AMCI - Week 6: Chapters 10-14 ICD-10 CM

Introduction

• Welcome to Week 6 of Part Two Classes by AMCI
• Focus on chapters 10-14 from ICD-10 CM covering: COPD, fractures, and skin
• Pre-class videos provided for warm-up scenarios

Warm-up Scenarios

1. Scenario 1: Nine-year-old with History of Reactive Airway Disease (RAD)

   • Options: (A) J45.901 + R06.2, (B) J45.901, (C) J45.909 + R06.2, (D) R06.2
   • Correct Answer: (B) J45.901
   • Key Points:
     • Diagnosed with RAD and wheezing
     • Wheezing (R06.2) is a symptom, not coded separately when RAD diagnosis is established
     • Code J45.901: Unspecified asthma with acute exacerbation

2. Scenario 2: Anemia Due to CKD

   • Options: (A) D63.1 + N18.30, (B) N18.30 + D63.1, (C) D63.8 + N18.9, (D) N18.9 + D63.8
   • Correct Answer: (B) N18.30 + D63.1
   • Key Points:
     • EPO-resistant anemia due to CKD stage 3
     • Code first underlying CKD (N18.30)
     • Followed by anemia in CKD (D63.1)

Coding Guidelines & Key Concepts

COPD and Respiratory Failure

• Keywords/Definitions:

  • Acute exacerbation: Worsening of chronic condition
  • Asthmaticus: Severe asthma episode, unresponsive to treatment
  • Respiratory Failure:
    • Acute: J96.0-
    • Chronic: J96.1-
    • Acute and Chronic: J96.2-

• Scenarios:

  1. Acute Respiratory Failure with Hypercapnia

     • Choices: (A) J96.02, (B) J96.01, (C) J96.12, (D) J96.22
     • Correct Answer: (A) J96.02

  2. Mild Persistent Asthma, Well-Controlled, Smoker

     • Choices: (A) J45.20 + F17.200, (B) J45.31 + F17.210, (C) J45.30 + F17.210, (D) J45.30 + Z72.0
     • Correct Answer: (C) J45.30 + F17.210

  3. COPD with Pneumonia

     • Choices: (A) J10.08 + J14 + J96.01, (B) J96.00 + J13, (C) J96.02 + J13, (D) J96.01 + J14
     • Correct Answer: (D) J96.01 + J14
     • Key Points:
       • COPD with acute respiratory failure with hypoxia + Pneumonia due to Hemophilus influenza (J14)

Skin and Subcutaneous Tissue

• Definitions:

  • Pressure Ulcers: Staged from 1 to 4 and classified as unstageable or unspecified
  • Key Terms:
    • Stage 1: Focal erythema
    • Stage 2: Partial thickness loss
    • Stage 3: Full thickness loss involving subcutaneous tissue
    • Stage 4: Full thickness loss with necrosis, exposing muscle/bone
    • Unstageable: Base covered by eschar, stage not determined
    • Unspecified: Stage not specified
    • Gangrene: Tissue death due to loss of blood supply

• Scenarios:

  1. Pressure Ulcer on Each Heel

     • Choices: (A) L97.409, (B) L89.619, (C) L89.610, (D) L89.619 + L89.629
     • Correct Answer: (D) L89.619 + L89.629

  2. Pressure Ulcer Ankle Stage 1

     • Correct Answer: L89.501

  3. Pressure Ulcer Unstageable Face

     • Correct Answer: L89.810

  4. Pressure Ulcer Stage 4 Left Heel

     • Correct Answer: L89.624

Genitourinary System

• Definitions:

  • Chronic Kidney Disease (CKD): Gradual loss of kidney function
  • Stages: I to V, with V being end-stage renal disease (ESRD)

• Key Guidelines:

  • Code only for ESRD if both stage and ESRD are documented

• Scenarios:

  1. BPH with Urinary Urgency

     • Choices: (A) N40.0 + R39.15, (B) N40.1 + R35.0, (C) N40.1 + R39.15, (D) N40.1
     • Correct Answer: (C) N40.1 + R39.15

  2. Right Hydronephrosis

     • Choices: (A) Q62.0 + N13.30, (B) N13.30 + Q62.0, (C) N13.30, (D) Q62.0
     • Correct Answer: (C) N13.30