Finding your way to the correct ICD-10 Code
ICD-10 is coming on October 1, 2015 and we are getting closer to the implementation date. As the saying goes there is only one way to eat an elephant: one bite at a time.
This month's “bite” is an introduction to navigating the ICD-10 manual. Much is made of the number of codes available in ICD-10, but exactly how do you go about choosing the correct code for your patient. Let's explore different avenues for finding the correct ICD-10 code.
General Equivalence Mapping or GEM's, were developed as a cross-walk between ICD-9 and ICD-10. It is one avenue you can use to identify a starting point in the ICD-10 manual. GEM's are not a quick and easy way to avoid learning ICD-10, but they are a tool to provide assistance in finding the correct code. Using GEM's as a starting point is common with software conversion programs, but the only place to confirm the code selection is from the Tabular list.
The Alphabetic Index is the most common method of locating the correct code. Use the index to find the condition treated in either the full ICD-10 manual, or the ChiroCode ICD-10 manual. For example, look up Sciatica in the Alphabetic List (Index). It will point you to M54.3. Wait! Your job isn't complete. Now move to the Chapter 13 of the Tabular List.
The Tabular List provides the remaining rules and details for selecting the appropriate code. Find M54.3 in the tabular list. This is your starting point for selecting the correct code. Read any instructions associated with the code. For this example there is an Excludes1 note.
lesion of sciatic nerve (G57.0)
sciatica due to intervertebral disc disorder (M51.1)
sciatica with lumbago (M54.4)
M54.30 Sciatica, unspecified side
M54.31 Sciatica, right side
M54.32 Sciatica, left side
Review the documentation for the encounter to determine if any of the excludes notes applies to this visit. Does the physicians note identify laterality? If not, M54.30 must be selected. Does the patient also have back pain? If so, see code M54.4 for further instructions.
When learning to code in ICD-10 it will take time to become familiar with the particulars of the codes used most frequently in your office. With practice, patience and perhaps a bit of guidance it will be a manageable transition.
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