Pair These ICD-10 2018 Official

Guideline Updates With Their Code Set

Counterparts
The ICD-10-CM 2018 Official Guidelines are out and ready for review. When you
check through the new OGs for changes, take special note of these updates that line
up with 2018 code set revisions.

Look at Level to Choose In Remission

Code
When you start to apply new codes for substance abuse in remission (youll find them
in categories F10-F19), keep in mind this new paragraph in Section I.C.5.b.1:

Mild substance use disorders in early or sustained remission are classified to the
appropriate codes for substance abuse in remission, and moderate or severe
substance use disorders in early or sustained remission are classified to the
appropriate codes for substance dependence in remission.
Ready for New Blindness Codes
ICD-10-CM 2018 introduces about 50 new subcategories and reportable codes for low vision and blindness. The
changes help you report the status of both eyes in a single code. Follow these rules from Section I.C.7.b when
documentation is less than ideal:

If blindness or low vision of both eyes is documented but the visual impairment category is not documented,
assign code H54.3, Unqualified visual loss, both eyes. If blindness or low vision in one eye is documented but
the visual impairment category is not documented, assign a code from H54.6-, Unqualified visual loss, one eye. If
blindness or visual loss is documented without any information about whether one or both eyes are affected,
assign code H54.7, Unspecified visual loss.
Keep Type in Mind for MI OGs
The OGs have long been important for understanding myocardial infarction (MI) coding. Things get a little more interesting
this year because the OGs have to take into account a new coding structure for MI. Existing codes I21.0- to I21.4 will apply
to type 1 MIs in the new code set. For MI NOS, youll have I21.9 (Acute myocardial infarction, unspecified). For type 2 MI,
youll choose I21. A1 (Myocardial infarction type 2), and for types 3-5 youll use I21.A9 (Other myocardial infarction type).

If you code MIs, be sure to read all of Section I.C.9.e because there are revisions sprinkled throughout showing that the
OGs youre accustomed to using will apply to type 1 MI. For subsequent MI, dont miss this added paragraph:

Do not assign code I22 for subsequent myocardial infarctions other than type 1 or unspecified. For subsequent type 2 AMI
assign only code I21.A1. For subsequent type 4 or type 5 AMI, assign only code I21.A9.

To help you get to know the new type 2 code, take note of this added paragraph:

Type 2 myocardial infarction, and myocardial infarction due to demand ischemia or secondary to ischemic balance, is
assigned to code I21.A1, Myocardial infarction type 2[,] with a code for the underlying cause. Do not assign code I24.8,
Other forms of acute ischemic heart disease[,] for the demand ischemia. Sequencing of type 2 AMI or the underlying cause
is dependent on the circumstances of admission. When a type 2 AMI code is described as NSTEMI or STEMI, only assign
code I21.A1. Codes I21.01-I21.4 should only be assigned for type 1 AMIs.
Put Your Knowledge to Work for Non-Pressure
ICD-10 2018 adds 72 new codes for non-pressure chronic ulcers in L97.- and L98.-, bulking up your already existing
options. As you get to know the new codes, spend some time on the OGs that have been added, too. If you know the
OGs for pressure ulcers, youve got a good head start on knowing the new OGs in Section I.C.12.b for non-pressure
chronic ulcers. To sum up:

Dont assign a code for a non-pressure ulcer if documentation states the ulcer was healed when the patient was
admitted
Assign a code for healing non-pressure ulcers based on documentation of severity
If severity progresses during admission, assign one code for level at admission and one code for the highest level
during the stay.

What About You?

Which ICD-10-CM 2018 guidelines will change the way you code? Do you check these guidelines before
coding throughout the year?

Source URL:- http://bit.ly/2eKIoXh

Our Products
Stay tuned to more articles covering 2018 code & reimbursement changes!

Visit blog.supercoder.com today!