The manager of clinical documentation integrity program/HIMS at a 300-bed academic medical center and pediatric specialty hospital has high hopes for computer-assisted coding (CAC). In particular, she anticipates that it will increase productivity and ease the transition from ICD-9-CM to ICD-10-CM/PCS.
Editor's note: With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. To help coders prepare for the upcoming transition, we will provide an occasional article about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation. This month's column addresses the anatomy of the feet.
Coders will need more information in order to code for fractures in ICD-10-CM. For instance, the physician must document which specific bone is fractured, including which side of the body. They will also need to document whether the patient is seen for an initial or subsequent visit.
Coders are aware that ICD-10-CM will allow much more specificity than ICD-9-CM, and that is very evident in the section covering injuries to the wrist, hand, and fingers (S60–S69).
ICD-10-CM Chapter 19 codes for injury, poisoning, and certain other consequences of external causes (S00-T88) demonstrate the specificity inherent in the new coding system. Betsy Nicoletti, MS, CPC, and Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, dig into the details of codes for injuries and underdosing.
Although ICD-10-CM resolves some problematic areas of coding, it isn't a panacea. Respiratory insufficiency is one diagnosis that will continue to challenge coders.
Some conditions, such as gangrene due to diabetes, require two codes to correctly report in ICD-9-CM. In ICD-10-CM, coders will only need one code. Jennifer Avery, CCS, CPC-H, CPC, CPC-I, and William E. Haik, MD, FCCP, CDIP, explain how these combination codes act as their own CC or MCC in ICD-10-CM.
The transition to ICD-10-CM is coming. The only question is when. Despite the delay, coders and other HIM professionals must continue to prepare for the transition.
Editor's note: With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. To help coders prepare for the upcoming transition, we will provide an occasional article about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation. This month's column addresses the anatomy of the thigh.
