CHAPTER 6CHAPTER 6CHAPTER-SPECIFIC GUIDELINES CHAPTER-SPECIFIC GUIDELINES

(ICD-10-CM CHAPTERS 11-14)(ICD-10-CM CHAPTERS 11-14)

Diseases of Digestive System, Diseases of Digestive System, Chapter 11Chapter 11

K00-K95K00-K95 Unspecified GI hemorrhage, K92.2Unspecified GI hemorrhage, K92.2 Combination codes with hemorrhageCombination codes with hemorrhage

Example: K57.21, Diverticulitis of large intestine Example: K57.21, Diverticulitis of large intestine with perforation and abscess with bleeding with perforation and abscess with bleeding

Diseases of the Skin and Diseases of the Skin and Subcutaneous Tissue, Chapter 12Subcutaneous Tissue, Chapter 12

L00-L99L00-L99 Also codes to report conditions of the:Also codes to report conditions of the:

NailsNails Sweat glandsSweat glands HairHair Hair folliclesHair follicles

InfectionsInfections

Use additional code before L00 directs coder Use additional code before L00 directs coder to report the infection with B95-B97to report the infection with B95-B97

Pressure UlcersPressure Ulcers

Stage 1: erythema (redness) of skinStage 1: erythema (redness) of skin Stage 2: partial loss of skin Stage 2: partial loss of skin

(epidermis or dermis) (epidermis or dermis) Stage 3: full thickness loss of skin Stage 3: full thickness loss of skin

(up to but not through fascia)(up to but not through fascia) Stage 4: full thickness loss Stage 4: full thickness loss

(extensive destruction and necrosis)(extensive destruction and necrosis)

Diseases of the Musculoskeletal Diseases of the Musculoskeletal System and Connective Tissue, System and Connective Tissue,

Chapter 13Chapter 13 M00-M99M00-M99 Most codes specify:Most codes specify:

Site: Location on the bodySite: Location on the body Laterality: Right, left, unilateral, bilateralLaterality: Right, left, unilateral, bilateral

Some codes include “multiple sites” such as:Some codes include “multiple sites” such as: M15.-, Polyosteoarthritis including multiple sitesM15.-, Polyosteoarthritis including multiple sites

Infectious ArthropathiesInfectious Arthropathies

M00-M02M00-M02 Direct infectionsDirect infections

Invades synovial tissue Invades synovial tissue Invades the joint Invades the joint Invasive organism has been identifiedInvasive organism has been identified

Indirect infectionsIndirect infections Reactive: Microbial infection identified but not in jointReactive: Microbial infection identified but not in joint Postinfective: Microbial antigen present, but not constant Postinfective: Microbial antigen present, but not constant

and no evidence of multiplicationand no evidence of multiplication

Pathological FracturesPathological Fractures

Also known as (AKA): Spontaneous fractureAlso known as (AKA): Spontaneous fracture Fracture reported in addition to underlying condition Fracture reported in addition to underlying condition

responsible for fractureresponsible for fracture Never assign a code for a traumatic fracture and Never assign a code for a traumatic fracture and

pathological fracture of same bonepathological fracture of same bone 77thth character indicates treatment plans, such as A for character indicates treatment plans, such as A for

initialinitial

OsteoporosisOsteoporosis

M80 and M81M80 and M81 Systemic condition that affects bonesSystemic condition that affects bones Fracture sustained with trauma that would not usually cause a Fracture sustained with trauma that would not usually cause a

fracturefracture Site is not a component of codesSite is not a component of codes Category M80, Osteoporosis with current pathological fracture Category M80, Osteoporosis with current pathological fracture

Age and other osteoporosis codesAge and other osteoporosis codes Category M81, Osteoporosis without current pathological Category M81, Osteoporosis without current pathological

fracture fracture

ConclusionConclusionCHAPTER 6CHAPTER 6

CHAPTER-SPECIFIC GUIDELINES CHAPTER-SPECIFIC GUIDELINES (ICD-10-CM CHAPTERS 11-14)(ICD-10-CM CHAPTERS 11-14)

Slide 10