Pair These ICD-10 2018 Official Guideline Updates With Their Code Set Counterparts

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Pair These ICD-10 2018 Official Guideline Updates
With Their Code Set Counterparts
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The ICD-10-CM 2018 Official Guidelines are out
and ready for review. When you check through the
new OGs for changes, take special note of these
updates that line up with 2018 code set
revisions. Look at Level to Choose In
Remission Code When you start to apply new codes
for substance abuse in remission (youll find
them in categories F10-F19), keep in mind this
new paragraph in Section I.C.5.b.1
Mild substance use disorders in early or
sustained remission are classified to the
appropriate codes for substance abuse in
remission, and moderate or severe substance use
disorders in early or sustained remission are
classified to the appropriate codes for substance
dependence in remission.
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Ready for New Blindness Codes
ICD-10-CM 2018 introduces about 50 new
subcategories and reportable codes for low vision
and blindness. The changes help you report the
status of both eyes in a single code. Follow
these rules from Section I.C.7.b when
documentation is less than ideal If blindness
or low vision of both eyes is documented but
the visual impairment category is not documented,
assign code H54.3, Unqualified visual loss, both
eyes. If blindness or low vision in one eye
is documented but the visual impairment category
is not documented, assign a code from H54.6-,
Unqualified visual loss, one eye. If blindness
or visual loss is documented without any
information about whether one or both eyes are
affected, assign code H54.7, Unspecified visual
loss.
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Keep Type in Mind for MI OGs
The OGs have long been important for
understanding myocardial infarction (MI) coding.
Things get a little more interesting this year
because the OGs have to take into account a new
coding structure for MI. Existing codes I21.0- to
I21.4 will apply to type 1 MIs in the new code
set. For MI NOS, youll have I21.9 (Acute
myocardial infarction, unspecified). For type 2
MI, youll choose I21. A1 (Myocardial infarction
type 2), and for types 3-5 youll use I21.A9
(Other myocardial infarction type). If you code
MIs, be sure to read all of Section I.C.9.e
because there are revisions sprinkled throughout
showing that the OGs youre accustomed to using
will apply to type 1 MI. For subsequent MI, dont
miss this added paragraph Do not assign code
I22 for subsequent myocardial infarctions other
than type 1 or unspecified. For subsequent type 2
AMI assign only code I21.A1. For subsequent type
4 or type 5 AMI, assign only code I21.A9. To
help you get to know the new type 2 code, take
note of this added paragraph Type 2 myocardial
infarction, and myocardial infarction due to
demand ischemia or secondary to ischemic balance,
is assigned to code I21.A1, Myocardial infarction
type 2, with a code for the underlying cause.
Do not assign code I24.8, Other forms of acute
ischemic heart disease, for the demand
ischemia. Sequencing of type 2 AMI or the
underlying cause is dependent on the
circumstances of admission. When a type 2 AMI
code is described as NSTEMI or STEMI, only assign
code I21.A1. Codes I21.01-I21.4 should only be
assigned for type 1 AMIs.
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Put Your Knowledge to Work for Non-Pressure

• ICD-10 2018 adds 72 new codes for non-pressure
  chronic ulcers in L97.- and L98.-, bulking up
  your already existing options. As you get to know
  the new codes, spend some time on the OGs that
  have been added, too. If you know the OGs for
  pressure ulcers, youve got a good head start on
  knowing the new OGs in Section I.C.12.b for
  non-pressure chronic ulcers. To sum up
• Dont assign a code for a non-pressure ulcer if
  documentation states the ulcer was healed when
  the patient was admitted
• Assign a code for healing non-pressure ulcers
  based on documentation of severity
• If severity progresses during admission, assign
  one code for level at admission and one code for
  the highest level during the stay.

What About You? Which ICD-10-CM 2018 guidelines
will change the way you code? Do you check these
guidelines before coding throughout the
year? Source URL- http//bit.ly/2eKIoXh
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