2022 Medicare Advantage Icd-10-cm
2022 MEDICAREADVANTAGEICD-10-CMPocket referenceDue to space limitations we are only able to represent somecoding detail. Codes in this Pocket Guide listed with a dash orhyphen (-), indicate the provider must use another resourcefor more specific coding. Please consult coding guidelines fordetailed information.Providers must be diligent about confirming the accuracy oftheir diagnoses and ensure that their diagnosis and codingpractices comply with all applicable legal requirements.Accurate and complete risk adjustment documentation, coding,and submission activities allow Cigna Medicare programsto provide quality care and resources to your patients. If youbelieve any codes were previously submitted in in error, contactyour provider education specialist or CCQI@Cigna.com.This Pocket Reference is intended to replace any previousversions prior to October 2021.PCOMM-2021-1268 929880
TABLE OF CONTENTSAmputation Status Amputation Status ICD-10 11Cardiovascular Cardiovascular ICD-10 35Cerebrovascular Diseases Cerebrovascular Diseases ICD-10 1112Chronic Kidney Disease (CKD) CKD Stages 1515Nephrology/Chronic KidneyDisease ICD-10 16Diabetes Diabetes ICD-10 1718Gastroenterology Gastroenterology ICD-10 2323Hypertension Hypertension ICD-10 2728Immunodeficiency Immunodeficiency ICD-10 3131Long-term MedicationUse ICD-10 I31
TABLE OF CONTENTSMental Disorders Mental Disorders ICD-10 3334Musculoskeletal/Nerve/Connective Tissue Musculoskeletal/Nerve/Connective Tissue ICD-10 38Neoplasms Neoplasms ICD-10 4142Neoplasms Secondary Nutrition/Metabolic Diseases Nutrition/MetabolicDiseases ICD-10 37434546Body Mass Index, 30–39 46Body Mass Index, 40–70 47Pulmonary Pulmonary ICD-10 4950Status Artificial Openings Status Artificial Openings/Ostomies ICD-10 5353II
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AMPUTATION STATUSAMPUTATION STATUS ICD-10Acquired absence of great toeZ89.41-Acquired absence of other toesZ89.42-Acquired absence of footZ89.43-Acquired absence of ankleZ89.44-Acquired absence of legbelow knee (BKA)Z89.51-Acquired absence of legabove knee (AKA)Z89.61-Requires 6th character indicating right (1) or left (2)See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 1
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CARDIOVASCULARCARDIOVASCULARDOCUMENTATION TIPSCoronary Artery Disease (CAD)› CAD/ASHD/ASCHD is coded with or without angina› Further delineated by native vessel/transplanted heart vessel/type of graft› Document causal relationship ofCAD/HTN/Heart failureAcute Myocardial Infarction (AMI)› Coded by STEMI/NSTEMI, wall, vessel› Type 1: STEMI or NSTEMI› Type 2: MI related to demand ischemia› Type 3: MI related to sudden cardiac death› Type 4a: MI related to percutaneous cath procedure› Type 4b: MI related to post cath stent thrombosis› Type 4c: MI related to restenosis of / 50%after successful cath procedure› Type 5: MI following CABG procedure› Acute episode or 4 weeks’ durationSee ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 3
Cardiovascular (continued)Old Myocardial Infarction (MI)An old MI (I25.2) should be documented eachyear to demonstrate the patient’s history of MI.Heart FailureDocument type (systolic, diastolic, and/or combined)and acuity (chronic, acute, acute on chronic).4
CARDIOVASCULAR ICD-10Angina, unstableI20.0Angina, prinzmetal (coronary spasm)I20.1Stable AnginaI20.8Angina, pectoris, NEC/NOSI20.9Left heart failure, unspecifiedI50.1Systolic heart failure, chronicI50.22Systolic heart failure, acute on chronicI50.23Diastolic heart failure, chronicI50.32Diastolic heart failure, acute on chronic I50.33Systolic and diastolic heart failure, chronicI50.42Biventricular heart failureI50.82Chronic right heart failureI50.812End-stage heart failureI50.84See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 5
CARDIOVASCULAR ICD-10Non-ischemic myocardial injury(non-traumatic)I5ASystolic and diastolic heart failure,acute on chronicI50.43Right heart failure due to leftheart failureI50.814Right heart failure, unspecifiedI50.810Atherosclerosis, aortaI70.0Atherosclerosis, renal arteryI70.1Other heart failureI50.89CAD/ASHDCAD – Unspecified type of nativecoronary artery, without angina pectorisI25.10CAD – Native coronary artery withunspecified angina pectorisI25.119CAD – Artery bypass graft(s) withoutangina pectorisI25.810CAD – Other coronary artery bypassgraft(s) with unspecified angina pectorisI25.7996
CARDIOVASCULAR ICD-10AMI unspecified site(Acute MI 4 weeks)I21.9Old MI – after 4 weeksI25.2PTCA with angioplasty implant andgraft (stent)Z95.5CABGZ95.1Pulmonary heart diseaseCor pulmonale (chronic) NOSI27.81Pulmonary hypertension, primaryI27.0Pulmonary hypertension, unspecifiedI27.20Secondary pulmonary (group 1)arterial hypertension, code primarydiagnosis firstI27.21Pulmonary hypertension (group 2)related to left heart disease, i.e., mitralvalve disease code alsoI27.22See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 7
CARDIOVASCULAR ICD-10Pulmonary hypertension (group 3)related to lung disease, i.e., interstitiallung or sleep apnea code alsoI27.23Pulmonary hypertension (group 4)related to thromboembolic disease, i.e.,chronic pulmonary emboli code alsoI27.24Other secondary pulmonaryhypertension (group 5), i.e., metabolicor hematological disorders code alsoI27.29CardiomyopathyEndomyocardial fibrosisI42.3Dilated cardiomyopathyI42.0Cardiomyopathy, unspecifiedI42.9Ischemic cardiomyopathyI25.5Other cardiomyopathiesI42.8Cardiomyopathy, alcoholicI42.6Cardiomyopathy, unspecifiedI42.9Myocarditis, unspecifiedI51.48
CARDIOVASCULAR ICD-10ArrhythmiasAtrial fibrillation, unspecifiedI48.91Atrial fibrillation, paroxysmal(paroxysmal: less than 7 days)I48.0Atrial fibrillation, persistentI48.1Long-standing persistent atrial fibrillation I48.11Permanent atrial fibrillationI48.21Atrial flutterI48.92Complete AV blockI44.2Sinoatrial node dysfunction(sick sinus syndrome)I49.5Tachycardia, paroxysmalatrial/supraventricularI47.1Tachycardia, paroxysmal ventricularI47.9Automated internal cardiac defibrillatorZ95.810See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 9
CARDIOVASCULAR ICD-10Cardiac pacemaker, in situZ95.0Other heart disease/diagnosesCardiomegalyI51.7Myocardial degenerationI51.510
CEREBROVASCULARDISEASESCEREBROVASCULAR/VASCULAR DISEASESDOCUMENTATION TIPSDocument use of long-term anticoagulants orantiplatelets, as this information can be capturedvia Z codes.Acute CVA codes (I63.-) apply during the first 72hours of onset, with history codes or late-effectcodes applicable after the 72-hour window.History of DVT (Z86.718) is used for a patientwho is still being treated with anticoagulantsprophylactically to prevent recurrence.Documentation must specify if prophylactic orcurrent treatment via anticoagulants.See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 11
CEREBROVASCULARDISEASES ICD-10Late effects of CVA – Documentation must linklate effect to CVA. May arise 18 months after theonset of the CVA.AphasiaI69.320DysarthriaI69.322Fluency disorderI69.323Dysphagia (requires additional code R13.1-) I69.391Hemiplegia right dominant sideI69.351Hemiplegia left nondominant sideI69.354Hemiplegia, unspecifiedI69.359Monoplegia upper limb, unspecifiedI69.339Monoplegia lower limb, unspecifiedI69.349Weakness(not synonymous with hemiparesis)R53.1Other paralytic syndrome(requires additional code)I69.96-History of CVA/TIA with no residualdeficits – not used with late effectsZ86.7312
VASCULAR DISEASES ICD-10Abdominal aortic aneurysmwithout ruptureI71.4Arteritis, unspecifiedI77.6Atherosclerosis of extremities withulceration, also code ulcer stage/severityI70.25Atherosclerosis of extremitieswith gangreneI70.269DVT, lower extremities,chronic, unspecifiedI82.509Peripheral vascular disease, unspecifiedI73.9Gangrene, NECI96Phlebitis and thrombophlebitisof unspecified lower extremities,unspecified deep vesselsI80.209Thrombosis and embolism of renal veinI82.3Thrombosis and embolism of otherspecified veins, chronic(Code also long-term use ofanticoagulant therapy, Z79.0-)I82.891See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 13
VASCULAR DISEASES ICD-10Atherosclerosis extremities, unspecified(may require additional code for totalocclusion)I70.209Atherosclerosis of extremities withintermittent claudication (may requireadditional code for total occlusion)I70.219Atherosclerosis of extremities withrest pain (may require additional codefor total occlusion)I70.229Chronic total occlusion of artery ofextremityI70.92History of DVTZ86.718Long-term (current) useof anticoagulantsZ79.01Peripheral vascular angioplastystatus with implants and graftsZ95.82014
CHRONIC KIDNEY DISEASECHRONIC KIDNEY DISEASE(CKD) DOCUMENTATION TIPSCKD is defined as abnormalities of kidney structureor function, present for 3 months with implicationsfor health.› CKD stages 1-2 – defined as a GFR 90 for stage 1 and GFR of 60-89 for stage 2,for a 3-month period of time in addition tothe presence of proteinuria and/or abnormalfindings on renal radiographic imaging(ultrasound or computerized tomography).› CKD stages 3-4 – require abnormaleGFR for greater than 3 months.› Code first any associated: Diabetic chronic kidney disease. Hypertensive chronic kidney disease.Use additional code to identify kidneytransplant status, if applicable (Z94.0).See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 15
NEPHROLOGY/CHRONICKIDNEY DISEASES ICD-10*CKD Stage 1 GFR 90N18.1*CKD Stage 2 GFR 60-89 – MildN18.2*For Stages 1-2, must include presence of proteinuriaand/or abnormal findings on renal radiographicimaging (ultrasound or computerized tomography).CKD Stage 3a GFR 45-59N18.31CKD Stage 3b GFR 30-44N18.32CKD Stage 4 GFR 15-29 – SevereN18.4CKD Stage 5 GFR 15 – No dialysisN18.5End-stage renal disease/CKD requiringchronic dialysis (Use additional code toidentify dialysis status)N18.6CKD, unspecified; CRF; CRIN18.9Dialysis statusRenal dialysis statusZ99.2Other kidney diseasesUnspecified kidney failure16N19
DIABETESDIABETES MELLITUSDOCUMENTATION TIPS› Type 2 is always defaulted if type 1is not documented› In most cases, a single code reports DMand the complication› Additional codes required for CKD stage,glaucoma, and ulcer site complicationCode to identify control using:› Insulin (Z79.4)› Oral antidiabetic drugs (Z79.84)Manifestations or complications› Document the manifestation to indicate link Ex.: Type 2 diabetes mellituswith polyneuropathy Ex.: Type 2 diabetes mellitus with diabeticchronic kidney disease› If the clinician chooses not to associate themanifestation with diabetes, then the clinicianmust document that the manifestation is notlinked to diabetesSee ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 17
DIABETES ICD-10 4th character denote the type of DM complication 5th and 6th characters denotes subclassificationof the body system complication A dash (-) indicates the code requires furthercharacters to account for specificity Uses 5 categories to identify clinical manifestation:ʱ E08: DM due to underlying conditionsʱ E09: Drug- or chemical-induced DMʱ E10: Type 1 DMʱ E11: Type 2 DMʱ E13: Other specified DMDiabetes mellitus type 2 –NO complicationsE11.9Type 2 DM with ketoacidosiswithout comaE11.10Diabetes with kidney complicationsE11.2-Diabetes with diabetic nephropathyE11.21Diabetes with other diabetickidney complication (for renaltubular degeneration)E11.29Diabetes type 2 with CKD, addE11.22additional code to identify CKD stage18
DIABETES ICD-10*Chronic kidney disease – stage 1N18.1(GFR 90)*Chronic kidney disease – stage 2N18.2(GFR 60-89)*For Stages 1-2, must include presence of proteinuriaand/or abnormal findings on renal radiographicimaging (ultrasound or computerized tomography).Chronic kidney disease – stage 3aN18.31(GFR 45-59)Chronic kidney disease – stage 3bN18.32(GFR 30-44)Chronic kidney disease – stage 4N18.4(GFR 15-29)Chronic kidney disease – stage 5N18.5 15 - no dialysisESRD/CKD requiring chronic dialysisN18.6(Code also Z99.2)CKD unspecifiedCRF (chronic renal failure)N18.9CRI (chronic renal insufficiency)Diabetes type 2 withE11.3ophthalmic complicationsSee ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 19
DIABETES ICD-10Code to highest specificity Fifth character - E11.31- E11.39 Sixth character1 - with macular edema9 - without macular edema E11.32-E11.35 requires 7th character todesignate laterality of the disease1 - Right eye3 - Bilateral2 - Left eye9 - Unspecified eyeDiabetes with unspecifiedE11.31diabetic retinopathyDiabetes with mild nonproliferativediabetic retinopathyE11.32-Diabetes with moderate nonproliferativediabetic retinopathyE11.33-Diabetes with severe nonproliferativediabetic retinopathyE11.34-Diabetes with proliferativediabetic retinopathyE11.35-Diabetes with diabetic cataractE11.36Diabetes with diabetic macular edema,resolved following treatmentE11.37-20
DIABETES ICD-10Diabetes with other diabetic ophthalmiccomplication (Use additional code toidentify manifestations)E11.39Diabetes type 2 with neurologicalcomplicationsE11.4-Diabetes with diabeticneuropathy, unspecifiedE11.40Diabetes with diabetic mononeuropathyE11.41Diabetes with diabetic polyneuropathyE11.42Diabetes with diabetic autonomic(poly) neuropathyE11.43Diabetes with diabetic amyotrophyE11.44Diabetes with other diabeticneurological complicationsE11.49Diabetes type 2 withcirculatory complicationsE11.5-Diabetes with diabetic peripheralangiopathy without gangreneE11.51Diabetes with diabetic peripheralangiopathy with gangreneE11.52See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 21
DIABETES ICD-10Diabetes with other circulatorycomplicationsE11.59Diabetes type 2 with otherspecified complicationsE11.6-Diabetes with diabetic arthropathyE11.61-Diabetes with skin complicationsE11.62-Ulcer sites’ single combination codeL97.1identifies skin ulcer site, laterality, and skinL97.92ulcer stage as being (1, 2, 3, 4)Diabetes with oral complicationsE11.63-Diabetes with hypoglycemiaE11.64-Diabetes with hyperglycemiaE11.65Diabetes with other specifiedcomplication (Need additionalcode to identify complication)E11.69Diabetes type 2 withunspecified complicationsE11.822
GASTROENTEROLOGYGASTROENTEROLOGY ICD-10GERD with esophagitisK21.0-GERD without esophagitisK21.9Other diseases of esophagusK22.-Achalasia of cardiaK22.0Ulcer of esophagus (Code first poisoningdue to drug or toxin [T36-T65.94XS],if applicable) (Use additional code foradverse effect [T36-T50.Z96S],if applicable, to identify drug)K22.1-Esophageal obstructionK22.2Perforation of esophagusK22.3Dyskinesia of esophagusK22.4Diverticulum of esophagus, acquiredK22.5Gastroesophageal lacerationhemorrhage syndromeK22.6See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 23
GASTROENTEROLOGY ICD-10Barrett’s esophagusK22.7-Other specified diseases of esophagusK22.8-Disease of esophagus, unspecifiedK22.9Crohn’s disease (regional enteritis)K50.-Crohn’s disease of small intestineK50.0-Crohn’s disease of large intestineK50.1-Crohn’s disease of both smalland large intestinesK50.8-Crohn’s disease, unspecifiedK50.9-Colitis, ulcerative (chronic) NOSK51.9-Chronic vascular disorders of the colonK55.1Irritable bowel syndromewith diarrheaK58.0Irritable bowel syndromewithout diarrheaK58.9Irritable bowel syndromewith constipationK58.124
GASTROENTEROLOGY ICD-10Mixed irritable bowel syndromeK58.2Other irritable bowel syndromeK58.8Alcoholic liver disease(Use additional code to identify alcoholabuse and dependence; F10.-)K70.-Alcoholic hepatitisK70.1-Alcoholic fibrosis and sclerosis of liverK70.2Alcoholic cirrhosis of liverK70.3-Alcoholic hepatic failureK70.4-Alcoholic liver disease, unspecifiedK70.9Alcohol-inducedchronic pancreatitis(Use additional code to identify alcoholabuse and dependence; F10-)K86.0Other chronic pancreatitisK86.1See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 25
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HYPERTENSIONHYPERTENSION (HTN)DOCUMENTATION TIPSHTN with CKDICD-10 guidelines assume cause and effect relationshipunless explicitly stated as otherwise in documentation.› Clearly specify stage of CKD in documentationHTN with heart diseaseICD-10 guidelines assume cause and effectrelationship unless explicitly stated as otherwise indocumentation. Use additional code to identify:› Congestive heart failure (CHF),using the (I50) code set› Tobacco status (exposure, use,dependence, or history of)See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 27
HYPERTENSION ICD-10Hypertension without manifestationsEssential (primary) hypertensionI10Hypertensive Heart Disease (HHD)Documentation should link HTN and heart disease.Requires additional code for type of heart failure,if known (I50.-).Hypertensive heart diseasewith heart failureI11.0Hypertensive heart diseasewithout heart failureI11.9Hypertensive Chronic Kidney DiseaseDocumentation should link HTN and CKD.Requires additional code for stage of chronickidney disease (N18.-).Hypertensive chronic kidney diseasewith stage 5 CKD or ESRDI12.0Hypertensive chronic kidney diseasewith stage 1-4 CKD, or unspecified CKDI12.9*Chronic kidney disease – stage 1(GFR 90)N18.1*Chronic kidney disease – stage 2(GFR 60-89)N18.228
HYPERTENSION ICD-10*For Stages 1-2, must include presence of proteinuriaand/or abnormal findings on renal radiographicimaging (ultrasound or computerized tomography).Chronic kidney disease stage 3a(GFR 45-59)N18.31Chronic kidney disease stage 3b(GFR 30-44)N18.32Chronic kidney disease – stage 4(GFR15-29)N18.4Chronic kidney disease – stage 5(GFR 15)N18.5Hypertensive Heart Disease and CKDDocumentation should link HTN, heart disease,and CKD. Requires additional code for type of heartfailure (I50.-), if known. Requires additional codefor stage of CKD (N18.-), if known.Hypertensive heart and CKDwith heart failure and stage 1-4 CKD,or unspecified CKDI13.0Hypertensive heart and CKDwithout heart failureI13.1-Hypertensive heart and CKD withoutheart failure, with stage 1-4 CKD,or unspecified CKDI13.10See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 29
HYPERTENSION ICD-10Hypertensive heart and CKD withoutheart failure, with stage 5 CKD, or ESRDI13.11Hypertensive heart and CKD with heartfailure and with stage 5 CKD, or ESRDI13.2Secondary hypertension(Code also underlying condition)I15.-Renovascular hypertensionI15.0Hypertension secondaryto other renal disordersI15.1Hypertension secondaryto endocrine disordersI15.2Other secondary hypertensionI15.8Secondary hypertension, unspecifiedI15.930
IMMUNODEFICIENCYIMMUNODEFICIENCY ICD-10AIDS - HIV/AIDS symptomaticB20HIV positive, asymptomatic statusZ21Other specified disorders involving theimmune mechanism, unspecifiedD89.89Disorder involving the immune system,unspecifiedD89.9LONG-TERM MEDICATIONUSE hromboticsNSAIDSteroidsAspirinBisphosphonatesOral hypoglycemic drugsInsulinOther long-term (current) drug 84Z79.4Z79.899See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 31
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MENTAL DISORDERSMENTAL DISORDERDOCUMENTATION TIPSNote: Utilization of the PHQ-9 tool can assist the clinicianin determining the type and severity of depression.Major depression can befurther specified as:› Single episode› Recurrent episode› Mild, moderate or severe› Partial remission (cessation of depressivesymptoms for 1–2 months)› Full remission (cessation of depressivesymptoms for 2 months)If depression without additionalinformation is documented, it willbe coded as Depression NOS.Documentation language should include “major”to be classified or coded as major depression.Depression/AnxietyLink diagnosis with “with” if patient has depressionwith anxiety.See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 33
MENTAL DISORDERS ICD-10Alcoholism, chronicF10.20Alcohol dependence, uncomplicatedF10.20Alcohol dependence, in remissionF10.21Drug dependence,unspecified, uncomplicatedF19.20Drug dependence,unspecified, in remissionF19.21Senile dementia,without behavior disturbanceF03.90Senile dementia, with behaviordisturbance (Use additional codeto identify wandering)F03.91Presenile dementiaF03.90Vascular dementia withoutbehavior disturbanceF01.50Vascular dementia withbehavior disturbanceF01.51Alzheimer’s disease (use additional codeto identify delirium, or type of dementia)G30.9Senile degeneration of brainG31.134
MENTAL DISORDERS ICD-10Cerebral degeneration, unspecifiedG31.9Bipolar disorder, unspecifiedF31.9Major depressive disorder,single episode(requiring additional 4th character)0 mild1 moderateF32.2 severe without psychotic features3 severe with psychotic features4 in partial remission5 in full remission9 unspecifiedDepression, unspecifiedF32.AMajor depression, recurrent episode(requiring additional 4th and 5th characteras applicable)0 mild1 moderate2 severe without psychotic featuresF33.3 severe with psychotic features4 in remission.40 unspecified.41 partial remission.42 full remissionPlease consult ICD-10-CM coding manual todetermine correct coding for depressive disorderSee ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 35
MENTAL DISORDERS ICD-10Dysthymic disorderF34.1Mood disorder, unspecifiedF39Delusional disorderF22Paranoid state, unspecifiedF22Schizophrenia – Please consult ICD-10-CM codingmanual to determine specific coding for specifiedtype of schizophreniaSchizophrenia, otherF20.89Schizophrenia, unspecifiedF20.936
MUSCULOSKELETAL/NERVE/CONNECTIVE TISSUEMUSCULOSKELETALDOCUMENTATION TIPSOsteomyelitisDocument if acute or chronic, when known.OsteoarthritisDocument all sites and laterality.Document if localized or generalized, when known.OsteoporosisDocument if senile, idiopathic, due to disuse,or other reasons (drug induced), when known.See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 37
MUSCULOSKELETAL/NERVE/CONNECTIVE TISSUE ICD-10Arthritis, rheumatoid, chronicM06.9Manifestations of rheumatoid arthritis requireadditional code (Please consult ICD-10-CMcoding manual to determine additionalspecificity codes)ʱ M25.4Effusion of jointʱ M25.5Pain in jointʱ M25.6- Stiffness of joint,not elsewhere classifiedMyopathy, inflammatoryG72.49Polyneuropathy incollagen vascular diseaseM35.9(G63)Ankylosing spondylitis/Inflammatoryspondylopathies, unspecifiedM45.9Cerebral palsy, NOSG80.9Chronic pain syndromeG89.4Disorder of bone and cartilage,unspecified (osteopenia)M85.938
MUSCULOSKELETAL/NERVE/CONNECTIVE TISSUE ICD-10Lupus, systemic (Use additional codefor , inflammatory,unspecifiedM06.4Multiple sclerosisG35Necrosis, bone, aseptic, unspecifiedM87.00Autoimmune disease (systemic), NOSM35.9Osteoporosis, unspecifiedM81.0Please consult ICD-10-CM coding manual todetermine correct coding for osteoporosisOsteomyelitis, chronic(Use additional code for organism):code for site and laterality, if knownM86.60Paraplegia, unspecifiedG82.20See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 39
MUSCULOSKELETAL/NERVE/CONNECTIVE TISSUE ICD-10Please consult ICD-10-CM coding manual todetermine correct coding for paraplegiaParaplegia, completeG82.21Paraplegia, incompleteG82.22Quadriplegia, unspecifiedG82.50Please consult ICD-10-CM coding manual todetermine correct coding for quadriplegiaQuadriplegia, C1-C4 completeG82.51Quadriplegia, C1-C4 incompleteG82.52Quadriplegia, C5-C7 completeG82.53Quadriplegia, C5-C7 incompleteG82.54Epilepsy, unspecifiedG40.909SeizuresR56.940
NEOPLASMSNEOPLASMDOCUMENTATION TIPS› Specify if malignancy is primary and/or secondary.› Clearly document if the malignancy is still presentin the body or if the malignancy has been excisedbut is still undergoing active treatment(radiotherapy, antineoplastic chemotherapy,antineoplastic immunotherapy, and/oroncology referral).› When primary malignancy has beenpreviously excised and no further treatmentis indicated, history codes apply.› Surveillance following completion of treatment isconsidered history of active/adjuvant neoplasm.› When secondary malignancy is still beingtreated, use code for secondary site.› Active neoplasm for which patient has refusedtreatment is still considered a current neoplasm.› Prophylactic treatment (tamoxifen, femara,lupron) is not considered active adjuvant treatmentand supports only a history Z code and aprophylactic-use Z code.See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 41
NEOPLASMS ICD-10Neoplasms Primary SecondaryPersonalhistoryMalignancies – 4th or 5th character indicates site.Please consult ICD-10-CM coding manual for 4th or5th Z85.841BreastC50.-C79.81Z85.3Cervix ,except -Lung andbronchusC34.-C78.0-Z85.1-Malignantmelanomaof skinC43.-C79.2Z85.820ProstateC61C79.82Z85.46Skin, siteunspecifiedC43.9C79.2Z85.82842
NEOPLASMSSecondaryLong-term (current) use of selectiveestrogen receptor modulatorsZ79.810Long-term (current) use ofaromatase inhibitorsZ79.811Long-term (current) use ofother agents affecting estrogenreceptors/levelsZ79.818See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 43
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NUTRITION/METABOLICDISEASESNUTRITIONAL DISORDERDOCUMENTATION TIPSBMI may be documented by nurse or dietitian;however, specific metabolic conditions such asobesity are diagnosed and documented by thetreating provider.Overweight BMI range25-29.9Obesity BMI range30.0-39.9Morbid obesity BMI range40 or greaterSee ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 45
NUTRITION/METABOLICDISEASES ICD-10Malnutrition, moderate degreeE44.0Malnutrition, mild degreeE44.1Malnutrition NOSE46Protein-calorie malnutrition, severeE43Obesity: Use additional code to identify BMIObesity, unspecified (BMI 30.0-39.9)code BMI, if known(Some BMIs 35.0 may also be considered E66.9morbid obesity if comorbid conditionssuch as hypertension or diabetes)Morbid obesity (BMI 40 or greater) codeBMI, if knownE66.01Overweight (BMI 25-29.9) code BMI,if knownE66.3BODY MASS INDEX, -39.946
BODY MASS INDEX, 40-70 40.0-44.9, adultZ68.4145.0-49.9, adultZ68.4250.0-59.9, adultZ68.4360.0-69.9, adultZ68.4470 and over, adultZ68.45See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 47
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PULMONARYPULMONARYDOCUMENTATION TIPSThe term “COPD” defaults to a nonspecific codethat should only be used when the type of COPDis unknown and/or not documented in the record.COPD comprises obstructive chronic bronchitisand emphysema.Asthma is identified in ICD–10 CM separatelyfrom obstructive chronic bronchitis.Asthma/Bronchitis/COPD/EmphysemaUse additional code to identify:› Exposure to environmental tobacco smoke (Z77.22)› Chronic respiratory failure withhypercapnia/hypercarbia (J96.12)› Exposure to tobacco smoke in theperinatal period (P96.81)› Occupational exposure to environmentaltobacco smoke (Z57.31)› History of tobacco dependence (Z87.891)› Nicotine dependence (F17.-)› Tobacco use (Z72.0)See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 49
PULMONARY ICD-10Asthma - 5th character for J45.2through J45.5-:0 Uncomplicated1 (Acute) exacerbation2 Status asthmaticusJ45.-Mild intermittent asthmaJ45.2-Mild persistent asthmaJ45.3-Moderate persistent asthmaJ45.4-Severe persistent asthmaJ45.5-Other and unspecified asthmaJ45.9-Bronchitis, not specified as acuteor chronicJ40Simple chronic bronchitisJ41.0Mucopurulent chronic bronchitisJ41.1Mixed simple and mucopurulent chronicbronchitisJ41.8Chronic bronchitis, unspecifiedJ4250
PULMONARY ICD-10EmphysemaJ43.-Unilateral pulmonary emphysema(MacLeod’s syndrome)J43.0Panlobular emphysemaJ43.1Centrilobular emphysemaJ43.2Other emphysemaJ43.8Emphysema, unspecifiedJ43.9Other chronic obstructivepulmonary diseaseJ44.-COPD with acute lower respiratoryinfection (Use additional code to identifythe infection)J44.0COPD with (acute) exacerbationJ44.1COPD, unspecifiedJ44.9Chronic respiratory failure, unspecificwhether with hypoxia or hypercapniaJ96.10See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 51
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STATUS ARTIFICIALOPENINGSSTATUS ARTIFICIAL OPENINGS/OSTOMIES ICD-10ColostomyZ93.3Cystostomy, ificial opening status, unspecifiedZ93.9TracheostomyZ93.0See ICD-10 Code Book for complete description of options and guidelinesICD-10-CM POCKET REFERENCE 53
To help ensure you are documentingto the highest degree of specificity forappropriate ICD-10 code assignment,go to Cigna.com/codingeducation.All Cigna products and services are provided exclusively by orthrough operating subsidiaries of Cigna Corporation, includingCigna Health and Life Insurance Company. The Cigna name,logos, and other Cigna marks are owned by Cigna Intellectual
CARDIOVASCULAR ICD-10 Angina, unstable I20.0 Angina, prinzmetal (coronary spasm) I20.1 Stable Angina I20.8 Angina, pectoris, NEC/NOS I20.9 Left heart failure, unspecified I50.1 Systolic heart failure, chronic I50.22 Systolic heart failure, acute on chronic I50.23 Diastolic heart failure, chronic I50.32 Diastolic heart failure, acute on chronic I50.33 Systolic and diastolic heart failure .
ICD-9 724.02 ICD-10 M48.06 Spinal stenosis, lumbar region ICD-9 720.2 ICD-10 M46.1 Sacroiliitis, not elsewhere classified ICD-9 724.8 ICD-10 R29.898 Other symptoms and signs involving the ** musculoskeletal system ICD-9 721.42 ICD-10 M47.16 Other spondylosis with myelopathy, lumbar region ICD-9 723.1 ICD-10 M54.2 Cervicalgia ICD
More on ICD-10. ICD-10-PCS replaces ICD-9-CM inpatient procedure coding: ICD-9-CM procedure codes 3 to 4 numeric digits ICD-10-CM codes 7 alphanumeric digits ICD-10-PCS code format substantially different from ICD -9 Unlike ICD-9, ICD-10
ICD-10 Tips from PHCS The Road to ICD-10 Flyer AMA ICD-10 Project Plan Template Educational Tools Folder Precyse University ICD-10 Physician Office Solution Brochure Precyse Catalog of ICD-10 Courses ICD-10 Precyse Apps for Physicians Resources Folder Free Resources ICD-9 to ICD-10 Crosswalk of Most Common ICD-9 .
Dec 14, 2010 · ICD-9. ICD-10. ICD-9. ICD-10. Inactive. Active. Combined Code Set. Core Technologies. ICD-9 and ICD-10 code values are unique. Generally, the industry is taking one of two approaches as it relates to the ICD-10 transition: Remediation: Modify/expand all systems and processes to accommodate ICD-
ICD-10 to ICD-10-CM Based on FY2017 ICD-10-CM codes Category and subcategory codes are shaded in grey and marked with an Cells shaded in pink and marked with an *indicate the preferred code when a single code maps to multiple codes (see Introduction) Reportable Neoplasms . Type of Code ICD-10 Category Chapter II (Neoplasms) ICD-10 Term . ICD .
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7/13/2015 1 Tonya Mitchell, RHIT July 17, 2015 Objectives Review the History of ICD‐10 Discuss the Myths and Facts of ICD‐10 Discuss GlGeneral DttiDocumentation CtConcepts Review ICD‐10 Documentation Concepts Analyze Documentation for Top Diagnosis in ICD‐10 WHY CHANGE FROM ICD‐9 TO ICD‐10? ICD‐9 was developed in the 1970s and cannot support current
of the previous ICD-9 coding system. The volume of ICD-10 codes as compared to ICD-9 codes is significant because in ICD-10, the code size has been expanded, code values and interpretations have been redefined and specificity has been further improved. Global ICD-10 adoption The current version of ICD is ICD-10, which was adopted by the World .
