New ICD 10 codes have been delayed for long time. Now, since we are using ICD 10 codes we should be aware of the common mistakes done by medical coders. ICD 10 codes are very specific and large in numbers as compared to ICD 9. This is one of the main difference between ICD 9 and ICD 10 codes. Because of specificity and increase in number of ICD 10 codes, medical coders should be very careful about how to use the new ICD 10 codes. Learning about ICD10 codes will be very useful for clearing medical coding certification exams . We will slowly checkout the new ICD 10 codes which are new and interesting to use in Medical coding.
Secondary codes for Pregnancy Complications
In ICD 10, we have new introduced category Z3A codes. These codes define the specific number of weeks of gestation. Earlier we have been using only pregnancy complication codes in ICD 9. But, in ICD 10 we will be using Z3A category codes along with pregnancy complication codes, which defines number of weeks of gestation for pregnancy. So, Medical coders do remember we will be having a primary and secondary ICD 10 code for pregnancy complications. Z3A category codes cannot be used as primary code, it should be always be followed by pregnancy complication code. There are exemption only in abortion cases, where the fetus is not alive , we should not code Z3A category code with abortion code.
Check Excludes 1 and Excludes 2
In ICD 10 we have two new words, Excludes 1 and Excludes 2. They are very different from each other. Excludes 1 and Excludes 2 are shown below ICD 10 codes. As per guidelines, Excludes 1 codes should not be coded with the respective ICD 10 and Excludes 2 codes can be coded together with the concerned ICD 10 code. For example for excludes 1, newborn codes cannot be coded with adult diagnosis codes or normal code and pregnancy complication code cannot be coded together. Do check the excludes 1 & 2 column below each ICD 10 codes before coding.
Be Careful with using Injury Codes
Injury codes have been increased widely in numbers in ICD 10. The injury codes have been generally divided into initial, subsequent encounter and sequela, which i have explained briefly in my previous post. These codes have to be used carefully, even till now I am having confusion of using injury codes for sequela. Injury codes should also be supported with external cause of injury codes, which were E codes in ICD 9.
Using Z codes in ICD 10
Z codes are the replacement of V codes of ICD 9. Z codes are mostly status codes. We should be more careful with Z codes, since few of them should be always reported as Primary diagnosis. For example code Z51.0 Encounter for antineoplastic radiation therapy, has to be used as Primary diagnosis as per coding guidelines. They have been used as Secondary codes like Z3A category which we have discussed above. Be careful next time for using Z codes as primary or secondary diagnosis.