Pediatric ICD-10-CM Coding Tip Sheet - BCBSM
Pediatric ICD-10-CM Coding Tip Sheet
Overview of Key Chapter Updates for Pediatric and Top 25 codes
Chapter 5 - Mental, Behavioral and Neurodevelopmental Disorders (F00-F99) Key Updates Classification improvements (different categories) Code expansions:
? Most notably, Other Isolated or Specific Phobias Updates to medical terminology:
? Bipolar I disorder, single manic episode will change to manic episode. ? Undersocialized conduct disorders, aggressive will become Conduct disorder
childhood-onset type. Nicotine dependence updated to identify specific tobacco products (cigarettes, chewing
tobacco, and other tobacco).
Chapter 7 - Diseases of the Eye and Adnexa (H00-H59) Key Updates Diseases of the Eye and Adnexa is a new chapter in ICD-10-CM which has been separated
from the Nervous System and Sense Organs chapter included in ICD-9-CM. Terminology improvements (bringing terms up to date) Revisions to identify laterality:
? Many of the codes have laterality designation and, in some instances bilateral designation for diseases of the eye.
? A code for unspecified site is also provided should the site not be identified in the medical record.
Chapter 10 - Diseases of the Respiratory System (J00-J99) Key Updates Modifications have been made to specific categories that bring the terminology up-to-date
with current medical practice. ? Emphysema now contains codes with panlobular and centrilobular in their description. ? Asthma is now classified as mild intermittent, mild persistent, moderate persistent and severe persistent.
Specificity increased for diseases like influenza, acute bronchitis. Coding notes updated to require the coder to include information about tobacco
use/dependence, where applicable. Procedural complications that affect the respiratory system are now included in this chapter
in ICD-10-CM.
Chapter 18 - Symptoms, Signs and Abnormal Clinical and Laboratory Findings (R00-R99) Key Updates Repeated falls are coded to a symptom code in ICD-10-CM (was a V code in ICD-9-CM). There are codes to identify a patient's coma scale. Systemic inflammatory response syndrome (SIRS) due to noninfectious process is moved
from the Injury and Poisoning ICD-9-CM chapter to this ICD-10-CM chapter. 1
Pediatric ICD-10-CM Coding Tip Sheet continued
Chapter 21 - Factors Influencing Health Status and Contact with Health Services (Z00Z99) Key Updates These codes are used in any healthcare setting. Z codes may be used as either a first-
listed or principal diagnosis code in the inpatient setting, or secondary code, depending on the circumstances of the encounter. Certain Z codes may only be used as first- listed or principal diagnosis in certain situations. Refer to Official Coding Guidelines for details. Z codes are not procedure codes. A corresponding procedure code must accompany a Z code to describe any procedure performed.
(Source: 2015 Draft ICD-10-CM Official Guidelines for Coding and Reporting)
The top 25 codes for Pediatrics in ICD-9 to ICD-10 mappings are found in the chart below.
Top 25
ICD-9 Code
1 V20.2
2 V04.81 3 V04.89 4 V05.3 5 462
6 V06.1
7 V03.82
8 V06.8
9 465.9 10 V03.89
11 V03.81
12
382.9
ICD-9 Description Routine infant or child health check
ICD-10 Code
Z00.121
Need for prophylactic vaccination and inoculation against influenza Need for prophylactic vaccination and inoculation against other viral disease Need for other prophylactic vaccination and inoculation against viral hepatitis
Z00.129 Z23 Z23 Z23
Acute pharyngitis
Need for prophylactic vaccination and inoculation against diphtheria-tetanispertussis, combined [DTP], [DTaP] Need for prophylactic vaccination and inoculation against streptococcus pneumonia [pneumococcus] Need for prophylactic vaccination and inoculation against other combinations of diseases Acute upper respiratory infection of unspecified site Need for prophylactic vaccination, other specified Other specified vaccinations against hemophilus influenza, type B [Hib]
Unspecified otitis media
J02.8 J02.9
Z23
Z23
Z23 J06.9 Z23 Z23 H66.90
ICD-10 Description Encounter for routine child health examination with abnormal findings Encounter for routine child health examination without abnormal findings
Encounter for immunization
Encounter for immunization
Encounter for immunization Acute pharyngitis due to other specified organisms Acute pharyngitis, unspecified
Encounter for immunization
Encounter for immunization
Encounter for immunization Acute upper respiratory infection, unspecified Encounter for immunization
Encounter for immunization Otitis media unspecified, unspecified ear
H66.91
2
Otitis media unspecified, right ear
Top 25
ICD-9 Code
13
V06.4
14
034.0
15 V05.4 16 V70.0 17 461.9 18 382.00
ICD-9 Description
Need for prophylactic vaccination and inoculation against measles-mumpsrubella [MMR] Streptococcal sore throat
Need for prophylactic vaccination and inoculation against varicella Routine general medical examination at a health care facility
ICD-10 Code H66.92 H66.93
Z23 J02.0 J03.00 J03.01
Z23
Z00.00
Z00.01
Acute sinusitis,unspecified
J01.90
Acute suppurative otitis media without spontaneous rupture of ear drum
J01.91 H66.001
H66.002
H66.003
H66.004
H66.005
H66.006
H66.007
19 780.60 Fever, unspecified
20 786.2
Cough
21
314.01
Attention deficit disorder of childhood with hyperactivity
H66.009 R50.2 R50.9 R05 F90.1 F90.2 F90.8
ICD-10 Description
Otitis media unspecified, left ear
Otitis media, unspecified, bilateral
Encounter for immunization
Streptococcal pharyngitis
Acute streptococcal tonsillitis,unspecified
Acute recurrent streptococcal tonsillitis
Encounter for immunization
Encounter for general adult medical examination without abnormal findings Encounter for general adult medical examination with abnormal findings
Acute sinusitis, unspecified
Acute recurrent sinusitis, unspecified
Acute suppurative otitis media without spontaneous rupture of ear drum, right ear Acute suppurative otitis media without spontaneous rupture of ear drum, left ear Acute suppurative otitis media without spontaneous rupture of ear drum, bilateral Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, right ear Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, left ear Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, bilateral Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, unspecified ear Acute suppurative otitis media without spontaneous rupture of ear drum, unspecified ear
Drug induced fever
Fever, unspecified
Cough Attention-deficit hyperactivity disorder, predominantly hyperactive type Attention-deficit hyperactivity disorder, combined type Attention-deficit hyperactivity disorder, other type
3
Top 25
ICD-9 Code
22 V30.00
23 V06.3 24 493.90 25 V04.0
ICD-9 Description
Single live born, born in hospital delivered w/o Cesarean section
Need for prophylactic vaccination and inoculation against diphtheria-tetanuspertussis w/poliomyelitis[DTP + polio] Asthma, unspecified
Need for prophylactic vaccination and inoculation against poliomyelitis
ICD-10 Code F90.9 Z38.00 ZZ38.2
Z23 J45.909 J45.998
Z23
ICD-10 Description Attention-deficit hyperactivity disorder, unspecified type Single liveborn infant, delivered vaginally Single liveborn infant, unspecified as to place of birth
Encounter for immunization Unspecified asthma, uncomplicated Other asthma
Encounter for immunization
The codes highlighted in orange indicate the individual ICD-9 code that is being mapped to one or many ICD-10 codes
(Source of ICD-9-CM to ICD-10-CM mappings: General Equivalence Mappings (GEMs), 2015)
The information in this document is not intended to impart legal advice. This overview is intended as an educational tool only and should not be relied upon as legal or compliance advice. If you have any legal questions about the information contained herein, you should consult your attorney or other professional legal services provider.
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