ICD-10 Putting Codes Into Practice - AmeriHealth

1 AmeriHealth HMO, Inc. AmeriHealth Insurance Company of New Jersey QCC Insurance Company d/b/a AmeriHealth Insurance CompanyPutting ICD-10 into Practice : Coding exercises and scenariosRevised December 2, 2013 Putting ICD-10 into Practice : Coding exercises and scenariosTable of ContentsPartners in Health UpdateSM editionPageJanuary 20133 February 20135 March 20137 April 20139 May 201311 June 201313 July 201315 August 201317 September 201319 October 201321 November 201323 December 201325 Putting ICD-10 into Practice : Coding exercises and scenarioscontinued on the next pageThe ICD-10 Spotlight: Know the Codes feature that appeared in Partners in Health Update throughout 2012 was designed to communicate various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10 .

2 These conventions and guidelines are rules and instructions that must be followed to classify and assign the most appropriate code. As with ICD-9, adherence to these guidelines is required under the Health Insurance Portability and Accountability Act (HIPAA).This year, we are introducing a new feature called Putting ICD-10 into Practice : Coding exercises and scenarios. Each month this feature will help you put the new guidelines and conventions you learned about last year into Practice . If needed, use the ICD-10 Spotlight: Know the Codes booklet for assistance with these exercises. An answer key is provided below so you can verify if your answers are correct. In addition, a list of code narratives is included to describe each ICD-10 exercises Code the following conditions according to ICD-10 coding conventions and guidelines:1.

3 Varicose vein of heel and mid-foot with presence of ulceration and swelling2. Premature menopause with headache3. Acute myocardial infarction of the anterolateral wall4. Subsequent encounter for obesity resulting from the prescription drug Tryptanol 5. Crohn s disease of ileum with rectal bleeding and abscess6. Bilateral central corneal ulcer7. Severe generalized abdominal pain with abdominal rigidity8. Female with bilateral breast cancer of lower outer quadrant9. Acute nonsuppurative otitis media of the right ear10. Initial encounter for concussion and edema of the thoracic spine11. Initial encounter for third degree burn of the right thigh by gasoline to fifteen percent of the total body surface areaCoding scenarioCode the following scenario according to ICD-10 coding conventions and guidelines:While chopping vegetables in the kitchen of his mobile home for the local food bank s Thanksgiving dinner, John Doe lacerated his right thumb causing injury to the to coding exercises: 1) 2) 3) 4) , 5) , 6) 7) 8) , 9) 10) 11) , , to coding scenario: , , , , , January 2013 | Partners in Health UpdateSM 3 ICD-10 into Practice : Coding exercises and scenariosJanuary 2013 | Partners in Health UpdateSM 4 following are the corresponding code narratives for each of the ICD-10 Codes in the answer.

4 Varicose veins of left lower extremity with both ulcer of heel and midfoot and : Symptomatic premature : ST elevation myocardial infarction (STEMI) involving other coronary artery of anterior : Drug-induced obesity : Adverse effect of tricyclic antidepressants, subsequent : Crohn s disease of small intestine with rectal : Crohn s disease of small intestine with : Central corneal ulcer, : Acute : Malignant neoplasm of lower-outer quadrant of right female : Malignant neoplasm of lower-outer quadrant of left female : Other acute nonsuppurative otitis media, right : Concussion and edema of thoracic spinal cord, initial : Corrosion of third degree of right thigh, initial : Toxic effect of petroleum products, accidental (unintentional), initial : Corrosions involving 10% 19% of body surface with 0% 9% third degree : Activity, food preparation and clean : Contact with knife, initial : Laceration without foreign body of right thumb with damage to nail, initial : Kitchen in mobile home as the place of occurrence of the external : Volunteer activityFor additional information related to the AmeriHealth transition to ICD-10 , please visit On this site you will find examples of how ICD-9 Codes will translate to ICD-10 Codes in the ICD-10 Spotlight: Know the Codes ICD-10 into Practice : Coding exercises and scenariosFebruary 2013 | Partners in Health UpdateSM 5 ICD-10 Spotlight.

5 Know the Codes feature that appeared throughout Partners in Health Update last year was designed to communicate various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10 . These conventions and guidelines are rules and instructions that must be followed to classify and assign the most appropriate code. As with ICD-9, adherence to these guidelines is required under the Health Insurance Portability and Accountability Act (HIPAA).As announced in the January 2013 edition of Partners in Health Update, we have introduced a new feature called Putting ICD-10 into Practice : Coding exercises and scenarios. Each month this feature will help you put the new guidelines and conventions you learned about last year into Practice . If needed, use the ICD-10 Spotlight: Know the Codes booklet for assistance with these exercises.

6 An answer key is provided below so you can verify if your answers are correct. In addition, a list of code narratives is included to describe each ICD-10 exercises Code the following conditions according to ICD-10 coding conventions and guidelines:1. Borderline glaucoma2. Congestive heart failure due to hypertension3. HIV positive status without symptom4. Urinary frequency5. Morbid obesity with a BMI of 42 in an adult6. Congenital red cell aplastic anemia7. Cleft palate involving both the soft and hard palate with bilateral cleft lip8. Severe persistent asthma with acute exacerbation9. Fatigue fracture of vertebra, lumbar region, and subsequent encounter for fracture with delayed healing10. Interstitial cystitis due to E. coli with hematuria11. Sleep-related teeth grinding12.

7 Non-conclusive HIV-test finding in infantsCoding scenarioCode the following scenario according to ICD-10 coding conventions and guidelines: Jane and John Doe were shopping at the mall the day after Thanksgiving to take advantage of the sales. While rushing for the newest iPhone, John fell down the stairs. Thankfully, John sustained only minor abrasions to his right to coding exercises: 1) 2) 3) Z21 4) 5) , 6) 7) 8) 9) 10) , 11) 12) R75 Answer to coding scenario: , , continued on the next pagePutting ICD-10 into Practice : Coding exercises and scenariosFebruary 2013 | Partners in Health UpdateSM 6 following are the corresponding code narratives for each of the ICD-10 Codes in the answer key for the coding exercises and coding : Preglaucoma, unspecified, right : Hypertensive heart disease with heart failureZ21: Asymptomatic human immunodeficiency virus [HIV] infection : Frequency of : Morbid (severe) obesity due to excess : Body mass index (BMI) , : Constitutional (pure) red blood cell.

8 Cleft hard and soft palate with bilateral cleft : Severe persistent asthma with (acute) : Fatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with delayed : Interstitial cystitis (chronic) with : Unspecified Escherichia coli [E. coli] as the cause of diseases classified : Sleep-related bruxismR75: Inconclusive laboratory evidence of human immunodeficiency virus [HIV] : Abrasion of right elbow, initial : Fall (on) (from) unspecified stairs and steps, initial : Other trade areas as the place of occurrence of the external causeFor additional information related to the AmeriHealth transition to ICD-10 , please visit On this site you will find examples of how ICD-9 Codes will translate to ICD-10 Codes in the ICD-10 Spotlight: Know the Codes booklet.

9 In addition, you will find examples of ICD-10 coding exercises and scenarios in the Putting ICD-10 into Practice : Coding exercises and scenarios ICD-10 into Practice : Coding exercises and scenariosMarch 2013 | Partners in Health UpdateSM 7 preparation for the transition to ICD-10 , each month AmeriHealth will include an article called Putting ICD-10 into Practice : Coding exercises and scenarios in Partners in Health Update. This feature will help you put the new guidelines and conventions you learned about last year into Practice . If needed, use the ICD-10 Spotlight: Know the Codes booklet for assistance with these exercises. An answer key is provided below so you can verify if your answers are correct. In addition, a list of code narratives is included to describe each ICD-10 exercises Code the following conditions according to ICD-10 coding conventions and guidelines:1.

10 Routine infant or child health check2. Acquired loss of teeth due to trauma, partial3. Influenzal myocarditis4. Elevated fasting triglycerides5. Hungry bone syndrome6. Primary open-angle glaucoma, moderate stage in left eye and mild stage in right eye7. Dorsal somatic dysfunction8. Invasive ductular carcinoma of breast, completely excised9. Decompensated COPD with (acute) exacerbation 10. Concussion without loss of consciousness, initial encounter with neck painCoding scenarioCode the following scenario according to ICD-10 coding conventions and guidelines: A 16-year-old student was at the gymnasium participating in a dancing contest to raise money for her class. She slipped on the gym floor and fell, injuring her left ankle. After she visited the emergency room, it was determined that she did not fracture her ankle.