This AmeriHealth series, ICD-10 in Action, features articles to recap some of the ICD-10 diagnosis code changes, introduce new coding scenarios, and/or communicate updates to ICD-10 coding conventions.
The ICD-10-CM Manual contains official guidelines for coding and reporting. There are coding conventions, general coding guidelines, and chapter-specific guidelines. These conventions and guidelines are rules and instructions that must be followed to classify and assign the most appropriate code. Understanding these guidelines and conventions is key to reaching the most appropriate code assignment.
- Conventions. A set of rules for use of the classification independent of the general or chapter-specific guidelines. Coding conventions and instructions of the classification take precedence over guidelines. (e.g., Code First).
- General guidelines. A set of rules and sequencing instructions for using the Tabular List and Alphabetic Index. These guidelines provide rules such as how to locate a code and obtain level of detail.
- Chapter-specific guidelines. A set of rules for specific diagnoses and conditions in a particular classification.
As with ICD-9, adherence to these guidelines is required under the Health Insurance Portability and Accountability Act (HIPAA).
Coding convention ? Seasonal activities
Even though the winter and holiday season is meant to be merry and bright, it also brings with it a multitude of accidents, injuries, and unfavorable incidents. These real and fictitious encounters can be identified and coded with an ICD-10 diagnosis code. Let's have some fun and code some seasonal activities.
Test Your Knowledge: Coding Scenarios
Code the following scenarios per ICD-10 coding conventions and guidelines.
- Timmy wanted to go sledding. He was so excited that after he got ready, he ran to the nearest hill and slid down. Unfortunately, in his haste, Timmy did not secure himself and fell out of the sled. There is no report of any injuries.
- Tina spent her entire day wrapping gifts for Kwanzaa. The wrapping took longer than normal because this year Tina wanted to give her family a different gift to represent the seven principles of Kwanzaa. Tina cut her finger several times on the wrapping paper.
- Little Suzie ran hysterically crying with her little Elf cradled in her hands. Suzie's mom asked "What's wrong?" Suzie said, "The Elf fell out of the Christmas tree and he needs to go to the doctor!" Her mom smiled and swaddled the little Elf, pretending to take it to the doctor. What is the incident code for the Elf?
- Jack was having a great time at his family's New Year's Eve celebration until his in-laws arrived. Jack tried to get everyone to count down to midnight and set-off celebration sparklers at the same time. However, this did not end well since Jack does not get along with his in-laws.
- Rudolph almost passed Tommy's home and came to an abrupt stop. He crashed into the chimney, injuring Santa.Tommy's father heard the crash and went outside to see what was going on. He noticed what happened and climbed to the roof to help Santa and Rudolph, whose hoof was stuck. While Tommy's dad tried to dislodge his hoof, Rudolph accidently kicked him.
- Clearly aware of their "sibling rivalry," Grandpa gave twins Daniel and David dreidels and a bag of chocolate gelt to keep them busy at the Hanukkah party. Grandpa made sure they got the same thing but just in a different color. The "sibling rivalry" continued and the twins still found a way to want the other's toy.
- Grandma wanted to go shopping at the mall on Black Friday. Her grandchildren warned her that it could be dangerous. Despite the warnings, Grandma still wanted to experience the hype. Sadly, she was trampled in the mall as shoppers scrambled for the new half-priced smart phone.
- Katie was not very happy as she wanted just one thing for Christmas – her big brother home for the holidays. However, he is in the military, stationed overseas, and was not able to come home.
- Stephanie always wanted to be a winter bride, so she decided to get married on New Year's Day at her favorite ski resort in Aspen. After the ceremony, her husband Troy carried her over the cabin threshold just as she dreamed. Unfortunately, her dream was shattered as Troy accidently dropped her after slipping on the icy doorway landing.
- Robert and his family gathered around the menorah for Hanukkah. As Robert prepared to light the last candle, the family dog jumped up on Robert, causing him to burn his hand.
Click here for answersStay tuned
We will continue to communicate ICD-10-specific information through this article series to review some of the ICD-10 diagnosis code changes. We encourage you to keep up with the latest news and information by visiting the ICD-10 webpage for AmeriHealth New Jersey or AmeriHealth Pennsylvania.