Home Forums Missing ICD-10 codes?

There are a lot of ICD-10 codes in yellow in the "Diagnoses" drop down list, indicating that they are not adequately specific codes. This is especially true for the trauma and injury codes such as "S70. " and "S80. " series, and probably many others as well. I started this thread in the belief that the database was missing the more detailed codes, but that is not the case. [Of note, these are not ICD-9 to ICD-10 conversion or mapping issues.] Below is a specific example of the kinds of issues that I encountered:

S81.812A is the ICD-10 code for initial encounter for left leg laceration without foreign body. The "A" at the end indicates that it is the initial encounter for this injury, with "D" being subsequent or follow-up encounter and "S" being sequlae. In the AC "Diagnoses" dropdown list, S81.812 is present but in yellow. It was not initially obvious to me how to code S81.812A (or "D" of "S" for that matter).

The solution to the above problem may not be very elegant, but it does exist.

If you double click on one of the yellow, nonspecific codes such as the above example S81.812, a "Diagnosis Code Alert" box opens up and asks if you want to "refine" this code. If you click "Yes", yet another box opens with additional code choices. If you select one of those (either point and double-click on specific code, or point and click specific code to select, then point and click on "Select Diagnosis" button) and wait a loooonnngg time, the more specific code will eventually show up in your patient's Assessment window. It's rather slow, but it does allow you to drill down to the specific code. Some of the descriptions are very long, perhaps that is why they aren't all available in the "Diagnoses" dropdown list. Alternatively, maybe it is a work-around for the speed issue, as the entire ICD-10 list is pretty long and this would allow working with a subset of the list for the more commonly used codes. In any case, I hope this is helpful to others. It took my quite a while to figure this out. If this system was available in ICD-9, I never had cause to dig for it.

Hi. The learning curve for coding Trauma and injury will be uphill and even after it is understood these descriptions will take longer to code because of their depth and breadth. Thank you for summarizing the issue succinctly. Capturing the 7th character associated with injuries(episode of care)will require refinement

I have pertinent codes to 7 digits learned and memorized, why can I not enter them directly?

sometimes its easier to use printed cheat sheets, then we'd like to be able to enter the code directly.

I found T14.8 in AC for insect bite but now the billing company is asking for clarification. If I pull up T14.8 on an ICD-10 website I get the following: This is frustrating

Other injury of unspecified body region
in hemorrhage beneath unbroken skin; a bruise. ? Abrasion T14.8 skin NEC T14.8 Contusion (skin surface intact) T14.8 bone NEC T14.8 skin NEC T14.8 subcutaneous NEC T14.8 subperiosteal NEC T14.8 Crush, crushed, crushing T14.8 internal organ (abdomen, chest, or pelvis) T14.8 severe, unspecified site T14.8 Fracture, traumatic (abduction) (adduction) (separation) - see also Fracture, pathological T14.8 bone NEC T14.8 Hematomyelia (central) G95.19 traumatic T14.8 Injury - see also specified injury type T14.90 blast (air) (hydraulic) (immersion) (underwater) T14.8 blood vessel NEC T14.8 specified NEC T14.8 internal T14.8 joint NOS T14.8 limb NEC T14.8 nerve NEC T14.8 peripheral NEC T14.8

Hi.
Coding Insect bites is an example of the complexity and granularity of ICD 10.
You can choose T14.8 which is Other injury of unspecified body region and is purported by CMS to be a billable code. This is the code you would find if you entered insect bite into the I-Magic tool from UMLS it is an ICD 10 codes that is mapped to a SNOMED code.
Or you can be specific. If the bite is toxic choose "Toxic and the vector- spider, ant, wasp,..."T63.451" Toxic effect of venom of hornets, accidental (unintentional)
Or Choose the site of the Injury. ICD 10 groups injuries by site in Chapter 19- "Injury, poisoning and certain other consequences of external causes (S00-T88)"
So an insect bite on the forearm would be input as "right forearm insect bite" this will return a yellow code which requires refining because injuries require the clinician document episode of care.
There are codes within ICD 10 that are considered billable and include the terminology of unspecified. Many billers and coders have been taught not to accept unspecified codes so as to avoid problems with reimbursement. CMS and other sources have addressed the concern around the use of unspecified codes. Individual practices will likely determine their own policy. (I addressed the use of these codes in the AC ICD 10 FAQs on the website). Thank you

The inclusion of episode of care particularly for Injuries( especially fractures) would mean 3 to 7 times as many codes to search through. We felt this would make the Problem search unmanageable . We appreciate hearing about your experiences using the ICD 10 search and will consider your input.Thank you for your patience.