ICD-10 Putting Codes Into Practice - AmeriHealth
Putting ICD-10 into Practice:
Coding exercises and scenarios
Revised December 2, 2013
AmeriHealth HMO, Inc. ? AmeriHealth Insurance Company of New Jersey ? QCC Insurance Company d/b/a AmeriHealth Insurance Company
Putting ICD-10 into Practice:
Coding exercises and scenarios
Table of Contents
Partners in Health UpdateSM edition
Page
January 2013
3
February 2013
5
March 2013
7
April 2013
9
May 2013
11
June 2013
13
July 2013
15
August 2013
17
September 2013
19
October 2013
21
November 2013
23
December 2013
25
Putting ICD-10 into Practice:
Coding exercises and scenarios
The ICD-10 Spotlight: Know the codes feature that appeared in Partners in Health Update throughout 2012 was
designed to communicate various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10.
These conventions and guidelines are rules and instructions that must be followed to classify and assign the most
appropriate code. As with ICD-9, adherence to these guidelines is required under the Health Insurance Portability and
Accountability Act (HIPAA).
This year, we are introducing a new feature called Putting ICD-10 into Practice: Coding exercises and scenarios. Each
month this feature will help you put the new guidelines and conventions you learned about last year into practice.
If needed, use the ICD-10 Spotlight: Know the codes booklet for assistance with these exercises. An answer key is
provided below so you can verify if your answers are correct. In addition, a list of code narratives is included to describe
each ICD-10 code.
Coding exercises
Code the following conditions according to ICD-10 coding conventions and guidelines:
1. Varicose vein of heel and mid-foot with presence of ulceration and swelling
2. Premature menopause with headache
3. Acute myocardial infarction of the anterolateral wall
4. Subsequent encounter for obesity resulting from the prescription drug Tryptanol?
5. Crohn¡¯s disease of ileum with rectal bleeding and abscess
6. Bilateral central corneal ulcer
7. Severe generalized abdominal pain with abdominal rigidity
8. Female with bilateral breast cancer of lower outer quadrant
9. Acute nonsuppurative otitis media of the right ear
10. Initial encounter for concussion and edema of the thoracic spine
11. Initial encounter for third degree burn of the right thigh by gasoline to fifteen percent of the total body surface area
Coding scenario
Code the following scenario according to ICD-10 coding conventions and guidelines:
While chopping vegetables in the kitchen of his mobile home for the local food bank¡¯s Thanksgiving dinner,
John Doe lacerated his right thumb causing injury to the nail.
S61.111A, W26.0xxA, Y92.020, Y93.G1, Y99.2,
Answer to coding scenario:
10) S24.0xxA 11) T24.711A, T32.10, T52.0x1A
1) I83.224 2) E28.310 3) I21.09 4) E66.1, T43.015D 5) K50.011, K50.014 6) H16.013 7) R10.0 8) C50.511, C50.512 9) H65.191
Answers to coding exercises:
continued on the next page
January 2013 | Partners in Health UpdateSM
3
providers
Putting ICD-10 into Practice:
Coding exercises and scenarios
Narratives
The following are the corresponding code narratives for each of the ICD-10 codes in the answer key:
I83.224: Varicose veins of left lower extremity with both ulcer of heel and midfoot and inflammation
E28.310: Symptomatic premature menopause
I21.09: ST elevation myocardial infarction (STEMI) involving other coronary artery of anterior wall
E66.1: Drug-induced obesity
T43.015D: Adverse effect of tricyclic antidepressants, subsequent encounter
K50.011: Crohn¡¯s disease of small intestine with rectal bleeding
K50.014: Crohn¡¯s disease of small intestine with abscess
H16.013: Central corneal ulcer, bilateral
R10.0: Acute abdomen
C50.511: Malignant neoplasm of lower-outer quadrant of right female breast
C50.512: Malignant neoplasm of lower-outer quadrant of left female breast
H65.191: Other acute nonsuppurative otitis media, right ear
S24.0xxA: Concussion and edema of thoracic spinal cord, initial encounter
T24.711A: Corrosion of third degree of right thigh, initial encounter
T52.0x1A: Toxic effect of petroleum products, accidental (unintentional), initial encounter
T32.10: Corrosions involving 10%¨C19% of body surface with 0%¨C9% third degree corrosion
Y93.G1: Activity, food preparation and clean up
W26.0xxA: Contact with knife, initial encounter
S61.111A: Laceration without foreign body of right thumb with damage to nail, initial encounter
Y92.020: Kitchen in mobile home as the place of occurrence of the external cause
Y99.2: Volunteer activity
For additional information related to the AmeriHealth transition to ICD-10, please visit icd10. On
this site you will find examples of how ICD-9 codes will translate to ICD-10 codes in the ICD-10 Spotlight: Know the
codes booklet.
January 2013 | Partners in Health UpdateSM
4
providers
Putting ICD-10 into Practice:
Coding exercises and scenarios
The ICD-10 Spotlight: Know the codes feature that appeared throughout Partners in Health Update last year was
designed to communicate various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10.
These conventions and guidelines are rules and instructions that must be followed to classify and assign the most
appropriate code. As with ICD-9, adherence to these guidelines is required under the Health Insurance Portability and
Accountability Act (HIPAA).
As announced in the January 2013 edition of Partners in Health Update, we have introduced a new feature called Putting
ICD-10 into Practice: Coding exercises and scenarios. Each month this feature will help you put the new guidelines and
conventions you learned about last year into practice. If needed, use the ICD-10 Spotlight: Know the codes booklet
for assistance with these exercises. An answer key is provided below so you can verify if your answers are correct. In
addition, a list of code narratives is included to describe each ICD-10 code.
Coding exercises
Code the following conditions according to ICD-10 coding conventions and guidelines:
1. Borderline glaucoma
2. Congestive heart failure due to hypertension
3. HIV positive status without symptom
4. Urinary frequency
5. Morbid obesity with a BMI of 42 in an adult
6. Congenital red cell aplastic anemia
7. Cleft palate involving both the soft and hard palate with bilateral cleft lip
8. Severe persistent asthma with acute exacerbation
9. Fatigue fracture of vertebra, lumbar region, and subsequent encounter for fracture with delayed healing
10. Interstitial cystitis due to E. coli with hematuria
11. Sleep-related teeth grinding
12. Non-conclusive HIV-test finding in infants
Coding scenario
Code the following scenario according to ICD-10 coding conventions and guidelines:
Jane and John Doe were shopping at the mall the day after Thanksgiving to take advantage of the sales. While rushing
for the newest iPhone, John fell down the stairs. Thankfully, John sustained only minor abrasions to his right elbow.
S50.311A, W10.9xxA, Y92.59
Answer to coding scenario:
12) R75
1) H40.001 2) I11.0 3) Z21 4) R35.0 5) E66.01, Z68.41 6) D61.01 7) Q37.4 8) J45.51 9) M48.46xG 10) N30.11, B96.20 11) G47.63
Answers to coding exercises:
continued on the next page
February 2013 | Partners in Health UpdateSM
5
providers
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