos • ICD-10 -01 Overview and Setup • ICD-10 -02 Assessment Search • ICD-10 -03 Order Sets and Templates • ICD-10 -04 ICD and CPT Associations and ICD Groups • ICD-10 -05 Lab Req Forms and Superbills • ICD-10 -06 Future Labs and Standing Orders

Documentation – Start Now All Conditions treated or assessed must be documented in the medical record. In addition to the documentation tips reviewed, below are more areas to document that will ensure proper ICD-10 -CM code selection. • • Site specificity Document notation of qualifiers – – – • • Indicate acute or chronic Indicate underlying or external cause factors – – • Exacerbation Manifestations Relapse Status Stages Medication Smoke Accidents Mechanical failure Laterality – Bilateral – Right – Left

Documentation – Start Now • Episode of Care for injuries, poisoning, external causes and other conditions – Initial Encounter • Use while the patient is receiving active treatment of the condition – Active treatment includes surgical treatment, an emergency encounter, and evaluation and treatment by a new physician – Subsequent Encounter • Used on encounter after the patient has received active treatment of the condition and is receiving routine care for the condition during the healing or recovery phase. – Medication adjustments, aftercare, device adjustments, cast change – Sequela • Used for complications or conditions that arise as a direct result of a condition, late effect

Documentation – Start Now • Combination codes that capture – Etiology and manifestation – Related conditions – Disease, injury or other medical condition and complications – Disease or other medical conditions and common signs or symptoms

Official Guidelines for Coding and Reporting Underdosing refers to taking less of a medication than is prescribed by a provider or a manufacturer’s instruction. For underdosing, assign the code from categories T 36 -T 50 (fifth or sixth character “ 6”). Codes for underdosing should never be assigned as principal or first-listed codes. If a patient has a relapse or exacerbation of the medical condition for which the drug is prescribed because of the reduction in dose, then the medical condition itself should be coded. Noncompliance (Z 91. 12 -, Z 91. 13 -) or complication of care (Y 63. 6 -Y 63. 9) codes are to be used with an underdosing code to indicate intent, if known. OGCR Section 1. C. 19. e. 5. c

V 00 - Z 99 Codes External Causes of Morbidity • V-codes – Transport Accidents • W 00 -X 58 codes – Other External Causes of Accidental Injury • X 71 -X 99. 9 codes – Intentional Self-Harm • Y 00 -Y 99. 9 Other External Causes of Morbidity • Z 00 -Z 99 Factors influencing health status and contact with health services

V 00 -V 99 Codes Other External Causes of Accidental Injury Code Range Description V 00 -V 09 Pedestrian injured V 10 -V 19 Pedal cycle injured in transport accident V 20 -V 29 Motorcycle rider injured in V 30 -V 39 Occupant of three-wheeled motor vehicle injured in transport accident V 40 -V 49 Car occupant injured in transport accident V 50 -V 59 Occupant of pick-up truck or van injured in transport accident V 60 -V 69 Occupant of heavy transport vehicle injured in transport accident V 70 -V 79 Bus occupant injured in transport accident V 80 -V 89 Other land transport accidents V 90 -V 94 Water transport accidents V 95 -V 97 Air and space transport accidents V 98 Other and unspecified transport accidents V 99 Unspecified transport accidents

W 00 -W 99 Codes Other External Causes of Accidental Injury Code Range Description W 00 -W 19 Slipping, Tripping, Stumbling, and Falls W 20 -W 49 Exposure to Inanimate Mechanical Forces • Struck by object due to collapse of building W 50 -W 64 Exposure to Animate Mechanical Forces • Struck by another person W 65 -W 74 Accidental non-transport drowning and submersion W 85 -W 99 Exposure to Electric Current, Radiation and Extreme Ambient Air Temperature and Pressure

X 00 -X 99 Codes Other External Causes of Accidental Injury Code Range Description X 00 -X 08 Exposure to Smoke, Fire and Flames X 10 -X 19 Contact with Heat and Hot Substances X 30 -X 39 Exposure to Forces of Nature X 52, X 59 Accidental Exposure to Other Specified Factors X 71 -X 83 Intentional Self-Harm X 92 -Y 09 Assault

Y 00 -Y 99. 9 Codes Other External Causes of Morbidity Code Range Description Y 00 -Y 09 Assault • Maltreatment and neglect Y 21 -Y 33 Event of undetermined intent Y 35 -Y 38 Legal Intervention, Operations of War, Military Operations, and Terrorism Y 62 -Y 69 Misadventures to Patients During Surgical and Medical Care Y 70 -Y 82 Medical Devices Associated with Adverse Incidents in Diagnostic and Therapeutic Use Y 83 -Y 84 Surgical and other Medical Procedures as the Cause of Abnormal Reaction Y 92 Place of occurrence of the external cause Y 93 Activity codes Y 95 Nosocomial condition Y 99 External cause status

Z 00 -Z 99 Factors influencing health status and contact with health services Code Range Description Z 00 -Z 13 Persons encountering health services for examination and investigation Z 14 -Z 15 Genetic carrier and genetic susceptibility to disease Z 16 Infection with drug-resistant microorganisms Z 17 Estrogen receptor status Z 18 Retained foreign body fragments Z 20 -Z 28 Persons with potential health hazards related to communicable disease Z 30 -Z 39 Persons encountering health services in circumstances related to reproduction Z 40 -Z 53 Persons encountering health services for specific procedures and health care

Z 00 -Z 99 (Continue) Code Range Description Z 40 -Z 53 Persons encountering health services for specific procedures and health care Z 55 -Z 65 Persons with potential health hazards related to socioeconomic and psychosocial circumstance Z 66 Do Not Resuscitate (DNR) status Z 67 Blood type Z 68 Body mass index (BMI) Z 69 -Z 76 Persons encountering health services in other circumstances Z 79 -Z 99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status

Questions codingresource@g 1 hs. com Centers for Disease Control and Prevention (ICD-10 -CM) http: //www. cdc. gov/nchs/icd 10 cm. htm