ICD-10-CM Expert for Physicians the Complete Official Code Set Codes Valid from October 1, 2019 Through September 30, 2020

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ICD-10-CM Expert for Physicians The complete official code set Codes valid from October 1, 2019 through September 30, 2020

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ITPS_GITPS20_CVR.indd 1 11/20/18 12:05 PM Contents

Preface ...... iii ICD-10-CM Index to Diseases and Injuries ...... 1 ICD-10-CM Official Preface ...... iii Characteristics of ICD-10-CM ...... iii ICD-10-CM Neoplasm Table ...... 331

What’s New for 20 ...... iv 20 ICD-10-CM Table of Drugs and Chemicals ...... 349 Official Updates ...... iv Proprietary Updates ...... vi ICD-10-CM Index to External Causes ...... 397 Introduction ...... vii History of ICD-10-CM ...... vii ICD-10-CM Tabular List of Diseases and Injuries ...... 433 Chapter 1. Certain Infectious and Parasitic Diseases (A00-B99) ...... 433 How to Use ICD-10-CM Expert for Physicians 2020 ...... viii Use of Official Sources ...... viii Chapter 2. Neoplasms (C00-D49) ...... 457 Steps to Correct Coding ...... viii Chapter 3. Diseases of the Blood and Blood-forming Organs Organization ...... viii and Certain Disorders Involving the Immune Mechanism (D50-D89) ...... 495 Introduction ...... viii Official ICD-10-CM Conventions and Guidelines...... viii Chapter 4. Endocrine, Nutritional and Metabolic Diseases Alphabetic Index to Diseases ...... viii (E00-E89) ...... 505 Neoplasm Table...... viii Chapter 5. Mental, Behavioral, and Neurodevelopmental Table of Drugs and Chemicals ...... viii Disorders (F01-F99) ...... 525 Index to External Causes ...... viii Chapter 6. Diseases of the Nervous System (G00-G99) ...... 549 Tabular List of Diseases ...... viii Chapter 7. Diseases of the Eye and Adnexa (H00-H59) ...... 569 Appendixes...... ix Illustrations...... ix Chapter 8. Diseases of the Ear and Mastoid Process (H60-H95) ...... 605 Chapter 9. Diseases of the Circulatory System (I00-I99) ...... 617 Overview of ICD-10-CM Official Conventions ...... x Format ...... x Chapter 10. Diseases of the Respiratory System (J00-J99) ...... 657 Punctuation ...... x Chapter 11. Diseases of the Digestive System (K00-K95) ...... 671 Abbreviations ...... x Chapter 12. Diseases of the Skin and Subcutaneous Tissue NEC ...... x (L00-L99) ...... 693 NOS...... x Chapter 13. Diseases of the Musculoskeletal System and Typeface ...... x Connective Tissue (M00-M99) ...... 713 General Notes ...... x Chapter 14. Diseases of the Genitourinary System Includes Notes ...... x (N00-N99) ...... 801 Inclusion Terms...... x Chapter 15. Pregnancy, Childbirth, and the Puerperium Excludes Notes...... x (O00-O9A) ...... 819 Note...... xi Chapter 16. Certain Conditions Originating in the Perinatal Default Codes...... xi Period (P00-P96) ...... 857 Syndromes...... xi And ...... xi Chapter 17. Congenital Malformations, Deformations and With ...... xi Chromosomal Abnormalities (Q00-Q99) ...... 869 See and See Also ...... xi Chapter 18. Symptoms, Signs and Abnormal Clinical and Instructional Notes Used in the Tabular List ...... xi Laboratory Findings, Not Elsewhere Code Assignment and Clinical Criteria ...... xi Classified (R00-R99) ...... 887 Chapter 19. Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) ...... 907 Additional Annotations ...... xii Code-Level Notations ...... xii Chapter 20. External Causes of Morbidity (V00-Y99)...... 1113 Italics ...... xii Chapter 21. Factors Influencing Health Status and Contact Color Coding/SymbolsSample ...... xii PageWith Health Services (Z00-Z99) ...... 1175 Other Code-Level Notations...... xiii Chapter-Level Notations ...... xiii Appendixes ...... Appendixes–1 Chapter-Specific Guidelines with Coding Examples...... xiii Appendix A: 10 Steps to Correct Coding ...... Appendixes–1 Muscle and Tendon Table...... xiii Appendix B: Valid 3-character ICD-10-CM Codes...... Appendixes–3 Index Notations ...... xiv Appendix C: Pharmacology List 2018...... Appendixes–5 Following References ...... xiv Appendix D: Z Codes for Long-Term Drug Use with Associated Drugs ...... Appendixes–23 ICD-10-CM Official Guidelines for Coding Appendix E: Z Codes Only as Principal/First-Listed and Reporting ...... Coding Guidelines–1 Diagnosis ...... Appendixes–27

ICD-10-CM 2019 i ICD-10-CM 2020 Madness

Lymphangitis — continued Lymphogranulomatosis (malignant) (see also Lym- Lymphoma — continued Index acute — continued phoma, Hodgkin) non-leukemic variant of B-CLL C83.0- S hip — see Lymphangitis, acute, lower limb benign (Boeck's sarcoid) (Schaumann's) D86.1 peripheral T-cell, not classified C84.4- S jaw (region) L03.212 Lymphohistiocytosis, hemophagocytic(familial) D76.1 primary cutaneous knee — see Lymphangitis, acute, lower limb Lymphoid — see condition anaplastic large cell C86.6 leg — see Lymphangitis, acute, lower limb Lymphoma (of) (malignant) C85.90 CD30-positive large T-cell C86.6 lower limb L03.12- S adult T-cell (HTLV-1-associated) (acute variant) primary effusion B-cell C83.8- S toe — see Lymphangitis, acute, toe (chronic variant) (lymphomatoid variant) SALT C88.4 navel L03.326 (smouldering variant) C91.5- S skin-associated lymphoid tissue [SALT-lymphoma] neck (region) L03.222 anaplastic large cell C88.4 orbit, orbital — see Cellulitis, orbit ALK-negative C84.7- S small cell B-cell C83.0- S pectoral (region) L03.323 ALK-positive C84.6- S splenic marginal zone C83.0- S perineal, perineum L03.325 CD30-positive C84.6- S subcutaneous panniculitis-like T-cell C86.3 scalp (any part) L03.891 primary cutaneous C86.6 T-precursor C83.5- S shoulder — see Lymphangitis, acute, upper limb angioimmunoblastic T-cell C86.5 true histiocytic C96.A (following C96.6) specified site NEC L03.898 BALT C88.4 Lymphomatosis — see Lymphoma thigh — see Lymphangitis, acute, lower limb B-cell C85.1- S Lymphopathia venereum, veneris A55 thumb (intrathecal) (periosteal) (subcutaneous) blastic NK-cell C86.4 Lymphopenia D72.810 (subcuticular) — see Lymphangitis, acute, blastic plasmacytoid dendritic cell neoplasm (BPDCN) Lymphoplasmacytic leukemia — see Leukemia, finger C86.4 chronic lymphocytic, B-cell type toe (intrathecal) (periosteal) (subcutaneous) (sub- B-precursor C83.5- S Lymphoproliferation, X-linked disease D82.3 cuticular) L03.04- S bronchial-associated lymphoid tissue [BALT-lym- Lymphoreticulosis, benign (of inoculation) A28.1 trunk L03.329 phoma] C88.4 Lymphorrhea I89.8 abdominal wall L03.321 Burkitt (atypical) C83.7- S Lymphosarcoma (diffuse) (see also Lymphoma) back (any part) L03.322 Burkitt-like C83.7- S C85.9- S buttock L03.327 centrocytic C83.1- S Lymphostasis I89.8 chest wall L03.323 cutaneous follicle center C82.6- S Lypemania — see Melancholia groin L03.324 cutaneous T-cell C84.A- S (following C84.7) Lysine and hydroxylysine metabolism disorder E72.3 perineal, perineum L03.325 diffuse follicle center C82.5- S Lyssa — see Rabies umbilicus L03.326 diffuse large cell C83.3- S umbilicus L03.326 anaplastic C83.3- S upper limb L03.12- S B-cell C83.3- S M axilla — see Lymphangitis, acute, axilla CD30-positive C83.3- S Macacus ear Q17.3 finger — see Lymphangitis, acute, finger centroblastic C83.3- S Maceration, wet feet, tropical (syndrome) T69.02- S thumb — see Lymphangitis, acute, finger immunoblastic C83.3- S MacLeod's syndrome J43.0 wrist — see Lymphangitis, acute, upper limb plasmablastic C83.3- S Macrocephalia, macrocephaly Q75.3 breast subtype not specified C83.3- S Macrocheilia, macrochilia (congenital) Q18.6 gestational — see Mastitis, obstetric T-cell rich C83.3- S chancroidal A57 Macrocolon (see also Megacolon) Q43.1 enteropathy-type (associated) (intestinal) T-cell C86.2 Macrocornea Q15.8 chronic (any site) I89.1 extranodal marginal zone B-cell lymphoma of mucosa- due to with glaucoma Q15.0 associated lymphoid tissue [MALT-lymphoma] Macrocytic — see condition Brugia (malayi) B74.1 C88.4 timori B74.2 Macrocytosis D75.89 extranodal NK/T-cell, nasal type C86.0 Macrodactylia, macrodactylism (fingers) (thumbs) Wuchereria bancrofti B74.0 follicular C82.9- S following ectopic or molar pregnancy O08.89 Q74.0 grade toes Q74.2 penis I C82.0- S acute N48.29 Macrodontia K00.2 II C82.1- S gonococcal (acute) (chronic) A54.09 Macrogenia M26.05 S puerperal, postpartum, childbirth O86.89 III C82.2- Macrogenitosomia (adrenal) (male) (praecox) E25.9 strumous, tuberculous A18.2 IIIa C82.3- S congenital E25.0 subacute (any site) I89.1 IIIb C82.4- S Macroglobulinemia (idiopathic) (primary) C88.0 tuberculous — see Tuberculosis, lymph gland specified NEC C82.8- S monoclonal (essential) D47.2 Lymphatic (vessel) — see condition hepatosplenic T-cell (alpha-beta) (gamma-delta) C86.1 Waldenström C88.0 Lymphatism E32.8 histiocytic C85.9- S Macroglossia (congenital) Q38.2 Lymphectasia I89.0 true C96.A (following C96.6) acquired K14.8 Lymphedema (acquired) (see also Elephantiasis) Hodgkin C81.9 S Macrognathia, macrognathism (congenital) congenital Q82.0 lymphocyte depleted (classical) C81.3- S (mandibular) (maxillary) M26.09 hereditary (chronic) (idiopathic) Q82.0 lymphocyte-rich (classical) C81.4- S Macrogyria (congenital) Q04.8 postmastectomy I97.2 mixed cellularity (classical) C81.2- S Macrohydrocephalus — see Hydrocephalus praecox I89.0 nodular Macromastia — see Hypertrophy, breast secondary I89.0 lymphocyte predominant C81.0- S Macrophthalmos Q11.3 surgical NEC I97.89 sclerosis (classical) C81.1- S in congenital glaucoma Q15.0 postmastectomy (syndrome) I97.2 nodular sclerosis (classical) C81.1- S Macropsia H53.15 Lymphoblastic — see condition specified NEC (classical) C81.7- S Macrosigmoid K59.39 Lymphoblastoma (diffuse) — see Lymphoma, lym- intravascular large B-cell C83.8- S congenital Q43.2 phoblastic (diffuse) Lennert's C84.4- S Macrospondylitis , acromegalic E22.0 giant follicular — see Lymphoma, lymphoblastic (dif- lymphoblastic (diffuse) C83.5- S Macrostomia (congenital) Q18.4 fuse) lymphoblastic B-cell C83.5- S Macrotia (external ear) (congenital) Q17.1 macrofollicular — see Lymphoma, lymphoblastic lymphoblastic T-cell C83.5- S Macula (diffuse) lymphoepithelioid C84.4- S cornea, corneal — see Opacity, cornea Lymphocele I89.8 lymphoplasmacytic C83.0- S degeneration (atrophic) (exudative) (senile) (see also Lymphocytic with IgM-production C88.0 Degeneration, macula) chorioencephalitis (acute) (serous) A87.2 MALT C88.4 hereditary — see Dystrophy, retina

choriomeningitis (acute) (serous) A87.2 mantle cell C83.1- S Maculae ceruleae B85.1 — Madness Lymphangitis meningoencephalitis A87.2 Samplemature T-cell NEC C84.4- S PageMaculopathy, toxic — see Degeneration, macula, toxic Lymphocytoma, benign cutis L98.8 mature T/NK-cell C84.9- S Madarosis (eyelid) H02.729 Lymphocytopenia D72.810 specified NEC C84.Z- S (following C84.7) left H02.726 Lymphocytosis (symptomatic) D72.820 mediastinal (thymic) large B-cell C85.2- S lower H02.725 infectious (acute) B33.8 Mediterranean C88.3 upper H02.724 Lymphoepithelioma — see Neoplasm, malignant, by mucosa-associated lymphoid tissue [MALT-lymphoma] right H02.723 site C88.4 lower H02.722 Lymphogranuloma (malignant) (see also Lymphoma, NK/T cell C84.9- S upper H02.721 Hodgkin) nodal marginal zone C83.0- S Madelung's chlamydial A55 non-follicular (diffuse) C83.9- S deformity (radius) Q74.0 inguinale A55 specified NEC C83.8- S disease venereum (any site) (chlamydial) (with stricture of non-Hodgkin (see also Lymphoma, by type) C85.9- S radial deformity Q74.0 rectum) A55 specified NEC C85.8- S symmetrical lipomas, neck E88.89 Madness — see Psychosis

2 Subterms under main terms may continue to next column or page S Additional Character Required — Refer to the Tabular List for Character Selection 215 Chapter 3. Disease of the Blood and Blood-Forming Organs D63–D68.311 499 < < < < < <

Fibrin Injury site D63–D68.311 circulating circulating Revised CodeTitle s intrinsic New Code Platelets l clotting factors clotting Autoimmune hemophilia Autoimmune inhibitors to clotting factors hemophilia Secondary deficiency Acquired hemophilia Acquired Revised Text Revised Coagulation deficiency capillary fragility (hereditary) (D69.8) (hereditary) fragility capillary (D66) NOS deficiency VIII factor (D66) defect functional with deficiency VIII factor wx

pregnancy (O00-O07, O08.1) puerperium (O45.0, O46.0, O67.0, O72.3) anticoagulants, antibodies, anticoagulants, inhibitors or antibodies, D68.311 tor VIII deficiency VIII tor IX tor Abnormal blood coagulation caused by deficient blood blood deficient by caused coagulation blood Abnormal factor VIII deficiency with vascular defect (D68.0) defect vascular with deficiency VIII factor (R79.1) profile coagulation abnormal molar or ectopic or abortion complicating defects coagulation the and childbirth pregnancy, complicating defects coagulation Red blood cells Angiohemophilia defect vascular with deficiency VIII Factor Vascular hemophilia 1 DEF: factor VII; congenital; symptoms include excess or prolonged bleeding. Hemophilia C deficiency [PTA] antecedent thromboplastin Plasma disease Rosenthal’s AC globulin deficiency afibrinogenemia Congenital [fibrinogen] I factor ofDeficiency [prothrombin] II factor Deficiency of factorDeficiency V [labile] of [stable] factor VII Deficiency of X [Stuart-Prower] factor Deficiency of [Hageman] XII factor Deficiency of stabilizing]factorDeficiency [fibrin XIII of (congenital) Dysfibrinogenemia Hypoproconvertinemia disease Owren's Proaccelerin deficiency Hereditary factor XI factor Hereditary D68.31 Hemorrhagic disorder due to 2016, 1Q, 14 1Q, 2016, Hereditary, sex-linked lack of antihemophilic globulin (AHG) (factor AHA: d Classical hemophilia Classical defect) (with functional VIII Deficiency factor Hemophilia A Hemophilia NOS 1 DEF: VIII); causes abnormal coagulation characterized by increased bleeding, tract; gastrointestinal nose, mouth, in bleeding skin, of large bruises function. and impaired in swelling resulting joints, into hemorrhages disease Christmas defect) functional (with deficiency IX Factor Hemophilia B [PTC] deficiency component Plasma thromboplastin 1 White blood cell White Unspecified Code D68.2 of other deficiency Hereditary D68.0disease Willebrand's Von D68.1 D68.3 to anticoagulants due Hemorrhagic disorder circulating Hereditary fac Hereditary fac Hereditary B c D66 D67 D68 defects coagulation Other b B < < < < < CMS-HCC ConditionCMS-HCC < Chapter 3. Disease of the Blood and Blood-Forming Organs and Blood-Forming theof Blood 3. Disease Chapter e puerperium (O45.0, O46.0, O46.0, (O45.0, e puerperium due to drugsandtoxins due to disease to due

anemia chemotherapy (D61.1) chemotherapy x

anemia antineoplastic chemotherapy anemia anemia anemia in neoplastic disease (D63.0) in neoplastic anemia aplastic anemia due to antineoplastic antineoplastic due to anemia aplastic anemias (D64.81) Page Sample (D61.1) 2014, 4Q, 22 4Q, 2014, (D65-D69) chronic diseases classified elsewhere Reversible adverse effect of chemotherapy, of chemotherapy, effect adverse Reversible Placeholder Alert Placeholder Manifestation Blackfan-Diamond syndrome (D61.01) syndrome Blackfan-Diamond Di Guglielmo's disease (C94.0) anemia due to antineoplastic chemotherapy (D64.81) chemotherapy to antineoplastic due anemia chemotherapy antineoplastic due to anemia aplastic anemia due to antineoplastic chemotherapy chemotherapy to antineoplastic anemia due O67.0, O72.3) O67.0, Antineoplastic chemotherapy induced anemia 2 AHA: DEF: causing inhibition of bone marrow production; decrease adequate prevents production cell blood red in oxygenation of the tissues and organs causing fatigue, conditions. medical of other and exacerbation SOB, 1 Infantile pseudoleukemia Infantile w g neoplastic disease disease kidney chronic [RAEB T] (C92.0-) [RAEB 2017, 1Q, 7 1Q, 2017, abortion or ectopic or molar pregnancy (O00-O07, O08.1) (P60) newborn in th pregnancy, and childbirth with fifth or sixth character 1-4 or 6) or sixth character fifth with 5) character sixth or fifth with (T36-T50 drug

sideroblastic q disseminated intravascular coagulation (complicating): coagulation intravascular disseminated refractory anemia (D46.-) anemia refractory transformation blasts in excess with anemia refractory diphyllobothriasis (B70.0) (B76.0-B76.9) disease hookworm hypothyroidism (E00.0-E03.9) (B50.0-B54) malaria (A52.79) syphilis late symptomatic (A18.89) tuberculosis Re Code first underlying disease, such as: such disease, underlying Code first Dyshematopoietic anemia(congenital) Code first neoplasm (C00-D49) neoplasm first Code anemia) resistant (EPO anemia resistant Erythropoietin (CKD) (N18.-)disease kidney underlying chronic Codefirst AHA: Code first poisoningdrug dueor to toxin,applicable if (T36-T65 identify to applicable, if effect, adverse for code additional Use NOS anemia Sideroblastic NEC anemia sideroblastic Pyridoxine-responsive 1 Sex-linked hypochromic sideroblastic anemia sideroblastic hypochromic Sex-linked underlying disease Code first 1 2 Congenital dyserythropoietic Secondary sideroblastic sideroblastic Secondary Hereditary sideroblastic Hereditary D64.81 Anemia due to D64.89 Other specified anemias 1 Afibrinogenemia, acquired Afibrinogenemia, coagulopathy Consumption Diffuse ordisseminated intravascular coagulation[DIC] Fibrinolytic hemorrhage, acquired Fibrinolytic purpura fulminans Purpura 1 D63.8 Anemia other in D64.3 Other D64.4 D64.1 D64.2 syndrome] D64.0 D64.8 anemias specified Other D63.1 Anemia in D63.0 Anemia in D64.9 Anemia, unspecified c D65 [defibrination coagulation intravascular Disseminated D64 Other anemias D63 elsewhere classified diseases chronic in Anemia Additional Character Coagulation defects, purpura and other hemorrhagic conditions b b ICD-10-CM 2020 S 2020 ICD-10-CM Chapter 10. Diseases of the Respiratory System 657

Guidelines and Examples and Guidelines iratory failure is a manifestation of manifestation is a iratory failure to whether acute respiratory failure failure respiratory acute whether to her identified influenza, then the Acute respiratory failure, unspecified whether with unspecified whether failure, respiratory Acute or hypercapnia hypoxia pneumoniae Pneumonia Streptococcus due to Poisoning by other opioids, accidental (unintentional), encounter initial whether with unspecified failure, respiratory Acute or hypercapnia hypoxia : When a patient is seen for respiratory failure and another and another failure respiratory for is seen a patient When : : Respiratory failure may be assigned as a principal diagnosis principal a as be assigned may Respiratoryfailure : ) may be applied be in these) may situations. Patient presents with acute pneumococcal pneumonia and acute acute and pneumonia pneumococcal acute with presents Patient respiratory failure J96.00 J13 Explanation acute condition, such as a bacterial pneumonia, the principal or every appliessame This in is not the situation. diagnosis first-listed nonrespiratory or respiratory a is condition acute the other whether chiefly the problem diagnosis dependsprincipal on The condition. encounter. the for responsible Acute respiratoryAcute failure due accidentalto oxycodone overdose T40.2X1A J96.00 Explanation itwhen is the condition established after study to be chiefly responsible and occasioning thefor theselection encounter, is supported by the chapter-specificAlphabetic Index List.coding However, and Tabular provide sequencingthatdirection poisoning, take such as guidelines, use improper the to or reaction poisoning a coding When precedence. wrong or taken in substance given error, overdose, of a medication (e.g. from the appropriate code firstof assign administration), route wrong categoriesT36–T50. Use additional code(s) forall manifestations of the Inpoisoning. this instance, the resp poisoning secondaryasis sequencedthe a and diagnosis. Section II, C. (J00–J99) When a patient is admitted with respiratory failure and another acute acute another and failure respiratory with is admitted When a patient accident, infarction, cerebrovascular myocardial condition, (e.g., in same be not the will diagnosis the principal pneumonia), aspiration every situation. This applies whether the other conditionacute is a respiratory or nonrespiratory Selectioncondition. of the principal If bothof admission. diagnosis will be circumstances dependent on the the respiratory failure and the other acute condition are equally occasioningand responsiblethe are there admission to the hospital, for or two guideline regarding the sequencing rules, chapter-specific no more diagnoses equally that the meet definition principalfor diagnosis ( If the documentation is not clear as is not clear documentation If the the occasioning for responsible equally are condition and another admission, query the provider for clarification. 3) another and acute condition respiratoryacute failure Sequencing of Code only confirmed cases of influenza due to certain identified influenza (category virus influenza identified other to due and J09), (category viruses hospitalthe inpatient guideline to SectionH. exception is an II, J10).This (Uncertain Diagnosis). documentationof positiverequire not does “confirmation” In this context, laboratory avian or other influenza A or novel testing specific for other coding should be basedidentified on influenzathe provider’s However, virus. other novel or influenza, avian has the patient that diagnostic statement influenza A, categoryfor J09, or has another particular identified ofstrain for or variant,influenza,H3N2, H1N1 but such as or not identified novel as J10. category avian “probable” or or “possible” “suspected” If provider records the ot or influenza, novel or influenza, unidentified to due Influenza J11, category from code influenza appropriate due Influenza categoryJ09, from A code assigned. be should virus, influenza nor shouldassigned a shouldto certain influenza not beidentified viruses, virus. influenza identified to other due Influenza J10, category from code c. viruses influenza identified Influenza certain to due Diseases of the Respiratory System Respiratory the of Diseases Chapter 10.

-CM Official Guidelines for

0 exacerbation,and those with status -CM uses combination codes to create create combination to -CM codes uses Page Sample 0 Moderate persistent asthma asthmaticus status persistent with Moderate Acute respiratory failure with hypoxia failure respiratory Acute Chronic obstructive pulmonary disease with (acute) exacerbation Acute bronchitis due streptococcus to obstructiveChronic pulmonary disease with acute lower respiratory infection Chronic obstructive pulmonary disease with (acute) exacerbation : Category J96 withclassifies failure respiratory combination : ICD-1 : Category J45 Asthma includes severity-specific organism-specific classifications for acute bronchitis. Category J44 J44 Category bronchitis. acute for classifications organism-specific codes include combination codes with severity whichcomponents, betweenwith respiratory acute COPDdifferentiate infection lower withoutexacerbation, withand (acute acute bronchitis),COPD COPD (unspecified). complication a of mention codes that designate the severity and the presence of hypoxia and as diagnosis, first-listed the as sequenced is J96.01 Code hypercapnia. a as be assigned may failure Respiratory encounter. the for reason the principalcondition diagnosis it is the when established to be after study and selection the is encounter occasioning the for chiefly responsible List. Tabular and Index Alphabetic the by supported J96.01 J44.1 Explanation Acute hypoxic respiratory failure due to exacerbation of chronic chronic of exacerbation to due failure respiratory hypoxic Acute obstructive bronchitis J45.42 Explanation asthmaticus. An acute exacerbation is a worsening or a decompensation of a chronic a of chronic a decompensation or a worsening is exacerbation An acute infectioncondition.is not equivalentto an exacerbation An acute superimposedcondition, thoughmay exacerbation be an chronic on a triggered by an infection, as in this example. Exacerbation of moderate persistent asthma with status asthmaticus between to distinguish codes fifth-character and subcategories acute in those cases, uncomplicated J44.1 Explanation Acute Acute streptococcal bronchitis with acute exacerbation of COPD J20.2 J44.0 The codesThe in categories J44 and J45 distinguish between uncomplicated a is exacerbation acute An exacerbation. acute in those and cases worsening or a decompensation of a chronic condition. An acute chronic on a superimposed infection to an not equivalent is exacerbation condition, though an exacerbation may be triggered by an infection. Respiratory may failure be listeda as secondary it diagnosis after if occurs admission, or if it is present on admission, but does not meet the definition of principal diagnosis. A code from subcategory J96.0,Acute respiratoryfailure, or subcategory a principal as assigned be may failure, respiratory chronic and Acute J96.2, diagnosis when it is the condition established after study to be chiefly the and hospital, the admission the to occasioning for responsible However, List. Tabular and Index Alphabetic the by is supported selection chapter-specific coding guidelines (such as obstetrics, HIV, poisoning, newborn) that provide sequencing direction precedence. take 1) and asthma bronchitis obstructive exacerbation of chronic Acute 2) Acute respiratory failure as secondary diagnosis 1) diagnosis as failure principal respiratory Acute The chapter specific guidelines from the ICD-1the chapter guidelines specific from The Chapter 10. Diseases of the Respiratory System System Respiratory the of 10. Diseases Chapter Examples Coding with Guidelines Specific Chapter Coding and Reporting Along have been with theseprovided below. guidelines developed been have that boxes, shaded the in contained examples, coding are helptheto illustrate coding sequencing and/or in these found guidance guidelines. a. pulmonary Chronic obstructive [COPD] disease asthma and ICD-10-CM 2020 ICD-10-CM 2020 ICD-10-CM b. failure respiratory Acute S05.5–S06.303 Chapter 19. Injury, Poisoning, and Certain Other Consequences of External Causes ICD-10-CM 2020 c S05.5 Penetrating wound with foreign body of eyeball 2 e S06.1X3 Traumatic cerebral edema with loss of < 2 retained (old) intraocular foreign body (H44.6-, H44.7) consciousness of 1 hour to 5 hours 59 B minutes g S05.50 Penetrating wound with foreign body of 2 unspecified eyeball e S06.1X4 Traumatic cerebral edema with loss of < consciousness of 6 hours to 24 hours g S05.51 Penetrating wound with foreign body of right 2 eyeball e S06.1X5 Traumatic cerebral edema with loss of < consciousness greater than 24 hours g S05.52 Penetrating wound with foreign body of left eyeball with return to pre-existing conscious c S05.6 Penetrating wound without foreign body of eyeball level Ocular penetration NOS 2 e S06.1X6 Traumatic cerebral edema with loss of < g S05.60 Penetrating wound without foreign body of B consciousness greater than 24 hours unspecified eyeball without return to pre-existing conscious level with patient surviving g S05.61 Penetrating wound without foreign body of right eyeball e S06.1X7 Traumatic cerebral edema with loss of consciousness of any duration with death g S05.62 Penetrating wound without foreign body of left due to brain injury prior to regaining eyeball consciousness c S05.7 Avulsion of eye e S06.1X8 Traumatic cerebral edema with loss of Traumatic enucleation consciousness of any duration with death g S05.70 Avulsion of unspecified eye B due to other cause prior to regaining g S05.71 Avulsion of right eye consciousness 2 S06.1X9 Traumatic cerebral edema with loss B S05.72 Avulsion of left eye e < g of consciousness of unspecified duration c S05.8 Other injuries of eye and orbit Traumatic cerebral edema NOS Lacrimal duct injury c S06.2 Diffuse traumatic brain injury d S05.8X Other injuries of eye and orbit Diffuse axonal brain injury e S05.8X1 Other injuries of right eye and orbit 1 traumatic diffuse cerebral edema (S06.1X-) e S05.8X2 Other injuries of left eye and orbit d S06.2X Diffuse traumatic brain injury e S05.8X9 Other injuries of unspecified eye B 2 e S06.2X0 Diffuse traumatic brain injury < and orbit without loss of consciousness c S05.9 Unspecified injury of eye and orbit 2 e S06.2X1 Diffuse traumatic brain injury with < Injury of eye NOS loss of consciousness of 30 minutes g S05.90 Unspecified injury of unspecified eye and orbit B or less 2 S05.91 Unspecified injury of right eye and orbit B e S06.2X2 Diffuse traumatic brain injury with < g loss of consciousness of 31 minutes to g S05.92 Unspecified injury of left eye and orbit B 59 minutes b S06 Intracranial injury 2 e S06.2X3 Diffuse traumatic brain injury with < 0 w7th characters D and S do not apply to codes in category S06 loss of consciousness of 1 hour to with 6th character 7 – death due to brain injury prior to 5 hours 59 minutes regaining consciousness, or 8 – death due to other cause 2 e S06.2X4 Diffuse traumatic brain injury with < prior to regaining consciousnessx loss of consciousness of 6 hours to 24 1 traumatic brain injury hours Code also any associated: 2 Chapter 19. Injury, Poisoning, and Certain Other Consequences of External Causes of External Other Consequences Certain and Poisoning, 19. Injury, Chapter e S06.2X5 Diffuse traumatic brain injury with < open wound of head (S01.-) loss of consciousness greater than 24 skull fracture (S02.-) hours with return to pre-existing 1 head injury NOS (S09.90) conscious levels AHA: 2017, 1Q, 42; 2015, 3Q, 37 2 e S06.2X6 Diffuse traumatic brain injury with < The appropriate 7th character is to be added to each code from loss of consciousness greater than 24 category S06. hours without return to pre-existing A initial encounter conscious level with patient surviving D subsequent encounter e S06.2X7 Diffuse traumatic brain injury with Ssequela loss of consciousness of any duration with death due to brain injury prior to c S06.0 Concussion regaining consciousness Commotio cerebri concussion with intracranial injuries classified in e S06.2X8 Diffuse traumatic brain injury with 1 loss of consciousness of any duration subcategories S06.1- to S06.6-, S06.81-, S06.82- with death due to other cause prior to code to specified intracranial injury regaining consciousness d S06.0X Concussion 2 e S06.2X9 Diffuse traumatic brain injury with

2 HCC with 7th character indicating initial encounter (A or B - specific to category) OR sequela. 3 HCC with 7th character indicating sequela. S05.5–S06.303 1 Not coded here 2 Not included here 8 Newborn Age: 0 9 Pediatric Age: 0-17 x Maternity Age: 12-55 y Adult Age: 15-124 920 ICD-10-CM 2020 ICD-10-CM 2020 Illustrations Chapter 10. Diseases of the Respiratory System (J00–J99)

Respiratory System

Sample Page

ICD-10-CM 2020 Illustrations–27