Coding Rules Published from Sep 2007 to Sep 2018 – Updated As at 30 June 2019

Total Page:16

File Type:pdf, Size:1020Kb

Coding Rules Published from Sep 2007 to Sep 2018 – Updated As at 30 June 2019 Australian Classification Exchange Coding Rules Published from Sep 2007 to Sep 2018 – Updated as at 30 June 2019 Contents Clot retention secondary to transurethral resection of the prostate (TURP) ................................................... 3 Current complications of AMI ........................................................................................................................... 4 Acute urinary retention due to clot obstruction in urinary catheters .............................................................. 5 Pre-op Workup .................................................................................................................................................. 6 Mollaret meningitis ........................................................................................................................................... 8 Assignment of specific sepsis codes with or without positive blood culture on pathology ............................. 9 Nicotine dependence tests .............................................................................................................................. 10 Short gut syndrome (short bowel syndrome) ................................................................................................. 11 Drug-induced conditions ................................................................................................................................. 12 Endoscopic cystogastrostomy ......................................................................................................................... 14 Rectus sheath haematoma secondary to overwarfarinisation ....................................................................... 15 Recurrent post procedural wound infection due to mesh .............................................................................. 16 Acquired brain injury (ABI) NOS ...................................................................................................................... 17 Mast Cell Activation Syndrome ....................................................................................................................... 18 Neonatal hypoglycaemia in infant of diabetic mother .................................................................................... 19 Osseointegration of limb implants on amputees ............................................................................................ 20 Facial palsy due to lacunar syndrome, injury, tumours or other disorders .................................................... 21 Y95 Nosocomial condition ............................................................................................................................... 23 CPR related injuries ......................................................................................................................................... 24 Selection of morphology codes from pathology reports ................................................................................ 25 Dialysis dysequilibrium syndrome ................................................................................................................... 26 Lords plication of hydrocele ............................................................................................................................ 27 Non accidental injury ....................................................................................................................................... 28 Same-day admissions for chemotherapy/pharmacotherapy for neoplasm(s) and neoplasm related conditions ........................................................................................................................................................ 29 Retinal artery occlusion ................................................................................................................................... 30 Basilar artery coiling ........................................................................................................................................ 31 Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) ...................................................... 32 Injection of sclerosing agent with aspiration of hydrocele ............................................................................. 33 External cause code for complication of percutaneous angioplasty with stenting of coronary arteries ....... 34 Insertion of leadless/transvenous pacemaker ................................................................................................ 35 Lymph node neck dissection ........................................................................................................................... 36 Incision and drainage of abscess with curettage............................................................................................. 37 Conditions described as secondary to or due to ............................................................................................. 38 External cause code for allergic reaction to over the counter hair dye .......................................................... 39 Zika virus; use of WHO code for emergency use ............................................................................................. 40 Elevated PSA .................................................................................................................................................... 41 Coblation of the laryngotrachea ...................................................................................................................... 42 Coding Rules - Current as at 17-Sep-2019 04:19 Page 1 of 79 Australian Classification Exchange Coding Rules Published from Sep 2007 to Sep 2018 – Updated as at 30 June 2019 Drug-induced anaemia .................................................................................................................................... 43 Same-day chemotherapy for neoplasm; participant in clinical drug trial ....................................................... 44 Gastroenteritis or diarrhoea due to Norovirus ............................................................................................... 45 E13 Other specified diabetes mellitus.............................................................................................................. 46 Thrombectomy and embolectomy of multiple arteries .................................................................................. 47 Middle East Respiratory Syndrome (MERS) .................................................................................................... 48 Paediatric Autoimmune Neuropsychiatric Disorders (PANDAS) ..................................................................... 49 Catheterisation and cannulation in neonates ................................................................................................. 50 Excision of neuroblastoma .............................................................................................................................. 51 Necrotic leg ulcer with diabetes mellitus and peripheral vascular disease (PVD) .......................................... 52 Contrast induced acute kidney failure (injury) ................................................................................................ 54 Confusion or delirium with dementia ............................................................................................................. 55 Intraoperative floppy iris syndrome (IFIS) ....................................................................................................... 57 Donor Lymphocyte Infusion ............................................................................................................................ 58 Skin Necrosis .................................................................................................................................................... 59 Removal of urethral sling following male stress incontinence procedure ...................................................... 60 CIN III as principal diagnosis and indication for LLETZ procedure ................................................................... 61 Principal diagnosis for prophylactic PEG insertion prior to oropharyngeal radiation therapy ....................... 62 Z03 Medical observation and evaluation for suspected diseases and conditions ........................................... 63 Ultrasound guided compression of pseudoaneurysm .................................................................................... 64 Alternating hemiplegia of childhood ............................................................................................................... 65 Banding of GAVE at gastroscopy ..................................................................................................................... 66 Same-day admission for both radiotherapy and chemotherapy .................................................................... 67 Healthcare associated Staphylococcus aureus bacteraemia (HA SAB) (2 of 2) ............................................... 68 Clinical diagnosis versus histology ................................................................................................................... 69 Morphology of recurrent mediastinal tumour ................................................................................................ 70 Principal diagnosis for insertion of fiducial markers (use of Z51.4 Preparatory care for subsequent
Recommended publications
  • Educational Achievement and Economic Self-Sufficiency in Adults After Childhood Bacterial Meningitis
    1 Supplementary Online Content Roed C, Omland LH, Skinhoj P, Rothman KJ, Sorensen HT, Obel N. Educational achievement and economic self-sufficiency in adults after childhood bacterial meningitis. JAMA. doi:10.1001/jama.2013.3792 Appendix 1. Description of Registries Appendix 2. Diagnosis Codes for Intrauterine and Birth Asphyxia or Chromosomal Abnormalities Appendix 3. Diagnosis Codes for Meningococcal, Pneumococcal, Or H influenzae Meningitis Appendix 4. Diagnosis Codes for Neuroinfections Other Than Bacterial Meningitis eTable 1. Number of Events in the Study Population and Total Observation Time eTable 2. Estimated Prevalence at Age 35 of Vocational Education, High School, Higher Education, Economic Self‐sufficiency and Disability pension Among Meningitis Patients, Members of the Population Comparison Cohorts, and Their Siblings Without Neonatal Morbidity eFigure 1. Cumulative Incidence of Having Been Economically Self‐sufficient for a Year and of Receiving Disability Pension in the Meningococcal, Pneumococcal and H. influenzae Meningitis Patients (Black), Members of the Population Comparison Cohort (Red), Full Siblings of Patients (Green) and Siblings of Members of the Population Comparison Cohort (Blue) eFigure 2. Cumulative Incidence of Vocational Education, High School and Higher Education for Meningococcal, Pneumococcal and H. influenzae Meningitis Patients (Black), Members of the Population Comparison Cohort (Red), Full Siblings of Patients (Green) and Full Siblings of Members of the Population Comparison Cohort (Blue) Born Before 1980 eFigure 3. Cumulative Incidence of Vocational Education, High School and Higher Education for Meningococcal, Pneumococcal and H. influenzae Meningitis Patients (Black), Members of the Population Comparison Cohort (Red), Full Siblings of Patients (Green) and Full Siblings of Members of the Population Comparison Cohort (Blue) Born After 1980 This supplementary material has been provided by the authors to give readers additional information about their work.
    [Show full text]
  • SNF Mobility Model: ICD-10 HCC Crosswalk, V. 3.0.1
    The mapping below corresponds to NQF #2634 and NQF #2636. HCC # ICD-10 Code ICD-10 Code Category This is a filter ceThis is a filter cellThis is a filter cell 3 A0101 Typhoid meningitis 3 A0221 Salmonella meningitis 3 A066 Amebic brain abscess 3 A170 Tuberculous meningitis 3 A171 Meningeal tuberculoma 3 A1781 Tuberculoma of brain and spinal cord 3 A1782 Tuberculous meningoencephalitis 3 A1783 Tuberculous neuritis 3 A1789 Other tuberculosis of nervous system 3 A179 Tuberculosis of nervous system, unspecified 3 A203 Plague meningitis 3 A2781 Aseptic meningitis in leptospirosis 3 A3211 Listerial meningitis 3 A3212 Listerial meningoencephalitis 3 A34 Obstetrical tetanus 3 A35 Other tetanus 3 A390 Meningococcal meningitis 3 A3981 Meningococcal encephalitis 3 A4281 Actinomycotic meningitis 3 A4282 Actinomycotic encephalitis 3 A5040 Late congenital neurosyphilis, unspecified 3 A5041 Late congenital syphilitic meningitis 3 A5042 Late congenital syphilitic encephalitis 3 A5043 Late congenital syphilitic polyneuropathy 3 A5044 Late congenital syphilitic optic nerve atrophy 3 A5045 Juvenile general paresis 3 A5049 Other late congenital neurosyphilis 3 A5141 Secondary syphilitic meningitis 3 A5210 Symptomatic neurosyphilis, unspecified 3 A5211 Tabes dorsalis 3 A5212 Other cerebrospinal syphilis 3 A5213 Late syphilitic meningitis 3 A5214 Late syphilitic encephalitis 3 A5215 Late syphilitic neuropathy 3 A5216 Charcot's arthropathy (tabetic) 3 A5217 General paresis 3 A5219 Other symptomatic neurosyphilis 3 A522 Asymptomatic neurosyphilis 3 A523 Neurosyphilis,
    [Show full text]
  • New Emergency Room Requirement for Hospital and Autopay List of Diagnosis Codes
    Provider update New emergency room requirement for hospitals Dell Children’s Health Plan reviewed our emergency room (ER) claims data and identified numerous reimbursements for services with diagnoses that are not indicative of urgent or emergent conditions. As a managed care organization, we promote the provision of services in the most appropriate setting and reinforce the need for members to coordinate care with their PCP unless the injury or sudden onset of illness requires immediate medical attention. Effective on or after August 1, 2020, for nonparticipating hospitals and on or after October 1, 2020, for participating hospitals, Dell Children’s Health Plan will only process an ER claim for a hospital as emergent and reimburse at the applicable contracted rate or valid out‐ of‐network Medicaid fee‐for‐service rate when a diagnosis from a designated auto‐pay list is billed as the primary diagnosis on the claim. If the primary diagnosis is not on the auto‐pay list, the provider must submit medical records with the claim. Upon receipt, the claim and records will be reviewed by a prudent layperson standard to determine if the presenting symptoms qualify the patient’s condition as emergent. If the reviewer confirms the visit was emergent, according to the prudent layperson criteria, the claim will pay at the applicable contracted rate or valid out‐of‐network Medicaid fee‐for‐service rate. If it is determined to be nonemergent, the claim will pay a triage fee. In the event a claim from a hospital is submitted without a diagnosis from the auto‐pay list as the primary diagnosis and no medical records are attached, the claim for the ER visit will automatically pay a triage fee.
    [Show full text]
  • Diagnosis One To
    Diagnosis One-to-One I9cm I9 Long Desc I10cm I10 Long Desc 0010 Cholera due to vibrio cholerae A000 Cholera due to Vibrio cholerae 01, biovar cholerae 0011 Cholera due to vibrio cholerae el tor A001 Cholera due to Vibrio cholerae 01, biovar eltor 0019 Cholera, unspecified A009 Cholera, unspecified 0021 Paratyphoid fever A A011 Paratyphoid fever A 0022 Paratyphoid fever B A012 Paratyphoid fever B 0023 Paratyphoid fever C A013 Paratyphoid fever C 0029 Paratyphoid fever, unspecified A014 Paratyphoid fever, unspecified 0030 Salmonella gastroenteritis A020 Salmonella enteritis 0031 Salmonella septicemia A021 Salmonella sepsis 00320 Localized salmonella infection, unspecified A0220 Localized salmonella infection, unspecified 00321 Salmonella meningitis A0221 Salmonella meningitis 00322 Salmonella pneumonia A0222 Salmonella pneumonia 00323 Salmonella arthritis A0223 Salmonella arthritis 00324 Salmonella osteomyelitis A0224 Salmonella osteomyelitis 0038 Other specified salmonella infections A028 Other specified salmonella infections 0039 Salmonella infection, unspecified A029 Salmonella infection, unspecified 0040 Shigella dysenteriae A030 Shigellosis due to Shigella dysenteriae 0041 Shigella flexneri A031 Shigellosis due to Shigella flexneri 0042 Shigella boydii A032 Shigellosis due to Shigella boydii 0043 Shigella sonnei A033 Shigellosis due to Shigella sonnei 0048 Other specified shigella infections A038 Other shigellosis 0049 Shigellosis, unspecified A039 Shigellosis, unspecified 0050 Staphylococcal food poisoning A050 Foodborne staphylococcal
    [Show full text]
  • BQI Icare HIV/AIDS
    RESOURCE AND PATIENT MANAGEMENT SYSTEM iCare Population Management GUI (BQI) HIV/AIDS Management User Manual Version 2.6 July 2017 Office of Information Technology (OIT) Division of Information Technology iCare Population Management GUI (BQI) Version 2.6 Table of Contents 1.0 Introduction ......................................................................................................... 1 1.1 Key Functional Features .......................................................................... 1 1.2 Sensitive Patient Data ............................................................................. 2 2.0 Patient Management ........................................................................................... 3 2.1 Data Specifically Related to HIV/AIDS ..................................................... 3 2.2 Search for and View a Patient Record ..................................................... 6 2.2.1 Using a Panel ........................................................................................ 6 2.2.2 Using Quick Search ............................................................................... 7 2.3 Displaying Care Management as Default Tab ......................................... 8 2.4 Add/Edit Care Management Data ............................................................ 8 2.4.1 Entering Data on the General Area ....................................................... 9 2.4.2 Entering Data on the Partner Notification Area .................................... 11 2.4.3 Entering Data on the Antiretroviral
    [Show full text]
  • ITDRD Book.Book
    2 0 2 DESK REFERENCE 1 optum360coding.com Seamless shopping starts here. Diagnoses ICD-10-CM for Reference Desk Coders’ Coders’ Desk Reference The redesigned optum360coding.com offers new conveniences and the same great coding resources you’ve always trusted for a convenient, seamless shopping experience. for ICD-10-CM Diagnoses Device-friendly shopping Product information at Clinical descriptions with answers to your your fingertips Effortlessly view our new website on toughest ICD-10-CM coding questions any device — desktop, tablet or Find product details and features — smartphone — optum360coding.com including item number, ISBN number and is with you wherever you go. availability date — quickly and easily. Intuitive product organization Streamlined checkout Optum360 coding products are View and edit your cart, ship to multiple organized by category so you can find recipients, add payment information, what you need quickly and easily. assign a PO number and complete your purchase — all on one page. Sign in to check out View all your account Signing in prior to checkout ensures information your online and offline transactions are seamlessly linked to the same account for Get immediate access to your order and your convenience. Don’t have an online invoice history, track shipments, renew a account? It’s easy to create one — visit product, create a wish list or update your optum360coding.com/register. contact information. Visit optum360coding.com © 2020 Optum360, LLC. All rights reserved. WF2305592 04/20 SAMPLE ITDRD21/ITDRD Made in the USA
    [Show full text]
  • Assessment of the Demyelinating Process
    Wiadomości Lekarskie, VOLUME LXXIV, ISSUE 3 PART 1, MARCH 2021 © Aluna Publishing ORIGINAL ARTICLE ASSESSMENT OF THE DEMYELINATING PROCESS ACTIVITY IN PATIENTS WITH HERPESVIRAL MENINGITIS AND MENINGOENCEPHALITIS BASED ON THE LEVEL OF MYELIN BASIC PROTEIN (MBP) IN THE CEREBROSPINAL FLUID DOI: 10.36740/WLek202103124 Anton V. Sokhan1, Yaroslava I. Burma1, Volodimir V. Pavlov2, Oleksandr O. Goidenko2, Larisa I. Markush2, Hanna O. Spitsyna3, Liudmyla V. Kolesnyk4 1 KHARKIV NATIONAL MEDICAL UNIVERSITY, KHARKIV, UKRAINE 2 KHARKIV REGIONAL CLINICAL INFECTIOUS DISEASES HOSPITAL, KHARKIV, UKRAINE 3 NATIONAL AEROSPACE UNIVERSITY «KHARKIV AVIATION INSTITUTE», KHARKIV, UKRAINE 4 KHARKIV NATIONAL UNIVERSITY OF RADIO ELECTRONICS, KHARKIV, UKRAINE ABSTRACT The aim: To study the peculiarities of demyelination by detection of changes in the levels of myelin basic protein (MBP) in CSF of patients with acute herpesviral meningitis (M) and meningoencephalitis (ME). Materials and methods: A total of 136 CSF samples from 68 patients with herpesviral M and ME were collected. The control group consisted of patients with acute respiratory infection and meningismus. MBP level in CSF was identified at the admission and after 10-12 days of treatment. Analysis of MBP concentrations in CSF was performed using an enzyme immunoassay. Results: Examination of patients on the first day of hospitalization showed the presence of a significant increase of MBP in the CSF in all patients with viral M/ME compared with the indicators of the comparison group (р<0.01). In all groups of patients with ME, the level of MBP in CSF was significantly higher than the indicators of comparison group and M groups of the suitable etiology of the disease (p<0.01).
    [Show full text]
  • Illness and Notifiable Diseases Policy
    Illness and Injury Policy Illness and Notifiable Diseases Policy At Walton Montessori we promote the good health of the children in the school and take all steps possible to prevent the spread of infection and will take appropriate action as outlined below when a child is ill. To ensure all members of staff are aware of the signs and symptoms of when a child might be ill or have injured themselves all practitioners and the nursery manager have current Paediatric First Aid certificates that are approved by Surrey County Council and completed over a minimum of 12 hours, these are renewed every 3 years, to ensure everyone has a refreshed knowledge of first aid procedures and are aware of any changes to first aid that could have been implemented. If a child is showing signs and symptoms of illness, a member of staff will initially check the child’s temperature. If the temperature is over 38oC then the parents will be called to be informed their child has a raised temperature and further history will be asked: Has your child been ill at home? Any changes to behaviour at home? Any concerns? The parent will then be asked if we can administer Calpol to the child, ensuring the child has not been given any in the 4-hour period previous. Parents must have also signed the Calpol consent form on registration, if this has not been completed another member of staff must also talk to the parent and confirm Calpol can be administered. This will then be taken to the child and 2 members of staff will administer the Calpol.
    [Show full text]
  • Coders' Desk Reference for ICD-10-CM Diagnoses
    2 0 2 DESK REFERENCE 1 ICD-10-CM Diagnoses for DeskCoders’ Reference Coders’ Desk Reference for ICD-10-CM Diagnoses Clinical descriptions with answers to your toughest ICD-10-CM coding questions Sample 2021 optum360coding.com Contents Introduction ................................................................................................................................... 1 Format .................................................................................................................................................................................1 Valid Code ..........................................................................................................................................................................1 Invalid Code .......................................................................................................................................................................2 Code Ranges ......................................................................................................................................................................3 Focus Point ........................................................................................................................................................................3 Illustrations ........................................................................................................................................................................4 Supplementary Sections ................................................................................................................................................4
    [Show full text]
  • Supplemental Information
    Article Supplemental Information INTERNATIONAL STATISTICAL CLASSIFICATION OF DISEASES G020* Meningitis in viral diseases AND RELATED HEALTH PROBLEMS, A852 Arthropod-borne viral classified elsewhere encephalitis, unspecified TENTH REVISION, CANADA CODES USED TO IDENTIFY POTENTIAL G021* Meningitis in mycoses A858 Other specified viral CASES G028* Meningitis in other specified encephalitis infectious and parasitic diseases A86 Unspecified viral encephalitis classified elsewhere A922 Venezuelan equine fever A170 Tuberculous meningitis G030 Nonpyogenic meningitis A923 West Nile virus infection A203 Plague meningitis G031 Chronic meningitis B004 Herpesviral encephalitis A321 Listerial meningitis and G032 Benign recurrent meningitis B011 Varicella encephalitis meningoencephalitis (Mollaret) B020 Zoster encephalitis A390 Meningococcal meningitis G038 Meningitis due to other A870 Enteroviral meningitis specified causes B050 Measles complicated by encephalitis A871 Adenoviral meningitis G039 Meningitis, unspecified B262 Mumps encephalitis A872 Lymphocytic choriomeningitis A811 Subacute sclerosing panencephalitis B582 Toxoplasma A878 Other viral meningitis meningoencephalitis A830 Japanese encephalitis A879 Viral meningitis, unspecified G040 Acute disseminated A831 Western equine encephalitis B003 Herpesviral meningitis encephalitis A832 Eastern equine encephalitis B010 Varicella meningitis G042 Bacterial meningoencephalitis A833 St Louis encephalitis B021 Zoster meningitis and meningomyelitis, not elsewhere A834 Australian encephalitis classified
    [Show full text]
  • Molecular Diagnostic Testing for Herpes Simplex Virus OH MCD PY
    REIMBURSEMENT POLICY STATEMENT OHIO MEDICAID Original Issue Date Next Annual Review Effective Date 12/01/2018 12/01/2019 12/01/2018 Policy Name Policy Number Molecular Diagnostic Testing for Herpes Simplex Virus PY-0449 Policy Type Medical Administrative Pharmacy REIMBURSEMENT Reimbursement Policies prepared by CSMG Co. and its affiliates (including CareSource) are intended to provide a general reference regarding billing, coding and documentation guidelines. Coding methodology, regulatory requirements, industry-standard claims editing logic, benefits design and other factors are considered in developing Reimbursement Policies. In addition to this Policy, Reimbursement of services is subject to member benefits and eligibility on the date of service, medical necessity, adherence to plan policies and procedures, claims editing logic, provider contractual agreement, and applicable referral, authorization, notification and utilization management guidelines. Medically necessary services include, but are not limited to, those health care services or supplies that are proper and necessary for the diagnosis or treatment of disease, illness, or injury and without which the patient can be expected to suffer prolonged, increased or new morbidity, impairment of function, dysfunction of a body organ or part, or significant pain and discomfort. These services meet the standards of good medical practice in the local area, are the lowest cost alternative, and are not provided mainly for the convenience of the member or provider. Medically necessary services also include those services defined in any federal or state coverage mandate, Evidence of Coverage documents, Medical Policy Statements, Provider Manuals, Member Handbooks, and/or other policies and procedures. This Policy does not ensure an authorization or Reimbursement of services.
    [Show full text]
  • City Research Online
    City Research Online City, University of London Institutional Repository Citation: Coathup, V., Boyle, E. M., Carson, C., Johnson, S., Kurinzcuk, J, Macfarlane, A. J. ORCID: 0000-0003-0977-7214, Petrou, S., Rivero-Arias, O. and Quigley, M. A. (2020). Gestational age and hospital admissions during childhood, the TIGAR study: population- based, record linkage study in England. BMJ: British Medical Journal, 371, m4075. doi: 10.1136/bmj.m4075 This is the published version of the paper. This version of the publication may differ from the final published version. Permanent repository link: https://openaccess.city.ac.uk/id/eprint/24988/ Link to published version: http://dx.doi.org/10.1136/bmj.m4075 Copyright: City Research Online aims to make research outputs of City, University of London available to a wider audience. Copyright and Moral Rights remain with the author(s) and/or copyright holders. URLs from City Research Online may be freely distributed and linked to. Reuse: Copies of full items can be used for personal research or study, educational, or not-for-profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. City Research Online: http://openaccess.city.ac.uk/ [email protected] ICD10 codes: categories of admission Infection A02.1 Salmonella sepsis A17.0 Tuberculous meningitis A17.1 Meningeal tuberculoma A17.8 Other tuberculosis of nervous system A17.9
    [Show full text]