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ICD-10-CM Expert for Physicians The complete official code set

Codes valid from October 1, 2021 through September 30, 2022

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2022 optum360coding.com Contents

Preface...... iii Chapter 5. Mental, Behavioral, and Neurodevelopmental ICD-10-CM Official Preface ...... iii Disorders (F01-F99) ...... 543 Characteristics of ICD-10-CM ...... iii Chapter 6. Diseases of the Nervous System (G00-G99) ...... 569 Chapter 7. Diseases of the Eye and Adnexa (H00-H59) ...... 593 How to Use ICD-10-CM Expert for Physicians 2022 ...... iv Chapter 8. Diseases of the Ear and Mastoid Process Introduction ...... iv (H60-H95) ...... 631 What’s New for 2022 ...... iv Chapter 9. Diseases of the Circulatory System (I00-I99) ...... 643 Conversion Table ...... iv 10 Steps to Correct Coding...... iv Chapter 10. Diseases of the Respiratory System (J00-J99) ...... 687 Official ICD-10-CM Guidelines for Coding and Reporting...... iv Chapter 11. Diseases of the Digestive System (K00-K95) ...... 705 Indexes ...... iv Chapter 12. Diseases of the Skin and Subcutaneous Tissue Index to Diseases and Injuries ...... iv (L00-L99) ...... 729 Neoplasm Table...... iv Chapter 13. Diseases of the Musculoskeletal System and Table of Drugs and Chemicals ...... v Connective Tissue (M00-M99) ...... 751 External Causes Index ...... v Chapter 14. Diseases of the Genitourinary System Index Notations ...... v (N00-N99) ...... 839 Tabular List of Diseases ...... vi Code and Code Descriptions...... vi Chapter 15. Pregnancy, Childbirth, and the Puerperium Tabular Notations ...... vi (O00-O9A) ...... 859 Optum360 Notations ...... vii Chapter 16. Certain Conditions Originating in the Perinatal Icons ...... vii Period (P00-P96) ...... 899 Color Bars ...... viii Chapter 17. Congenital Malformations, Deformations and Footnotes...... viii Chromosomal Abnormalities (Q00-Q99) ...... 913 Chapter-Level Notations ...... viii Chapter 18. Symptoms, Signs and Abnormal Clinical and Appendixes...... viii Laboratory Findings (R00-R99) ...... 933 Illustrations...... ix Chapter 19. Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) ...... 955 What’s New for 2022 ...... x Chapter 20. External Causes of Morbidity (V00-Y99)...... 1157 Official Updates ...... x Chapter 21. Factors Influencing Health Status and Contact Proprietary Updates ...... xvii With Health Services (Z00-Z99) ...... 1221 Chapter 22. Codes for Special Purposes (U00-U85)...... 1257 Conversion Table of ICD-10-CM Codes ...... xix Appendixes ...... Appendixes–1 10 Steps to Correct Coding...... xx Appendix A: Valid 3-character ICD-10-CM Codes...... Appendixes–1 Appendix B: Pharmacology List 2021...... Appendixes–3 ICD-10-CM Official Guidelines for Coding Appendix C: Z Codes for Long-Term Drug Use with and Reporting ...... Coding Guidelines–1 Associated Drugs ...... Appendixes–23 Appendix D: Z Codes Only as Principal/First-Listed Diagnosis ...... Appendixes–27 ICD-10-CM Index to Diseases and Injuries ...... 1 Appendix E: Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC) ...... Appendixes–29 ICD-10-CM Neoplasm Table ...... 335 Appendix F: Centers for Medicare & Medicaid Services Quality Payment Program ...... Appendixes–31 ICD-10-CM Table of Drugs and Chemicals ...... 354 Illustrations...... Illustrations–1 Chapter 3. Diseases of the Blood and Blood-forming Organs and ICD-10-CM Index to External Causes...... 403 Certain Disorders Involving the Immune SAMPLEMechanism (D50–D89) ...... Illustrations–1 ICD-10-CM Tabular List of Diseases and Injuries ...... 439 Red Blood Cells ...... Illustrations–1 Chapter 1. Certain Infectious and Parasitic Diseases White Blood Cell ...... Illustrations–1 (A00-B99) ...... 439 Platelet ...... Illustrations–2 Coagulation ...... Illustrations–2 Chapter 2. Neoplasms (C00-D49) ...... 465 Spleen Anatomical Location and Chapter 3. Diseases of the Blood and Blood-forming Organs External Structures ...... Illustrations–3 and Certain Disorders Involving the Immune Spleen Interior Structures ...... Illustrations–3 Mechanism (D50-D89) ...... 505 Chapter 4. Endocrine, Nutritional and Metabolic Chapter 4. Endocrine, Nutritional and Metabolic Diseases Diseases (E00–E89) ...... Illustrations–4 (E00-E89) ...... 519 Endocrine System ...... Illustrations–4 Thyroid ...... Illustrations–5

ICD-10-CM 2022 i Contents Thyroid and Parathyroid Glands ...... Illustrations–5 Lower Respiratory System ...... Illustrations–27 Pancreas ...... Illustrations–6 Paranasal Sinuses ...... Illustrations–27 Anatomy of the Adrenal Gland ...... Illustrations–6 Lung Segments ...... Illustrations–28 Structure of an Ovary ...... Illustrations–7 Alveoli ...... Illustrations–28 Testis and Associated Structures ...... Illustrations–7 Chapter 11. Diseases of the Digestive System Thymus ...... Illustrations–8 (K00–K95) ...... Illustrations–29 Chapter 6. Diseases of the Nervous System Digestive System ...... Illustrations–29 (G00–G99) ...... Illustrations–9 Omentum and Mesentery ...... Illustrations–30 Brain ...... Illustrations–9 Peritoneum and Retroperitoneum ... Illustrations–30 Cranial Nerves ...... Illustrations–9 Chapter 12. Diseases of the Skin and Subcutaneous Peripheral Nervous System ...... Illustrations–10 Tissue (L00–L99) ...... Illustrations–31 Spinal Cord and Spinal Nerves ...... Illustrations–11 Nail Anatomy ...... Illustrations–31 Nerve Cell ...... Illustrations–12 Skin and Subcutaneous Tissue ...... Illustrations–31 Chapter 7. Diseases of the Eye and Adnexa Chapter 13. Diseases of the Musculoskeletal System (H00–H59) ...... Illustrations–13 and Connective Tissue (M00–M99) ...... Illustrations–32 Eye ...... Illustrations–13 Bones and Joints ...... Illustrations–32 Posterior Pole of Globe/Flow of Shoulder Anterior View ...... Illustrations–33 Aqueous Humor ...... Illustrations–13 Shoulder Posterior View ...... Illustrations–33 Lacrimal System ...... Illustrations–14 Elbow Anterior View ...... Illustrations–33 Eye Musculature ...... Illustrations–14 Elbow Posterior View ...... Illustrations–33 Eyelid Structures ...... Illustrations–14 Hand ...... Illustrations–33 Chapter 8. Diseases of the Ear and Mastoid Hip Anterior View ...... Illustrations–34 Process (H60–H95) ...... Illustrations–15 Hip Posterior View ...... Illustrations–34 Ear Anatomy ...... Illustrations–15 Knee Anterior View ...... Illustrations–34 Chapter 9. Diseases of the Circulatory Knee Posterior View ...... Illustrations–34 System (I00–I99) ...... Illustrations–16 Foot ...... Illustrations–34 Anatomy of the Heart ...... Illustrations–16 Muscles...... Illustrations–35 Heart Cross Section ...... Illustrations–16 Chapter 14. Diseases of the Genitourinary Heart Valves ...... Illustrations–17 System (N00–N99) ...... Illustrations–36 Heart Conduction System ...... Illustrations–17 Urinary System ...... Illustrations–36 Coronary Arteries ...... Illustrations–18 Male Genitourinary System ...... Illustrations–37 Arteries ...... Illustrations–19 Female Internal Genitalia ...... Illustrations–37 Veins ...... Illustrations–20 Female Genitourinary Tract Lateral Internal Carotid and Vertebral View ...... Illustrations–37 Arteries and Branches ...... Illustrations–21 Chapter 15. Pregnancy, Childbirth and the External Carotid Artery and Puerperium (O00–O9A) ...... Illustrations–38 Branches ...... Illustrations–21 Term Pregnancy – Single Branches of Abdominal Aorta ...... Illustrations–22 Gestation ...... Illustrations–38 Portal Venous Circulation ...... Illustrations–22 Twin Gestation–Dichorionic– Lymphatic System ...... Illustrations–23 Diamniotic (DI-DI) ...... Illustrations–38 Axillary Lymph Nodes ...... Illustrations–24 Twin Gestation–Monochorionic– Lymphatic System of Head Diamniotic (MO-DI) ...... Illustrations–39 and Neck ...... Illustrations–24 Twin Gestation–Monochorionic– Lymphatic Capillaries ...... Illustrations–25 Monoamniotic (MO-MO) ...... Illustrations–39 Lymphatic Drainage ...... Illustrations–25 Chapter 19. Injury, Poisoning and Certain Other Chapter 10. Diseases of the Respiratory Consequences of External Causes System (J00–J99) ...... Illustrations–26 (S00-T88) ...... Illustrations–40 Respiratory System ...... Illustrations–26 Types of Fractures ...... Illustrations–40 Upper Respiratory SystemSAMPLE ...... Illustrations–27 Salter-Harris Fracture Types ...... Illustrations–40

ii ICD-10-CM 2022 10 Steps to Correct Coding

Follow the 10 steps below to correctly code encounters for health care • “NEC,” abbreviation for “not elsewhere classified,” follows some main services. terms or subterms and indicates that there is no specific code for the condition even though the medical documentation may be very specific. Step 1: Identify the reason for the visit or encounter (i.e., a sign, symptom, diagnosis and/or condition). • “NOS,” abbreviation for “not otherwise specified,” follows some main The medical record documentation should accurately reflect the patient’s terms or subterms and is the equivalent of unspecified; NOS signifies condition, using terminology that includes specific diagnoses and that the information in the medical record is insufficient for assigning symptoms or clearly states the reasons for the encounter. a more specific code. 10 Steps to Correct Coding Coding Correct to Steps 10 • Following references help coders locate alphanumeric codes that are Choosing the main term that best describes the reason chiefly responsible out of sequence in the tabular section. for the service provided is the most important step in coding. If symptoms are present and documented but a definitive diagnosis has not yet been • Check-additional-character symbols flag codes that require determined, code the symptoms. For outpatient cases, do not code additional characters to make the code valid; the characters available conditions that are referred to as “rule out,” “suspected,” “probable,” or to complete the code should be verified in the tabular section. “questionable.” Diagnoses often are not established at the time of the Step 6: Choose a potential code and locate it in the initial encounter/visit and may require two or more visits to be tabular list. established. Code only what is documented in the available outpatient To prevent coding errors, always use both the alphabetic index (to identify records and only to the highest degree of certainty known at the time of a code) and the tabular list (to verify a code), as the index does not include the patient’s visit. For inpatient medical records, uncertain diagnoses may the important instructional notes found in the tabular list. An added be reported if documented at the time of discharge. benefit of using the tabular list, which groups like things together, is that Step 2: After selecting the reason for the encounter, while looking at one code in the list, a coder might see a more specific one consult the alphabetic index. that would have been missed had the coder relied solely on the The most critical rule is to begin code selection in the alphabetic index. alphabetic index. Additionally, many of the codes require a fourth, fifth, Never turn first to the tabular list. The index provides cross-references, sixth, or seventh character to be valid, and many of these characters can essential and nonessential modifiers, and other instructional notations be found only in the tabular list. that may not be found in the tabular list. Step 7: Read all instructional material in the tabular Step 3: Locate the main term entry. section. The alphabetic index lists conditions, which may be expressed as nouns or The coder must follow any Includes, Excludes 1 and Excludes 2 notes, and eponyms, with critical use of adjectives. Some conditions known by other instructional notes, such as “Code first” and “Use additional code,” several names have multiple main entries. Reasons for encounters may be listed in the tabular list for the chapter, category, subcategory, and located under general terms such as admission, encounter, and subclassification levels of code selection that direct the coder to use a examination. Other general terms such as history, status (post), or different or additional code. Any codes in the tabular range A00.0- presence (of) can be used to locate other factors influencing health. through T88.9- may be used to identify the diagnostic reason for the encounter. The tabular list encompasses many codes describing disease Step 4: Scan subterm entries. and injury classifications (e.g., infectious and parasitic diseases, Scan the subterm entries, as appropriate, being sure to review continued neoplasms, symptoms, nervous and circulatory system etc.). lines and additional subterms that may appear in the next column or on the next page. Shaded vertical guidelines in the index indicate the Codes that describe symptoms and signs, as opposed to definitive indentation level for each subterm in relation to the main terms. diagnoses, should be reported when an established diagnosis has not been made (confirmed) by the physician. Chapter 18 of the ICD-10-CM Step 5: Pay close attention to index instructions. code book, “Symptoms, Signs, and Abnormal Clinical and Laboratory • Parentheses ( ) enclose nonessential modifiers, terms that are Findings, Not Elsewhere Classified” (codes R00.-–R99), contains many, but supplementary words or explanatory information that may or may not not all, codes for symptoms. appear in the diagnostic statement and do not affect code selection. ICD-10-CM classifies encounters with health care providers for • Brackets [ ] enclose manifestation codes that can be used only as circumstances other than a disease or injury in chapter 21, “Factors secondary codes to the underlying condition code immediately Influencing Health Status and Contact with Health Services” (codes preceding it. If used, manifestation codes must be reported with the Z00–Z99). Circumstances other than a disease or injury often are recorded appropriate etiology codes. as chiefly responsible for the encounter. • Default codes are listed next to the main term and represent the condition most commonly associated with the main term or the A code is invalid if it does not include the full number of characters unspecified code for the main term. (greatest level of specificity) required. Codes in ICD-10-CM can contain from three to seven alphanumeric characters. A three-character code is to •“See” cross-references, identified by italicizedSAMPLE type and “code by” be used only if the category is not further subdivided into four-, five-, six-, cross-references indicate that another term must be referenced to locate or seven-character codes. Placeholder character X is used as part of an the correct code. alphanumeric code to allow for future expansion and as a placeholder for •“See also” cross-references, identified by italicized type, provide empty characters in a code that requires a seventh character but has no alternative terms that may be useful to look up but are not mandatory. fourth, fifth, or sixth character. Note that certain categories require • “Omit code” cross-references identify instances when a code is not seventh characters that apply to all codes in that category. Always check applicable depending on the condition being coded. the category level for applicable seventh characters for that category. • “With” subterms are listed out of alphabetic order and identify a Step 8: Consult the official ICD-10-CM conventions and presumed causal relationship between the two conditions they link. guidelines. • “Due to” subterms identify a relationship between the two conditions The ICD-10-CM Official Guidelines for Coding and Reporting govern the use they link. of certain codes. These guidelines provide both general and chapter-specific coding guidance.

xx ICD-10-CM 2022 Admission ICD-10-CM 2022 Admission — continued Admission — continued Aftercare — continued examination at health care facility — seealso Examina- removal of — continued following surgery (for) (on) tion — continued drains Z48.03 amputation Z47.81 vision — continued dressing (nonsurgical) Z48.00 attention to Index infant or child (over 28 days old) Z00.129 implantable subdermal contraceptive Z30.46 drains Z48.03 with abnormal findings Z00.121 intrauterine contraceptive device Z30.432 dressings (nonsurgical) Z48.00 fitting (of) neuropacemaker (brain) (peripheral nerve) (spinal surgical Z48.01 artificial cord) Z46.2 sutures Z48.02 arm — see Admission, adjustment, artificial, arm implanted Z45.42 circulatory system Z48.812 eye Z44.2 S staples Z48.02 delayed (planned) wound closure Z48.1 leg — see Admission, adjustment, artificial, leg surgical dressing Z48.01 digestive system Z48.815 brain neuropacemaker Z46.2 sutures Z48.02 explantation of joint prosthesis (staged procedure) implanted Z45.42 ureteral stent Z46.6 hip Z47.32 breast prosthesis (external) Z44.3 S respirator [ventilator] use during power failure Z99.12 knee Z47.33 colostomy belt Z46.89 restoration of organ continuity (poststerilization) Z31.0 shoulder Z47.31 contact lenses Z46.0 aftercare Z31.42 genitourinary system Z48.816 cystostomy device Z46.6 sensitivity test — see also Test, skin joint replacement Z47.1 dental prosthesis Z46.3 allergy NEC Z01.82 neoplasm Z48.3 dentures Z46.3 Mantoux Z11.1 nervous system Z48.811 device NEC tuboplasty following previous sterilization Z31.0 oral cavity Z48.814 abdominal Z46.89 aftercare Z31.42 organ transplant nervous system Z46.2 vasoplasty following previous sterilization Z31.0 bone marrow Z48.290 implanted — see Admission, adjustment, aftercare Z31.42 heart Z48.21 device, implanted, nervous system vision examination Z01.00 heart-lung Z48.280 orthodontic Z46.4 with abnormal findings Z01.01 kidney Z48.22 prosthetic Z44.9 following failed vision screening Z01.020 liver Z48.23 breast Z44.3 S with abnormal findings Z01.021 lung Z48.24 dental Z46.3 infant or child (over 28 days old) Z00.129 multiple organs NEC Z48.288 eye Z44.2 S with abnormal findings Z00.121 specified NEC Z48.298 substitution waiting period for admission to other facility Z75.1 orthopedic NEC Z47.89 auditory Z46.2 Adnexitis (suppurative) — see Salpingo-oophoritis planned wound closure Z48.1 implanted — see Admission, adjustment, Adolescent X-linked adrenoleukodystrophy E71.521 removal of internal fixation device Z47.2 device, implanted, hearing device Adrenal (gland) — see condition respiratory system Z48.813 nervous system Z46.2 Adrenalism, tuberculous A18.7 scoliosis Z47.82 implanted — see Admission, adjustment, Adrenalitis, adrenitis E27.8 sense organs Z48.810 device, implanted, nervous system autoimmune E27.1 skin and subcutaneous tissue Z48.817 visual Z46.2 meningococcal, hemorrhagic A39.1 specified body system implanted Z45.31 Adrenarche, premature E27.0 circulatory Z48.812 hearing aid Z46.1 Adrenocortical syndrome — see Cushing's, syndrome digestive Z48.815 ileostomy device Z46.89 Adrenogenital syndrome E25.9 genitourinary Z48.816 intestinal appliance or device NEC Z46.89 acquired E25.8 nervous Z48.811 neuropacemaker (brain) (peripheral nerve) (spinal congenital E25.0 oral cavity Z48.814 cord) Z46.2 salt loss E25.0 respiratory Z48.813 implanted Z45.42 Adrenogenitalism, congenital E25.0 sense organs Z48.810 orthodontic device Z46.4 Adrenoleukodystrophy E71.529 skin and subcutaneous tissue Z48.817 orthopedic device (brace) (cast) (shoes) Z46.89 neonatal E71.511 teeth Z48.814 prosthesis Z44.9 X-linked E71.529 specified NEC Z48.89 arm — see Admission, adjustment, artificial, arm Addison only phenotype E71.528 spinal Z47.89 breast Z44.3 S Addison-Schilder E71.528 teeth Z48.814 dental Z46.3 adolescent E71.521 fracture — code to fracture with seventh character D eye Z44.2 S adrenomyeloneuropathy E71.522 involving leg — see Admission, adjustment, artificial, leg childhood cerebral E71.520 removal of specified type NEC Z44.8 other specified E71.528 drains Z48.03 spectacles Z46.0 Adrenomyeloneuropathy E71.522 dressings (nonsurgical) Z48.00 follow-up examination Z09 Adventitious bursa — see Bursopathy, specified type staples Z48.02 intrauterine device management Z30.431 NEC surgical dressings Z48.01 initial prescription Z30.014 Adverse effect — see Table of Drugs and Chemicals, sutures Z48.02 mental health evaluation Z00.8 categories T36-T50, with 6th character 5 neuropacemaker (brain) (peripheral nerve) (spinal cord) requested by authority Z04.6 Advice — see Counseling Z46.2 observation — see Observation Adynamia (episodica) (hereditary) (periodic) G72.3 implanted Z45.42 orthopedic NEC Z47.89 Papanicolaou smear, cervix Z12.4 Aeration lung imperfect, newborn — see Atelectasis postprocedural — see Aftercare, following surgery for suspected malignant neoplasm Z12.4 Aerobullosis T70.3 S After-cataract — see Cataract, secondary plastic and reconstructive surgery following medical Aerocele — see Embolism, air procedure or healed injury NEC Z42.8 Agalactia (primary) O92.3 Aerodermectasia elective, secondary or therapeutic O92.5 plastic surgery, cosmetic NEC Z41.1 subcutaneous (traumatic) T79.7 S postpartum observation Agammaglobulinemia(acquired (secondary) (nonfamil- Aerodontalgia T70.29 S ial) D80.1 immediately after delivery Z39.0 Aeroembolism T70.3 S routine follow-up Z39.2 with Aerogenes capsulatus infection A48.0 immunoglobulin-bearing B-lymphocytes D80.1 poststerilization (for restoration) Z31.0 Aero-otitis media T70.0 S aftercare Z31.42 lymphopenia D81.9 Aerophagy, aerophagia (psychogenic) F45.8 autosomal recessive (Swiss type) D80.0 procreative management Z31.9 Aerophobia F40.228 prophylactic (measure) — seealso Encounter, prophy- Bruton's X-linked D80.0 SAMPLEAerosinusitis T70.1 S common variable (CVAgamma) D80.1 lactic measures Aerotitis T70.0 S organ removal Z40.00 congenital sex-linked D80.0 Affection — see Disease breast Z40.01 hereditary D80.0 fallopian tube(s) Z40.03 Afibrinogenemia — see also Defect, coagulation D68.8 lymphopenic D81.9 with ovary(s) Z40.02 acquired D65 Swiss type (autosomal recessive) D80.0 ovary(s) Z40.02 congenital D68.2 X-linked (with growth hormone deficiency) (Bruton) specified organ NEC Z40.09 following ectopic or molar pregnancy O08.1 D80.0 testes Z40.09 in abortion — see Abortion, by type, complicated by, Aganglionosis (bowel) (colon) Q43.1 vaccination Z23 afibrinogenemia Age (old) — see Senility psychiatric examination (general) Z00.8 puerperal O72.3 Agenesis requested by authority Z04.6 African adrenal (gland) Q89.1 radiation therapy (antineoplastic) Z51.0 sleeping sickness B56.9 alimentary tract (complete) (partial) NEC Q45.8 reconstructive surgery following medical procedure or tick fever A68.1 upper Q40.8 healed injury NEC Z42.8 trypanosomiasis B56.9 anus, anal (canal) Q42.3 removal of gambian B56.0 with fistula Q42.2 cystostomy catheter Z43.5 rhodesian B56.1 aorta Q25.41 Aftercare — see also Care Z51.89 Admission — Agenesis 14 S Additional Character Required — Refer to the Tabular List for Character Selection 2 Subterms under main terms may continue to next column or page Chapter 1. Certain Infectious and Parasitic Diseases 439

risk behavior. risk behavior. - cyvirus [HIV] infectionstatus. counter) because of an HIV-related de Z71.7, Human immunodeficiency immunodeficiency Human Z71.7, de Iron deficiencyIron anemia, unspecified Asymptomatic human immunodeficiency virus [HIV] infection status Acute cystitis without cystitis Acute hematuria as the of cause [E.coli] coli Escherichia Unspecified elsewhere classified diseases An instructionalAn cystitisthe the category under for note cystitis (A00–B99), U07.1(A00–B99), Patient is beingPatient seen deficiency for iron anemia. Status positive HIV test on withAtripla, no prior symptoms D50.9 Z21 Z21 Code is sequenced second documentation since Explanation: thatindicates the patienthashad positive a HIV test but has been indicationis not an Being medication HIV for asymptomatic. on been has there Unless of Z21. instead used is B20 code that that the or documentation prior has patient had current symptomsor HIV-related complications,The code B20 is not used. anemiais not an AIDS-related complicationand issequenced first. E. coli If a patient with signs or symptoms is being seen for HIV testing, code code HIV testing, beingsymptoms seensignsIf for is patient or with a the signs Anand symptoms. additional counseling Z71.7, Humancode is counseling be if used [HIV]may virus immunodeficiency counseling, test. the for encounter the during provided When a patient returns to be informed of his/her HIV results test and use co negative, result is the test [HIV]virus counseling. as guidelines codes andprevious assign see positive, are results If the appropriate. Patients with inconclusive HIV serology, but no definitive butor diagnosis no inconclusiveHIV with serology, Patients manifestations of the illness, may be assigned code R75, Inconclusive laboratory of human immunodeficiency [HIV]. virus evidence withPatients any known prior diagnosisof an HIV-related illness shouldbe codedato B20. patient developed Once has HIV-related an every B20 on code be assigned always should patient the illness, subsequent previously Patients diagnosed admission/encounter. with any HIV illness (B20) should be assignednever to R75 or Z21, human immunodeficien Asymptomatic admitted a patient childbirth puerperium, or the During pregnancy, en a health care for (or presenting illness should a principalreceive diagnosis code of O98.7-,Human immunodeficiency [HIV] childbirth pregnancy, disease complicating the for code(s) the and B20 by followed puerperium, the and HIV-related illness(es). Codesfrom Chapter15 always takesequencing priority. withPatients asymptomatic HIV infection status admitted (or childbirth, during pregnancy, a health encounter) presenting care for Z21. and O98.7- of codes receive should puerperium the or If a patient is being seen determineto his/her HIV usestatus, code immunodeficiency virus human for screening for Encounter Z11.4, [HIV]. Use additional codes forany associated high described as having any condition(s) resulting from his/her HIV from condition(s) resulting any having described as cases. these B20 in use status; positive (e) serology HIV inconclusive with Patients (f) illness HIV-related diagnosed Previously (g) the childbirth and puerperium in HIV pregnancy, infection HIV for (h) testing for Encounters Acute N30.00 B96.20 Explanation: codeto indicates also the specific organism. Certain infections are classified in chapters other than Chapter 1 and no is it identifiedastheseinstances, In partorganism is the infection code. of organism.identifynecessary theChapteran to additionalto use 1 from code A code from category B95, Streptococcus, Staphylococcus, and Enterococcus Other bacterial B96, chapters, other to classified diseases of cause the as Viral B97, or chapters, other to classified diseases of cause the as agents an as used be to is chapters, other to classified diseases of cause the as agents additionalAnto identifyinstructional the organism. code found note will be atthe infection code advising that an additionalorganism code isrequired. b. Infectious agents as cause other of diseases the to chapters classified

-CM Official Guidelines for 0 SAMPLE eated for any HIV-related illness or is Human immunodeficiency virus [HIV] disease [HIV] virus immunodeficiency Human unspecified disease, Cytomegaloviral Human immunodeficiency virus [HIV] disease skin of sarcoma Kaposi’s Sprain of other ligament of right ankle, initial initial ankle, right of ligament other of Sprain encounter Human immunodeficiency virus [HIV] disease Even though the HIV was diagnosed on a previous The The ankle so sprain it isis not the to related HIV, Cytomegaloviral infection Cytomegaloviral condition, is an HIV related Only the hypothyroidism is coded in this scenario because Hypothyroidism, unspecified Hypothyroidism, encounter, itis still sequenced first when codedwith an condition. Kaposi’sHIV-related sarcoma is an HIV-related condition. C46.0 Explanation: first-listed diagnosis code, diagnosisfirst-listed and code, HIV is reported secondarily. lesionsdiagnosed in multiple cutaneous Kaposi’sNewly sarcoma previously diagnosed HIV disease B20 Sprain of the internal collateral ligament, right ankle; HIV S93.491A B20 Explanation: so the HIV diagnosis code is reported by the first, followed code for the CMV. HIV with CMV with HIV B20 B25.9 Explanation: Z21, Asymptomatic immunodeficiency Asymptomatic human Z21, virus [HIV] infection beappliedto when is the patient withoutstatus, documentation any test“HIV “known HIV,” of symptoms is listed as being “HIV positive,” or similar Doterminology. not use this positive,” code if the term is used“AIDS” or if the patient is tr Whether theWhether patient is newly diagnosed or has had previous admissions/encounters for HIV conditions is to irrelevant the decision. sequencing If a patient with HIV disease is admitted an unrelatedfor condition (such as a traumatic injury), the code for the unrelated condition (e.g., of injury nature theprincipal should code) the Other be diagnosis. diagnosesbeadditionalfollowed would B20 bydiagnosis codes all for reported HIV-relatedconditions. If a patient is admitted anfor condition,HIV-related the principal diagnosis should be B20, Human immunodeficiency virus [HIV] disease followed by additional diagnosis codes allfor reported conditions.HIV-related E03.9 Explanation: Patient being seen for hypothyroidism with possibleinfection HIV with hypothyroidism seen for being Patient infectionpresent. HIVthat not been is an confirmedit has (d) Asymptomatic human immunodeficiency virus (c) is diagnosed newly the Whether patient (b) condition unrelated admitted for disease HIV with Patient (a) Patient admitted for HIV-related condition condition (a) HIV-related for admitted Patient Code only confirmed to casesan exception is ofThis HIV infection/illness. the hospital inpatient guideline Section II, H. does In thisnot require documentation context, “confirmation” of statement diagnostic provider’s the HIV; for or culture serology positive that the patient is HIV positive, or has an HIV-related illness is sufficient. 2) Selection and sequencing of HIV codes 1) cases confirmed only Code Chapter-specific Guidelines with Coding Examples Coding with Guidelines Chapter-specific chapter-specificThe guidelines from the ICD-1 ICD-10-CM Tabular List of Diseases and Injuries and of Diseases List Tabular ICD-10-CM Chapter 1. Certain Infectious andDiseases Parasitic 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 found in theseguidance guidelines. a. infections (HIV) virus immunodeficiency Human ICD-10-CM 2022 H60–H60.599 Chapter 8. Diseases of the Ear and Mastoid Process ICD-10-CM 2022 Chapter 8. Diseases of the Ear and Mastoid Process H60.399 Other infective otitis externa, unspecified ear 6 (H60-H95) c H60.4 Cholesteatoma of external ear NOTE Use an external cause code following the code for the ear condition, Keratosis obturans of external ear (canal) if applicable, to identify the cause of the ear condition 2 cholesteatoma of middle ear (H71.-) 2 certain conditions originating in the perinatal period (P04-P96) recurrent cholesteatoma of postmastoidectomy certain infectious and parasitic diseases (A00-B99) cavity (H95.0-) complicationsofpregnancy,childbirthandthepuerperium(O00-O9A) DEF: Cholesteatoma: Noncancerous cyst-like mass of cell debris, congenital malformations, deformations and chromosomal including cholesterol and epithelial cells resulting from trauma, abnormalities (Q00-Q99) repeated or improperly healed infections, and congenital endocrine, nutritional and metabolic diseases (E00-E88) enclosure of epidermal cells. injury, poisoning and certain other consequences of external causes H60.40 Cholesteatoma of external ear, unspecified ear (S00-T88) H60.41 Cholesteatoma of right external ear neoplasms (C00-D49) H60.42 Cholesteatoma of left external ear symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94) H60.43 Cholesteatoma of external ear, bilateral H60.5 Acute noninfective otitis externa This chapter contains the following blocks: c H60-H62 Diseases of external ear d H60.50 Unspecified acute noninfective otitis externa H65-H75 Diseases of middle ear and mastoid Acute otitis externa NOS H80-H83 Diseases of inner ear H60.501 Unspecified acute noninfective otitis H90-H94 Other disorders of ear externa, right ear 6 H95 Intraoperative and postprocedural complications and disorders of H60.502 Unspecified acute noninfective otitis ear and mastoid process, not elsewhere classified externa, left ear 6 H60.503 Unspecified acute noninfective otitis Diseases of external ear (H60-H62) externa, bilateral 6 b H60 Otitis externa H60.509 Unspecified acute noninfective otitis externa, unspecified ear 6

Chapter 8. Diseases of the Ear and Mastoid Process TIP: When the specific infectious agent is identified, a code from Chapter 1 is assigned instead of a code from this category. d H60.51 Acute actinic otitis externa c H60.0 Abscess of external ear H60.511 Acute actinic otitis externa, right ear 6 Boil of external ear H60.512 Acute actinic otitis externa, left ear 6 Carbuncle of auricle or external auditory canal H60.513 Acute actinic otitis externa, Furuncle of external ear bilateral 6 H60.00 Abscess of external ear, unspecified ear H60.519 Acute actinic otitis externa, unspecified H60.01 Abscess of right external ear ear 6 H60.02 Abscess of left external ear d H60.52 Acute chemical otitis externa H60.03 Abscess of external ear, bilateral H60.521 Acute chemical otitis externa, right c H60.1 Cellulitis of external ear ear 6 Cellulitis of auricle H60.522 Acute chemical otitis externa, left Cellulitis of external auditory canal ear 6 H60.10 Cellulitis of external ear, unspecified ear H60.523 Acute chemical otitis externa, H60.11 Cellulitis of right external ear bilateral 6 H60.12 Cellulitis of left external ear H60.529 Acutechemicalotitisexterna,unspecified H60.13 Cellulitis of external ear, bilateral ear 6 c H60.2 Malignant otitis externa d H60.53 Acute contact otitis externa H60.20 Malignant otitis externa, unspecified ear H60.531 Acute contact otitis externa, right H60.21 Malignant otitis externa, right ear ear 6 H60.22 Malignant otitis externa, left ear H60.532 Acute contact otitis externa, left ear 6 H60.23 Malignant otitis externa, bilateral H60.533 Acute contact otitis externa, c H60.3 Other infective otitis externa bilateral 6 H60.539 Acute contact otitis externa, unspecified d H60.31 Diffuse otitis externa ear 6 H60.311 Diffuse otitis externa, right ear 6 d H60.54 Acute eczematoid otitis externa H60.312 Diffuse otitis externa, left ear 6 H60.541 Acute eczematoid otitis externa, right H60.313 Diffuse otitis externa, bilateral 6 ear 6 H60.319 Diffuse otitis externa, unspecified H60.542 Acute eczematoid otitis externa, left ear 6 ear 6 d H60.32 Hemorrhagic otitis externa H60.543 Acute eczematoid otitis externa, H60.321 Hemorrhagic otitis externa, right bilateral 6 ear 6 H60.549 Acute eczematoid otitis externa, H60.322 Hemorrhagic otitis externa, left ear 6 unspecified ear 6 H60.323 Hemorrhagic otitis externa, d H60.55 Acute reactive otitis externa bilateral 6 H60.551 Acute reactive otitis externa, right H60.329 Hemorrhagic otitis externa, unspecified ear 6 earSAMPLE6 H60.552 Acute reactive otitis externa, left d H60.33 Swimmer's ear ear 6 DEF: Commonly occurs when water gets trapped in H60.553 Acute reactive otitis externa, the ear after swimming. bilateral 6 H60.331 Swimmer's ear, right ear 6 H60.559 Acute reactive otitis externa, unspecified H60.332 Swimmer's ear, left ear 6 ear 6 H60.333 Swimmer's ear, bilateral 6 d H60.59 Other noninfective acute otitis externa H60.339 Swimmer's ear, unspecified ear 6 H60.591 Other noninfective acute otitis externa, d H60.39 Other infective otitis externa right ear 6 H60.391 Other infective otitis externa, right H60.592 Other noninfective acute otitis externa, ear 6 left ear 6 H60.392 Other infective otitis externa, left H60.593 Other noninfective acute otitis externa, bilateral 6 H60–H60.599 ear 6 H60.393 Other infective otitis externa, H60.599 Other noninfective acute otitis externa, bilateral 6 unspecified ear 6

< CMS-HCC 6 QPP 8 Newborn: 0 9 Pediatric: 0-17 x Maternity: 9-64 y Adult: 15-124 632 ICD-10-CM 2022 ICD-10-CM 2022 Chapter 10. Diseases of the Respiratory System J39.3–J43.9

J39.3 Upper respiratory tract hypersensitivity reaction, site b J43 Emphysema Chapter 1 0 . Diseases of the Respiratory System unspecified Use additional code to identify: 1 hypersensitivity reaction of upper respiratory tract, exposure to environmental tobacco smoke (Z77.22) such as: history of tobacco dependence (Z87.891) extrinsic allergic alveolitis (J67.9) occupational exposure to environmental tobacco smoke (Z57.31) pneumoconiosis (J60-J67.9) tobacco dependence (F17.-) J39.8 Other specified diseases of upper respiratory tract tobacco use (Z72.0) J39.9 Disease of upper respiratory tract, unspecified 1 compensatory emphysema (J98.3) emphysema due to inhalation of chemicals, gases, fumes or Chronic lower respiratory diseases (J40-J47) vapors (J68.4) 1 bronchitis due to chemicals, gases, fumes and vapors (J68.0) emphysema with chronic (obstructive) bronchitis (J44.-) 2 cystic fibrosis (E84.-) emphysematous (obstructive) bronchitis (J44.-) J40 Bronchitis, not specified as acute or chronic interstitial emphysema (J98.2) Bronchitis NOS mediastinal emphysema (J98.2) Bronchitis with tracheitis NOS neonatal interstitial emphysema (P25.0) Catarrhal bronchitis surgical (subcutaneous) emphysema (T81.82) Tracheobronchitis NOS traumatic subcutaneous emphysema (T79.7) Use additional code to identify: 2 wtraumatic subcutaneous emphysema (T79.7)x exposure to environmental tobacco smoke (Z77.22) DEF: Pathological condition in which there is destructive enlargement of exposure to tobacco smoke in the perinatal period (P96.81) the air sacs in the lungs resulting in damage and lack of elasticity to the history of tobacco dependence (Z87.891) alveolar walls, commonly seen in long-term smokers. occupational exposure to environmental tobacco smoke (Z57.31) tobacco dependence (F17.-) Emphysema tobacco use (Z72.0) Healthy alveoli Alveoli w/ Emphysema 1 acute bronchitis (J20.-) Patent allergic bronchitis NOS (J45.909-) bronchiole asthmatic bronchitis NOS (J45.9-) Collapsed bronchitis due to chemicals, gases, fumes and vapors (J68.0) bronchiole AHA: 2020,1Q,34-36 TIP: Assign as a secondary code for a patient with bronchitis of unspecified acuity due to COVID-19; assign U07.1 as the principal or first-listed code. b J41 Simple and mucopurulent chronic bronchitis Use additional code to identify: exposure to environmental tobacco smoke (Z77.22) exposure to tobacco smoke in the perinatal period (P96.81) Well-vascularized Broken/ history of tobacco dependence (Z87.891) Enlarged alveoli fewer occupational exposure to environmental tobacco smoke (Z57.31) capillaries tobacco dependence (F17.-) Dilated alveoli Alveolar membranes break down tobacco use (Z72.0) Excess mucus 1 chronic bronchitis NOS (J42) chronic obstructive bronchitis (J44.-) J43.0 Unilateral pulmonary emphysema [MacLeod's J41.0 Simple chronic bronchitis <6 syndrome] <6 J41.1 Mucopurulent chronic bronchitis <6 Swyer-James syndrome J41.8 Mixed simple and mucopurulent chronic bronchitis <6 Unilateral emphysema J42 Unspecified chronic bronchitis <6 Unilateral hyperlucent lung Chronic bronchitis NOS Unilateral pulmonary artery functional hypoplasia Chronic tracheitis Unilateral transparency of lung Chronic tracheobronchitis J43.1 Panlobular emphysema <6 Use additional code to identify: Panacinar emphysema exposure to environmental tobacco smoke (Z77.22) J43.2 Centrilobular emphysema <6 exposure to tobacco smoke in the perinatal period (P96.81) J43.8 Other emphysema <6 history of tobacco dependence (Z87.891) J43.9 Emphysema, unspecified <6 occupational exposure to environmental tobacco smoke (Z57.31) Bullous emphysema (lung)(pulmonary) tobacco dependence (F17.-) Emphysema (lung)(pulmonary) NOS tobacco use (Z72.0) Emphysematous bleb 1 chronic asthmatic bronchitis (J44.-) Vesicular emphysema (lung)(pulmonary) chronic bronchitis with airways obstruction (J44.-) AHA: 2019,1Q,34-36; 2017,4Q,97-98 chronic emphysematous bronchitis (J44.-) chronic obstructive pulmonary disease NOS (J44.9) simple andSAMPLE mucopurulent chronic bronchitis (J41.-) J39.3–J43.9

SAdditional Character Required g Placeholder Alert Manifestation Unspecified Dx wx Revised Text l New Code s Revised Code Title ICD-10-CM 2022 695 ICD-10-CM 2022 Chapter 18. Symptoms, Signs and Abnormal Clinical and Laboratory Findings R00–R05

Chapter 18. Symptoms, Signs and Abnormal Clinical R00.1 Bradycardia, unspecified Findings Laboratory and Clinical Abnormal and Signs Symptoms, 18. Chapter Sinoatrial bradycardia and Laboratory Findings, Not Elsewhere Classified Sinus bradycardia (R00-R99) Slow heart beat Vagal bradycardia NOTE This chapter includes symptoms, signs, abnormal results of clinical Use additional code for adverse effect, if applicable, to identify or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded. drug (T36-T50 with fifth or sixth character 5) neonatal bradycardia (P29.12) Signs and symptoms that point rather definitely to a given diagnosis 1 have been assigned to a category in other chapters of the AHA: 2020,2Q,23 classification. In general, categories in this chapter include the less DEF: Slowed heartbeat, usually defined as a rate fewer than 60 well-defined conditions and symptoms that, without the necessary beats per minute. Heart rhythm may be slow as a result of a study of the case to establish a final diagnosis, point perhaps equally congenital defect or an acquired problem. to two or more diseases or to two or more systems of the body. R00.2 Palpitations Practically all categories in the chapter could be designated 'not Awareness of heart beat otherwise specified', 'unknown etiology' or 'transient'. The R00.8 Other abnormalities of heart beat Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other R00.9 Unspecified abnormalities of heart beat chapters. The residual subcategories, numbered .8, are generally b R01 Cardiac murmurs and other cardiac sounds provided for other relevant symptoms that cannot be allocated 1 cardiac murmurs and sounds originating in the perinatal elsewhere in the classification. period (P29.8) The conditions and signs or symptoms included in categories R01.0 Benign and innocent cardiac murmurs R00-R94 consist of: Functional cardiac murmur (a) cases for which no more specific diagnosis can be made even R01.1 Cardiac murmur, unspecified after all the facts bearing on the case have been investigated; Cardiac bruit NOS (b) signs or symptoms existing at the time of initial encounter Heart murmur NOS that proved to be transient and whose causes could not be determined; Systolic murmur NOS (c) provisional diagnosis in a patient who failed to return for R01.2 Other cardiac sounds further investigation or care; Cardiac dullness, increased or decreased (d) cases referred elsewhere for investigation or treatment before Precordial friction the diagnosis was made; b R03 Abnormal blood-pressure reading, without diagnosis (e) cases in which a more precise diagnosis was not available for R03.0 Elevated blood-pressure reading, without diagnosis of any other reason; hypertension (f) certain symptoms, for which supplementary information is NOTE This category is to be used to record an episode of provided, that represent important problems in medical care elevated blood pressure in a patient in whom no in their own right. formal diagnosis of hypertension has been made, 2 abnormal findings on antenatal screening of mother (O28.-) or as an isolated incidental finding. certain conditions originating in the perinatal period (P04-P96) signs and symptoms classified in the body system chapters R03.1 Nonspecific low blood-pressure reading signs and symptoms of breast (N63, N64.5) 1 hypotension (I95.-) AHA: 2017,1Q,6,7 maternal hypotension syndrome (O26.5-) This chapter contains the following blocks: neurogenic orthostatic hypotension (G90.3) R00-R09 Symptoms and signs involving the circulatory and respiratory systems b R04 Hemorrhage from respiratory passages R10-R19 Symptoms and signs involving the digestive system and abdomen R20-R23 Symptoms and signs involving the skin and subcutaneous tissue R04.0 Epistaxis R25-R29 Symptoms and signs involving the nervous and musculoskeletal Hemorrhage from nose systems Nosebleed R30-R39 Symptoms and signs involving the genitourinary system R04.1 Hemorrhage from throat R40-R46 Symptoms and signs involving cognition, perception, emotional state 2 hemoptysis (R04.2) and behavior R04.2 Hemoptysis R47-R49 Symptoms and signs involving speech and voice Blood-stained sputum R50-R69 General symptoms and signs R70-R79 Abnormal findings on examination of blood, without diagnosis Cough with hemorrhage R80-R82 Abnormal findings on examination of urine, without diagnosis AHA: 2013,4Q,118 R83-R89 Abnormal findings on examination of other body fluids, substances c R04.8 Hemorrhage from other sites in respiratory passages and tissues, without diagnosis R04.81 Acute idiopathic pulmonary hemorrhage in R90-R94 Abnormal findings on diagnostic imaging and in function studies, infants 9 without diagnosis R97 Abnormal tumor markers AIPHI R99 Ill-defined and unknown cause of mortality Acute idiopathic hemorrhage in infants over 28 days old Symptomsandsignsinvolvingthecirculatoryandrespiratory 1 perinatal pulmonary hemorrhage (P26.-) systems (R00-R09) von Willebrand's disease (D68.0) R04.89 Hemorrhage from other sites in respiratory b R00 Abnormalities of heart beat passages 1 abnormalities originating in the perinatal period (P29.1-) Pulmonary hemorrhage NOS 2 specified arrhythmias (I47-I49) R04.9 Hemorrhage from respiratory passages, unspecified R00.0 Tachycardia, unspecifiedSAMPLE CoughR05 Rapid heart beat 1 cough with hemorrhage (R04.2) Sinoauricular tachycardia NOS smoker's cough (J41.0) Sinus [sinusal] tachycardia NOS AHA: 2016,2Q,33 1 neonatal tachycardia (P29.11) paroxysmal tachycardia (I47.-)

DEF: Excessively rapid heart rate of more than 100 beats per R00–R05 minute.

SAdditional Character Required g Placeholder Alert Manifestation Unspecified Dx wx Revised Text l New Code s Revised Code Title ICD-10-CM 2022 935 ICD-10-CM 2022 Chapter 21. Factors Influencing Health Status and Contact With Health Services Z62.6–Z67.10

Z62.6 Inappropriate (excessive) parental pressure Z63.79 Other stressful life events affecting family and Services Health With Contact and Status Health Influencing Factors 21. Chapter c Z62.8 Other specified problems related to upbringing household d Z62.81 Personal history of abuse in childhood Anxiety (normal) about sick person in family Health problems within family Z62.810 Personal history of physical and sexual Ill or disturbed family member abuse in childhood Isolated family 1 current child physical abuse (T74.12, T76.12) Z63.8 Other specified problems related to primary support group current child sexual abuse Family discord NOS (T74.22, T76.22) Family estrangement NOS High expressed emotional level within family Z62.811 Personal history of psychological abuse in childhood Inadequate family support NOS 1 current child psychological Inadequate or distorted communication within family abuse (T74.32, T76.32) Z63.9 Problem related to primary support group, unspecified Z62.812 Personal history of neglect in childhood Relationship disorder NOS 1 current child neglect (T74.02, b Z64 Problems related to certain psychosocial circumstances T76.02) Z64.0 Problems related to unwanted pregnancy ; Z62.813 Personalhistoryofforcedlabororsexual Z64.1 Problems related to multiparity ; exploitation in childhood AHA: 2018,4Q,32,35 Z64.4 Discord with counselors Discord with probation officer Z62.819 Personal history of unspecified abuse in childhood Discord with social worker 1 current child abuse NOS b Z65 Problems related to other psychosocial circumstances (T74.92, T76.92) Z65.0 Conviction in civil and criminal proceedings without d Z62.82 Parent-child conflict imprisonment Z62.820 Parent-biological child conflict Z65.1 Imprisonment and other incarceration Parent-child problem NOS Z65.2 Problems related to release from prison Z62.821 Parent-adopted child conflict Z65.3 Problems related to other legal circumstances Z62.822 Parent-foster child conflict Arrest d Z62.89 Other specified problems related to upbringing Child custody or support proceedings Z62.890 Parent-child estrangement NEC Litigation Z62.891 Sibling rivalry Prosecution Z62.898 Other specified problems related to Z65.4 Victim of crime and terrorism upbringing Victim of torture Z62.9 Problem related to upbringing, unspecified Z65.5 Exposure to disaster, war and other hostilities b Z63 Otherproblemsrelatedtoprimarysupportgroup,includingfamily 1 target of perceived discrimination or persecution circumstances (Z60.5) 2 maltreatment syndrome (T74.-, T76) Z65.8 Other specified problems related to psychosocial parent-child problems (Z62.-) circumstances problems related to negative life events in childhood (Z62.-) Religious or spiritual problem problems related to upbringing (Z62.-) Z65.9 Problem related to unspecified psychosocial circumstances Z63.0 Problems in relationship with spouse or partner Do not resuscitate status (Z66) Relationship distress with spouse or intimate partner 1 counseling for spousal or partner abuse problems Z66 Do not resuscitate (Z69.1) DNR status counseling related to sexual attitude, behavior, and DEF: Medical order written by a physician that instructs others not to orientation (Z70.-) perform cardiopulmonary resuscitation (CPR), intubation, or advanced Z63.1 Problems in relationship with in-laws life support (ACLS). It prevents unnecessary invasive treatment to prolong c Z63.3 Absence of family member life should breathing stop or cardiac arrest occur. 1 absenceoffamilymemberduetodisappearanceand Blood type (Z67) death (Z63.4) absence of family member due to separation and b Z67 Blood type divorce (Z63.5) AHA: 2015,3Q,40 Z63.31 Absence of family member due to military deployment Individual or family affected by other family member Blood Types being on military deployment Antigen B 1 family disruption due to return of family Antigen A member from military deployment Blood Type Blood Type (Z63.71) A B Z63.32 Other absence of family member Z63.4 Disappearance and death of family member Assumed death of family member Anti-B Bereavement SAMPLEantibody Anti-A AHA: 2014,1Q,25 antibody Z63.5 Disruption of family by separation and divorce Marital estrangement Z63.6 Dependent relative needing care at home

c Z63.7 Other stressful life events affecting family and household Blood Type Z62.6–Z67.10 S S EN Z63.71 Stress on family due to return of family member IE IG AB OD T IB N from military deployment T A N O A N Individual or family affected by family member having O returned from military deployment (current or N Blood Type past conflict) Antigen A O Z63.72 Alcoholism and drug addiction in family Antigen B

c Z67.1 Type A blood Z67.10 Type A blood, Rh positive

SAdditional Character Required g Placeholder Alert Manifestation Unspecified Dx wx Revised Text l New Code s Revised Code Title ICD-10-CM 2022 1241 Appendix A: Valid 3-character ICD-10-CM Codes Appendixes–1

physiological condition condition elsewhere classified diseases factors physical and disturbances elsewhere elsewhere classified elsewhere E46E52 malnutrition protein-calorie Unspecified E54 [pellagra] deficiency Niacin E58 Ascorbic acid deficiency E59 deficiency calcium Dietary E60 Dietary selenium deficiency E65 deficiency zinc Dietary E68 Localized adiposity F04 hyperalimentation of Sequelae F05 Amnestic disorder due to known physiological condition F09 Delirium duetoknown physiological condition F21 Unspecified mental due to known disorder physiological condition F22 disorder Schizotypal F23 Delusional disorders F24 disorder psychotic Brief F28 disorder psychotic Shared known or substance a due to not disorder Other psychotic F29 not psychosis Unspecified todue a substance or known physiological F39F54 Unspecified mood [affective] disorder or disorders with associated factors and behavioral Psychological F59 physiological with associated syndromes behavioral Unspecified F66F69disorders sexual Other F70 behavior and personality adult of disorder Unspecified F71 disabilities intellectual Mild F72 disabilities intellectual Moderate F73 disabilities intellectual Severe F78 Profound intellectualdisabilities F79disabilities Other intellectual F82 disabilities intellectual Unspecified F88motor function of disorder developmental Specific F89 development psychological of disorders Other F99 development psychological of disorder Unspecified G01 Mental disorder, not otherwise specified G02 elsewhere classified diseases bacterial in Meningitis Meningitis inother infectious and parasitic diseasesG07 classified diseases in granuloma and abscess intraspinal and Intracranial G08G09 thrombophlebitis and phlebitis intraspinal and Intracranial G10 system nervous central of diseases inflammatory of Sequelae G14 disease Huntington's G20 syndrome Postpolio G26 disease Parkinson's classified diseases in disorders movement and Extrapyramidal G35G53 sclerosis Multiple G55 elsewhere classified diseases in disorders nerve Cranial G59 elsewhere classified diseases in compressions and plexus root Nerve G63 elsewhere classified diseases in Mononeuropathy G64elsewhere classified diseases in Polyneuropathy G92 system nervous peripheral of disorders Other G94 Toxic encephalopathy H22 Other disordersof brain in diseases classified elsewhere H28 Disorders of iris and ciliary body indiseases classified elsewhere H32 elsewhere classified diseases in Cataract H36 Chorioretinal disordersin diseases classifiedelsewhere H42 elsewhere classified diseases in disorders Retinal I00 elsewhere classified diseases in Glaucoma I10 heart involvement without fever Rheumatic I32 hypertension (primary) Essential I38 elsewhere classified diseases in Pericarditis unspecified valve Endocarditis, SAMPLE membrane lesions classified elsewhere Appendix A: Valid 3-character ICD-10-CM 3-character Codes Valid A: Appendix A09A33 unspecified colitis, and gastroenteritis Infectious A34 neonatorum Tetanus A35 tetanus Obstetrical A46 tetanus Other A55 Erysipelas A57 (venereum) lymphogranuloma Chlamydial A58 Chancroid A64 Granuloma inguinale A65 disease transmitted sexually Unspecified A70 Nonvenereal syphilis A78 infections psittaci Chlamydia A86 fever Q A89 Unspecified viral encephalitis A90 nervouscentral of infection system Unspecified viral A91 Dengue fever[classical dengue] A94 hemorrhagic Dengue fever A99 fever viral arthropod-borne Unspecified B03 Unspecified hemorrhagic viral fever B04 Smallpox B09 Monkeypox Unspecified viral infection characterizedB20 byskin and mucous B49 Human immunodeficiency virus [HIV] disease B54 Unspecified mycosis B59 Unspecified malaria B64 Pneumocystosis B72 Unspecified protozoal disease B75 Dracunculiasis B79 Trichinellosis B80 Trichuriasis B86 Enterobiasis B89 Scabies B91 Unspecified parasitic disease B92 Sequelae of poliomyelitis C01 Sequelae of leprosy C07 Malignant neoplasm of base tongue of C12 Malignant neoplasm of parotid gland C19 neoplasm Malignant of pyriform sinus C20 Malignant neoplasm ofrectosigmoid junction C23 neoplasm Malignant of rectum C33 Malignant neoplasm of gallbladder C37 Malignant neoplasm of trachea C52 neoplasm Malignant of thymus C55 Malignant neoplasm of vagina C58 part unspecified neoplasm of Malignant uterus, C61 Malignant neoplasm of placenta C73 Malignant neoplasm of prostate D34 Malignant neoplasm of gland thyroid D45 Benign neoplasm of thyroid gland D62 Polycythemia vera D65 posthemorrhagic Acute anemia D66 syndrome] [defibrination coagulation intravascular Disseminated D67 Hereditary factor VIII deficiency D71 deficiency IX factor Hereditary D77of polymorphonuclear neutrophils disorders Functional Other disordersblood of and blood-forming organs in diseases E02E15 Subclinical iodine-deficiency hypothyroidism E35 coma hypoglycemic Nondiabetic E40 Disordersof endocrine glands in diseasesclassified elsewhere E41 Kwashiorkor E42 marasmus Nutritional E43 kwashiorkor Marasmic E45 Unspecified severe protein-calorie malnutrition malnutrition protein-calorie following development Retarded ICD-10-CM 2022 ICD-10-CM 2022 Illustrations Chapter 12. Diseases of the Skin and Subcutaneous Tissue (L00–L99)

Nail Anatomy

Hyponychium Cuticle

Nail plate Nail fold Nail bed Nail root

Hyponychium Matrix

Skin

Distal phalanx bone

Skin and Subcutaneous Tissue

Hair

Basal layer Layer corneal

Epidermis

Hair shaft

Dermis

Sebaceous gland

SAMPLEBulb Hypodermis (subcutaneous layer)

Hair follicles Sweat (eccrine gland) Sensory nerve Adipose tissue

Blood vessels

ICD-10-CM 2022 Illustrations–31