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

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

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Preface ...... iii ICD-10-CM Official Guidelines for Coding ICD-10-CM Official Preface ...... iii and Reporting ...... Coding Guidelines–1 Characteristics of ICD-10-CM ...... iii ICD-10-CM Index to Diseases and Injuries ...... 1 What’s New for 2019 ...... iv Official Updates ...... iv ICD-10-CM Neoplasm Table ...... 331 Proprietary Updates ...... vii ICD-10-CM Table of Drugs and Chemicals ...... 349 Introduction ...... viii History of ICD-10-CM ...... viii ICD-10-CM Index to External Causes ...... 397 How to Use ICD-10-CM Expert for Hospitals 2019 ...... ix ICD-10-CM Tabular List of Diseases and Injuries ...... 433 Use of Official Sources ...... ix Chapter 1. Certain Infectious and Parasitic Diseases Steps to Correct Coding ...... ix (A00-B99) ...... 433 Organization ...... ix Chapter 2. Neoplasms (C00-D49) ...... 459 Introduction ...... ix Official ICD-10-CM Conventions and Guidelines...... ix Chapter 3. Diseases of the Blood and Blood-forming Alphabetic Index to Diseases ...... ix Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) ...... 499 Neoplasm Table...... ix Table of Drugs and Chemicals ...... ix Chapter 4. Endocrine, Nutritional and Metabolic Diseases Index to External Causes ...... ix (E00-E89) ...... 509 Tabular List of Diseases ...... x Chapter 5. Mental, Behavioral, and Neurodevelopmental Appendixes...... x Disorders (F01-F99) ...... 531 Illustrations...... x Chapter 6. Diseases of the Nervous System (G00-G99) ...... 555 ICD-10-CM Hospital Data Files...... x Chapter 7. Diseases of the Eye and Adnexa (H00-H59) ...... 577 Overview of ICD-10-CM Official Conventions ...... xi Chapter 8. Diseases of the Ear and Mastoid Process (H60-H95) ...... 615 Format ...... xi Punctuation ...... xi Chapter 9. Diseases of the Circulatory System (I00-I99) ...... 627 Abbreviations ...... xi Chapter 10. Diseases of the Respiratory System (J00-J99) ...... 669 NEC ...... xi Chapter 11. Diseases of the Digestive System (K00-K95) ...... 685 NOS ...... xi Chapter 12. Diseases of the Skin and Subcutaneous Tissue Typeface ...... xi (L00-L99) ...... 709 Boldface...... xi Chapter 13. Diseases of the Musculoskeletal System and General Notes ...... xi Connective Tissue (M00-M99) ...... 731 Includes Notes ...... xi Chapter 14. Diseases of the Genitourinary System (N00-N99)..821 Inclusion Terms...... xi Excludes Notes...... xi Chapter 15. Pregnancy, Childbirth and the Puerperium Note...... xii (O00-O9A) ...... 839 Default Codes...... xii Chapter 16. Certain Conditions Originating in the Perinatal Syndromes...... xii Period (P00-P96) ...... 879 And ...... xii Chapter 17. Congenital Malformations, Deformations and With ...... xii Chromosomal Abnormalities (Q00-Q99) ...... 893 See and See Also ...... xii Chapter 18. Symptoms, Signs and Abnormal Clinical and Instructional Notes Used in the Tabular List ...... xii Laboratory Findings Not Elsewhere Code Assignment andSample Clinical Criteria ...... xii PageClassified (R00-R99) ...... 913 Chapter 19. Injury, Poisoning and Certain Other Consequences Additional Annotations ...... xiii of External Causes (S00-T88) ...... 933 Code-Level Notations ...... xiii Chapter 20. External Causes of Morbidity (V00-Y99)...... 1155 Italics ...... xiii Chapter 21. Factors Influencing Health Status and Contact Color Coding/Symbols...... xiii With Health Services (Z00-Z99) ...... 1217 Other Code Level Notations ...... xv Footnotes...... xv Appendixes ...... Appendixes–1 Chapter-Level Notations ...... xvi Appendix A: 10 Steps to Correct Coding ...... Appendixes–1 Chapter-Specific Guidelines with Coding Examples...... xvi Appendix B: Valid 3-character ICD-10-CM Muscle Tendon Table ...... xvi Codes ...... Appendixes–5 Index Notations...... xvi Appendix C: Pharmacology List 2018...... Appendixes–7 Following References ...... xvi

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) Samplelymphoepithelioid C84.4- S Pagecornea, 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 mature T-cell NEC C84.4- S Maculopathy, 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. Diseases of the Blood and Blood-forming Organs D63.8–D68.311

503 < < < < < d Here A A A A de a Fibrin Injury site circulating circulating D63.8–D68.311 intrinsic 2Not Inclu re Platelets He PDX collection 503 other clotting factors Autoimmune hemophilia Autoimmune inhibitors to clotting factors hemophilia Secondary Excl: CC deficiency Acquired hemophilia Acquired Coagulation deficiency capillary fragility (hereditary) (D69.8) (hereditary) fragility capillary (D66) NOS deficiency VIII factor (D66) defect functional with deficiency VIII factor 1Not Coded

pregnancy (O00-O07, O08.1) puerperium (O45.0, O46.0, O67.0, O72.3) anticoagulants, antibodies, anticoagulants, inhibitors or antibodies, D68.311 tor IX IX tor Abnormal blood coagulation caused by deficient blood blood deficient by caused coagulation blood Abnormal dition abnormal coagulation profile (R79.1) profile coagulation abnormal molar or ectopic or abortion complicating defects coagulation the and childbirth pregnancy, complicating defects coagulation Red blood cells PDXcollection 502 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 Angiohemophilia defect vascular with deficiency VIII Factor Vascular hemophilia Hereditary factor XI factor Hereditary D68.31 Hemorrhagic disorder due to 2016, 1Q, 14 1Q, 2016, CC Forcodes Excl: CCD68, unless otherwise in category noted: PDX collection 502 d Christmas disease Christmas defect) functional (with deficiency IX Factor Hemophilia B [PTC] deficiency component Plasma thromboplastin Excl: CC 1 AHA: White blood cell White CMS-HCC CMS-HCC Con D68.2 of deficiency Hereditary D68.1 D68.3 to anticoagulants due Hemorrhagic disorder circulating Hereditary fac Hereditary D68.0disease Willebrand's Von < c D67 D68 defects coagulation Other b

E-R HAC < < < < < < a a Manifestation PDx Chapter3. Diseases the of Bloodand Blood-forming Organs due to drugsandtoxins anemia

Unacceptable chemotherapy (D61.1) chemotherapy

anemia antineoplastic chemotherapy anemia due to disease to due anemia aplastic anemia due to antineoplastic antineoplastic due to anemia aplastic disease (D63.0) in neoplastic anemia anemias 2014, 4Q, 22 4Q, 2014, Page Sample (D65-D69) Reversible adverse effect of chemotherapy, of chemotherapy, effect adverse Reversible specified anemias specified Blackfan-Diamond syndrome (D61.01) syndrome Blackfan-Diamond Di Guglielmo's disease (C94.0) Placeholder Placeholder t Aler O67.0, O72.3) O67.0, Antineoplastic chemotherapy induced anemia Infantile pseudoleukemia Infantile 1 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, other chronic diseases classified elsewhere [RAEB T] (C92.0-) [RAEB Other unspecified g 2017, 1Q, 7 1Q, 2017, abortion or ectopic or molar pregnancy (O00-O07, O08.1) (P60) newborn in O46.0, (O45.0, the puerperium and childbirth pregnancy, tor VIII deficiency with fifth or sixth character 1-4 or 6) sixth or character fifth with 5) character sixth or fifth with (T36-T50 drug sideroblastic

specified anemias specified factor VIII deficiency with vascular defect (D68.0) 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 PDX collection 502 PDX collection 502 Dyshematopoietic anemia(congenital) AHA: Sex-linked hypochromic sideroblastic anemia sideroblastic hypochromic Sex-linked underlying disease Code first 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 Code first underlying disease, such as: such disease, underlying Code first Secondary sideroblastic sideroblastic Secondary Other Congenital dyserythropoietic Hereditary sideroblastic Hereditary Other D64.81 Anemia due to D64.89 Hereditary, sex-linked lack of antihemophilic globulin (AHG) (factor 1 DEF: VIII); causesabnormalcoagulation characterizedincreasedby bleeding, tract; gastrointestinal nose, in mouth, bleeding of skin, bruises large hemorrhages into joints, resulting in swelling and impaired function. CC Excl: Afibrinogenemia, acquired Afibrinogenemia, coagulopathy Consumption Diffuse ordisseminated intravascular coagulation[DIC] Fibrinolytic hemorrhage, acquired Fibrinolytic purpura fulminans Purpura 1 CC Excl: Classical hemophilia defect) functional (with VIII factor Deficiency Hemophilia A Hemophilia NOS 1 D64.9 Anemia, D64.1 D64.2 D64.3 D64.4 syndrome] D64.0 Hereditary fac Hereditary D64.8 D63.8 Anemia in c D66 D65 [defibrination coagulation intravascular Disseminated D64 Other anemias Additional Character Req Coagulation defects, purpura and other hemorrhagic conditions b S ICD-10-CM 2020 2020 ICD-10-CM Chapter 10. Diseases of the Respiratory System 669

Guidelines and Examples and Guidelines y or nonrespiratory condition. The condition. or nonrespiratory y bacterial pneumonia, the principal principal the pneumonia, bacterial to whether acute respiratory failure failure respiratory acute whether to Acute respiratory failure, unspecified whether with unspecified whether failure, respiratory Acute or hypercapnia hypoxia pneumoniae Pneumonia Streptococcus due to Pneumonia due to Streptococcus pneumoniae Pneumonia Streptococcus due to with unspecified whether failure, respiratory Acute or hypercapnia hypoxia Poisoning by other opioids, accidental (unintentional), encounter initial whether with unspecified failure, respiratory Acute or hypercapnia hypoxia : When a patient is admitted with respiratory failure and : Respiratory failure may be assigned as a principal diagnosis principal a as be assigned may Respiratoryfailure : as a secondary listed may be failure respiratory Acute : ) may be applied in these situations. Acute pneumococcal pneumonia and acute respiratory failure, both both failure, respiratory acute and pneumonia pneumococcal Acute present on admission J96.00 J13 Explanation such as a condition, another acute diagnosis is not the same in every situation. This applies whether the other acute condition is a respirator principal diagnosis depends on the circumstances of admission. Acute respiratoryAcute failure due accidentalto oxycodone overdose T40.2X1A J96.00 Explanation itwhen is the condition established after study to be chiefly responsible occasioningfor the admission to the andhospital, the selection is chapter- However, List. Tabular and Index Alphabetic the by supported specific coding guidelines, such as poisoning, that provide sequencing the to or reaction poisoning a coding When precedence. take direction wrong substance or improper given use of aoverdose, medication (e.g. the assign administration), first of route wrong in error, taken all for code(s) additional Use T36–T50. categories from code appropriate ofmanifestations the poisoning. In this the respiratoryinstance, failure a secondary as sequenced and is the of poisoning a manifestation is diagnosis. of development subsequent with pneumonia pneumococcal Acute failure respiratoryacute J13 J96.00 Explanation diagnosis if it after occurs admission, or if it is on admissionpresent but does not meet the definition of principal diagnosis. (J00–J99) Section II, C. 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 ( Respiratory failure may be listed as a secondary diagnosis if it occurs after after occurs it if diagnosis a secondary as listed be may failure Respiratory butthedoeson admission, not meet is present it admission,or if definition of principal 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 2) Acute respiratory secondary failure as diagnosis 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 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

this example. of the Treatment . Patient alsowithacute exacerbationof Patient . -CM uses combination codes to create organism- create combination to codes -CM uses Page Sample 0 Diseases of the Respiratory System System Respiratory the of Diseases Moderate persistent asthma asthmaticus status persistent with Moderate Acute respiratory failure with hypoxia failure respiratory Acute Chronic obstructive pulmonary disease with (acute) exacerbation Pneumonia due to Streptococcus pneumoniae Streptococcus Pneumonia due to obstructiveChronic pulmonary disease with acute lower respiratory infection Chronic obstructive pulmonary disease with (acute) exacerbation : Category J96 withclassifies failure respiratory combination : Category J45 Asthma includes severity-specific : ICD-1 Streptococcus pneumoniae Streptococcus specific classifications for acute pneumonia. specific for classifications Category J44 includecodes combination codes with severity whichcomponents, differentiate infection (acute respiratory lower with acute betweenCOPD without COPD and exacerbation, acute with COPD pneumonia), (unspecified). complication a of mention J96.01 J44.1 Explanation 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 assigned may be failure Respiratory admission. the for reason the principalcondition diagnosis it is the when established to be after study hospital the and admission to the occasioning for responsible chiefly the selection is supported by the Alphabetic IndexList. and Tabular Acute hypoxic respiratory failure due to COPD exacerbation COPD to due failure respiratory hypoxic Acute J45.42 Explanation between to distinguish codes fifth-character and subcategories acute in those cases, uncomplicated Exacerbation of moderate persistent asthma with status asthmaticus 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 pneumonia necessitated the inpatient admission. Instructional notes at the which coder informs also identify to the infection,” J44.0 say “code to the of Sequencing applicable. if assigned be must code another that II, Section the by governed are exacerbation COPD and pneumonia guidelines. In this case it“Selection was the of Principal Diagnosis,” occasioning responsible the for admission” pneumonia that was “chiefly treatment. IVwith vancomycin the J13 J44.0 J44.1 Explanation Vancomycin IV started was a patient to treat pneumonia withVancomycin acute due to COPD continued on home meds. 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. 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 1) diagnosis as failure principal respiratory Acute The chapter specific guidelines from the ICD-1the chapter guidelines specific from The Chapter 10. 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 S06–S06.306 Chapter 19. Injury, Poisoning and Certain Other Consequences of External Causes ICD-10-CM 2020 b S06 Intracranial injury e S06.1X8 Traumatic cerebral edema laI 0 w7th characters D and S do not apply to codes in category S06 with loss of consciousness with 6th character 7 – death due to brain injury prior to of any duration with death due regaining consciousness, or 8 – death due to other cause to other cause prior to regaining prior to regaining consciousnessx consciousness 1 traumatic brain injury CC Excl: MCC with 7th character A: Code also any associated: PDX collection 1154 open wound of head (S01.-) 11 e S06.1X9 Traumatic cerebral laI< skull fracture (S02.-) edema with loss of consciousness 1 head injury NOS (S09.90) of unspecified duration AHA: 2017, 1Q, 42; 2015, 3Q, 37 Traumatic cerebral edema NOS The appropriate 7th character is to be added to each code from c S06.2 Diffuse traumatic brain injury category S06. Diffuse axonal brain injury A initial encounter 1 traumatic diffuse cerebral edema (S06.1X-) D subsequent encounter d S06.2X Diffuse traumatic brain injury Ssequela 11 e S06.2X0 Diffuse traumatic brain injury < without loss of consciousness CC Excl: For codes in category S06, unless otherwise noted: CC or MCC with 7th character A: PDX collection 1154 11 e S06.2X1 Diffuse traumatic brain injury AI< with loss of consciousness of c S06.0 Concussion 30 minutes or less Commotio cerebri 11 e S06.2X2 Diffuse traumatic brain injury AI< 1 concussion with other intracranial injuries classified in with loss of consciousness of subcategories S06.1- to S06.6-, S06.81 and 31 minutes to 59 minutes S06.82- code to specified intracranial injury 11 e S06.2X3 Diffuse traumatic brain injury AI< d S06.0X Concussion with loss of consciousness of 12 e S06.0X0 Concussion without loss of < 1 hour to 5 hours 59 minutes consciousness 11 e S06.2X4 Diffuse traumatic brain injury AI< 12 e S06.0X1 Concussion with loss of AI< with loss of consciousness of consciousness of 30 minutes or less 6 hours to 24 hours 12 e S06.0X9 Concussion with loss of AI< 11 e S06.2X5 Diffuse traumatic brain injury AI< consciousness of unspecified duration with loss of consciousness Concussion NOS greater than 24 hours with c S06.1 Traumatic cerebral edema return to pre-existing conscious levels Diffuse traumatic cerebral edema 11 e S06.2X6 Diffuse traumatic brain injury aI< Focal traumatic cerebral edema with loss of consciousness greater than 24 hours without CC Excl: For codes in subcategory S06.1, unless return to pre-existing conscious otherwise noted: level with patient surviving MCC with 7th character A: PDX collection 1155 e S06.2X7 Diffuse traumatic brain injury aI d S06.1X Traumatic cerebral edema with loss of consciousness of any 11 e S06.1X0 Traumatic cerebral edema la< duration with death due to brain

Chapter 19. Injury, and Poisoning Certain Other Consequences of External Causes without loss of consciousness injury prior to regaining consciousness CC Excl: MCC with 7th character A: e S06.2X8 Diffuse traumatic brain injury aI PDX collection 612 with loss of consciousness of any 11 e S06.1X1 Traumatic cerebral laI< duration with death due to other edema with loss of consciousness cause prior to regaining consciousness of 30 minutes or less 11 e S06.2X9 Diffuse traumatic brain injury AI< 11 e S06.1X2 Traumatic cerebral laI< with loss of consciousness of edema with loss of consciousness unspecified duration of 31 minutes to 59 minutes Diffuse traumatic brain injury NOS 11 e S06.1X3 Traumatic cerebral laI< c S06.3 Focal traumatic brain injury edema with loss of consciousness 1 any condition classifiable to S06.4-S06.6 of 1 hour to 5 hours 59 minutes focal cerebral edema (S06.1) 11 e S06.1X4 Traumatic cerebral laI< d S06.30 Unspecified focal traumatic brain injury edema with loss of consciousness 11 of 6 hours to 24 hours e S06.300 Unspecified focal traumatic brain < 11 injury without loss of consciousness e S06.1X5 Traumatic cerebral laI< 11 edemawith loss of consciousness e S06.301 Unspecified focal traumatic AI< greater than 24 hours with return brain injury with loss of consciousness to pre-existing conscious level of 30 minutes or less 11 11 e S06.1X6 Traumatic cerebral laI< e S06.302 Unspecified focal traumatic AI< edema with loss of consciousness brain injury with loss of consciousness greater than 24 hours without of 31 minutes to 59 minutes return to pre-existing conscious 11 e S06.303 Unspecified focal traumatic AI< Samplelevel with patient surviving Pagebrain injury with loss of consciousness CC Excl: MCC with 7th character A: of 1 hour to 5 hours 59 minutes PDX collection 1154 11 e S06.304 Unspecified focal traumatic AI< e S06.1X7 Traumatic cerebral edema laI brain injury with loss of consciousness with loss of consciousness of 6 hours to 24 hours of any duration with death due 11 e S06.305 Unspecified focal traumatic AI< to brain injury prior to regaining brain injury with loss of consciousness consciousness greater than 24 hours with return CC Excl: MCC with 7th character A: to pre-existing conscious level PDX collection 1154 11 e S06.306 Unspecified focal traumatic aI< brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving

11 HCC with 7th character indicating initial encounter (A or B - specific to category) OR sequela. 12 HCC with 7th character indicating sequela. S06–S06.306

8 Newborn: 0 9 Pediatric: 0-17 x Maternity: 12-55 y Adult: 15-124 a Major CC Condition l PDx acts as own MCC A CC Condition m PDx acts as own CC 948 ICD-10-CM 2020 ICD-10-CM 2020 Illustrations Chapter 10. Diseases of the Respiratory System (J00–J99)

Respiratory System

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