Article Index
Reporting Knee pain

Knee Pain cause, injury, stretching or disease?

Knee pain is a common symptom in people of all ages. It may start suddenly, often after an injury or exercise. Knee pain may also begin as a mild discomfort and slowly worsen. Since it takes the full weight of the body, the knee joint is vulnerable to damage and pain.

Simple causes of knee pain can be taken care of, but  being overweight can be a greater risk for knee problems.

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Map ICD-9-CM to ICD-10-CM to ease transition

Map ICD-9-CM to ICD-10-CM to ease transition

While there are many steps a practice needs to take to get ready for ICD-10, the ones that most affect providers are documentation improvement and understanding which codes will change for their practice specifically. The best way to prepare for the coding changes is to map ICD-9-CM to ICD-10-CM the most frequently used codes in your practice. Depending on the practice, it could be the top 20 codes or top 100. For many primary-care providers, the number will be more like 20 codes to 50 codes. Mapping these top ICD-9 codes to their ICD-10 equivalents will help providers get a feel for the new codes and prepare to start using them. Providers should not rely entirely on an ICD-9 to ICD-10 crosswalk because some new codes have many very specific options.

With the upcoming switch to ICD-10, major changes are being made. The most important differences between ICD-9-CM and ICD-10-CM to know:

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Adverse effects and poisonings in ICD-10-CM

Adverse effects and poisonings in ICD-10-CM

One of the challenges in ICD-10-CM  is understanding the difference between coding for adverse effects and poisonings. And to understand the coding differences, the difference between the two, has to be understood. In the ICD-10-CM draft manual, the columns have changed. Now the “therapeutic column” has been deleted from the table, and a new column for “adverse effect” has been added. The poisoning column no longer exists but has been replaced by several columns that read: “poisoning accidental (unintentional)”, “poisoning Intentional/self-inflicted”, “poisoning assault”, and “poisoning undetermined.” A new column  has been added to identify “underdosing,” which seems to be an increasing problem.

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Hypertension and Hypertensive Diseases in ICD-10

Hypertension and Hypertensive, primary, secondary and combination

Coding for hypertension and hypertensive (without complications) is easier in ICD-10-CM because there is no “benign” vs. “malignant” issue — there is only essential hypertension, indicated by code I10 Essential (primary) hypertension.

Hypertension has a limited number of ICD-10 codes –

  • Only nine codes for primary hypertension and
  • Five codes for secondary hypertension. This makes the task of coding hypertension relatively simple ,at least compared to some of the other ICD-10 complexities.

Combination codes come into play, in cases when hypertension affects a body system. The code set is as follows:

  • Hypertensive heart diseasewith category I11,
  • Hypertensive chronic kidney diseasewith category I12  and
  • Hypertensive heart and chronic kidney diseasewith category I13.

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COPD Coding, Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease, COPD Coding under ICD-10-CM

Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. COPD is one of the most common respiratory diseases. COPD affects more men than women, although rates in women are increasing. The main cause of COPD is smoking. The likelihood of developing COPD increases the more you smoke and the longer you’ve been smoking. This is because smoking irritates and inflames the lungs, which results in scarring. Over many years, the inflammation leads to permanent changes in the lung. The walls of the airways thicken and more mucus is produced. Damage to the delicate walls of the air sacs in the lungs causes emphysema and the lungs lose their normal elasticity. The smaller airways also become scarred and narrowed. These changes cause the symptoms of breathlessness, cough and phlegm associated with COPD. Some cases of COPD are caused by fumes, dust, air pollution and genetic disorders, but these are rarer.

Symptoms include:

  • Increasing breathlessness when active
  • A persistent cough with phlegm
  • Frequent chest infections

 

Diagnosis 
It is important that COPD is diagnosed as early as possible so treatment can be used to try to slow down the deterioration of your lungs.
COPD is usually diagnosed after a consultation with your doctor, which may be followed by breathing tests.

Treating COPD 
Although the damage that has already occurred to your lungs cannot be reversed, you can slow down the progression of the disease. Stopping smoking is particularly effective at doing this.
Treatments for COPD usually involve relieving the symptoms with medication, for example by using an inhaler to make breathing easier. Pulmonary rehabilitation may also help increase the amount of exercise you are capable of doing.
Surgery is only an option for a small number of people with COPD.

Living with COPD 
COPD can affect your life in many ways, but help is available to reduce its impact.
Simple steps such as living in a healthy way, being as active as possible, learning breathing techniques, and taking your medication can help you to reduce the symptoms of COPD.
Financial support and advice about relationships and end of life care is also available for people with COPD.

Can COPD be prevented ? 
Although COPD causes about 25,000 deaths a year in the UK, severe COPD can usually be prevented by making changes to your lifestyle.
If you smoke, stopping is the single most effective way to reduce your risk of getting the condition.

ICD-10-CM guidelines for coding COPD

ICD-10 codes J40-J44 will be used to define the various diagnoses of Chronic Obstructive pulmonary disease including all disease entities bronchitis and lung disease. Code J44 will be used for other chronic obstructive pulmonary disease including asthma with chronic, obstructive pulmonary disease, chronic asthmatic obstructive bronchitis, chronic bronchitis with airways obstruction, chronic bronchitis with emphysema and chronic obstructive asthma.

Chronic Obstructive Pulmonary Disease [COPD] and Asthma
1) Acute exacerbation of chronic obstructive bronchitis and asthma. The codes in categories J44 and J45 distinguish between uncomplicated cases and those in acute exacerbation. An acute exacerbation is a worsening or a decompensation of a chronic condition. An acute exacerbation is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection.

ICD-10 added a code for a common acute exacerbation that brings a patient with COPD back to seek care — COPD with acute lower respiratory infection such as acute bronchitis or pneumonia. The specific pneumonia or bronchitis code can be coded in addition.

Codes for COPD ICD-10-CM  :

 J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection

As with ICD-9, there is an ICD-10 code for COPD with exacerbation, which captures “decompensated” COPD, without any additional documentation.

J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation  

Replaces
491.21 Obstructive chronic bronchitis with (acute) exacerbation 
493.22 Chronic obstructive asthma with (acute) exacerbation

And of course there is an unspecified option, which no longer questions about whether the COPD is predominantly asthma or predominantly bronchitis — it’s just COPD.

J44.9 Chronic obstructive pulmonary disease, unspecified

Replaces

491.20 Obstructive chronic bronchitis without exacerbation
493.20 Chronic obstructive asthma, unspecified
496 Chronic airway obstruction, not elsewhere classified

To specify and distinguish between uncomplicated cases and those conditions in acute exacerbation, the ICD-10 codes between J44 and j45 are normally used. Acute exacerbation is not equivalent to an infection superimposed on a chronic condition although it might be triggered by an infection is one worth noting it.

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Anemia Conditions – Coding using the ICD-10-CM Guidelines

Anemia Conditions Review and Follow the ICD-10-CM Guidelines for Coding

ICD-10 Guidelines are specific for Anemia Conditions. Proper reviewing of the document as well as following  the guidelines will ensure accuracy for coding this condition.

Anemia is a condition in which the number of red blood cells or the amount of hemoglobin (the protein that carries oxygen in them) is low. Red blood cells contain hemoglobin, a protein that enables them to carry oxygen from the lungs and deliver it to all parts of the body. When the number of red blood cells is reduced or the amount of hemoglobin in them is low, the blood cannot carry an adequate supply of oxygen. An inadequate supply of oxygen in the tissues produces the symptoms of anemia.

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ICD-10-CM Reporting Pain

ICD-10-CM Reporting Pain

Coders will need to be ready to assign the appropriate codes for reporting different types of pain in different encounters, once ICD-10 is implemented on October 1st.

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Coding GERD in ICD-10-CM

Coding GERD (Gastroesophageal reflux disease) in ICD-10-CM

Overview 
Gastroesophageal reflux disease (GERD) is the most common disease encountered by the gastroenterologist. It is a chronic disease. This happens when the muscle at the end of the esophagus does not close. Anyone can have GERD, even infants and children. GERD can be with or without heart burn. The following guideline will provide an overview of GERD and its presentation, management of this common and important disease and comparison between ICD9 and ICD 10 Coding pattern.

Symptoms
Everyone has experienced gastroesophageal reflux. It happens when you burp, have an acid taste in your mouth or have heartburn. However, when these symptoms interfere in the daily activities it is a matter of concern
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Tracking the Ebola Outbreak In ICD10.

Ebola Virus Disease in ICD-10-CM is a single code A98.4

The ongoing outbreak of the Ebola virus is an example of the way transitioning to ICD-10 can benefit the ability of public health officials to respond to global pandemics. Tracking of the Ebola outbreak  with coded data is imprecise due to the lack of a specific code for Ebola in ICD-9-CM. There is no code for Ebola disease in ICD-9-CM,but is available in ICD-10-CM.The code used in ICD9 is 078.89 which refers to multiple viral diseases. However under ICD-10 there is a code available Ebola Virus Disease A98.4. This is yet another reason that the ICD-10-CM/PCS code sets need to be implemented on October 1, 2015.
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Coding Of Neoplasms In ICD-10-CM

Coding Neoplasms by Site, Behavior, Classification Morphology or Histologic Type

Like other sections in ICD-10-CM , neoplasm chapter in ICD-10-CM has also some significant changes. Neoplasms are classified primarily by site and behavior. The behavior may be benign, carcinoma in-situ, malignant, uncertain behavior, and unspecified. However, in ICD-10-CM  additional neoplasms  are also classified by morphology or histologic type. Therefore, selecting the most specific code for some types of neoplasms will require documentation of the histologic  type of the neoplasm. If a histological term is documented, that term should be referenced first, instead of going directly to the Neoplasm Table.

Based on the type of neoplasm and the site, the proper code is provided by the Neoplasm Table. The proper column in the table should be selected that corresponds to the type of neoplasm. The Tabular List should then be referenced to verify that the correct code has been coded and a more specific site code does not exist.

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