ICD-10 for Pediatrics - CMS
ICD-10
Clinical Concepts for Pediatrics
ICD-10 Clinical Concepts Series
Common Codes Clinical Documentation Tips Clinical Scenarios
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ICD10
ICD-10 Compliance Date: October 1, 2015
Official CMS Industry Resources for the ICD-10 Transition ICD10
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Table Of Contents
Common Codes
? Abdominal Pain ? Acute Bronchitis ? Acute Pharyngitis ? Allergic Inflammation of the
Nasal Airways ? Asthma ? Chest Pain ? Diabetes Mellitus (Select)
Clinical Documentation Tips
? Asthma ? Underdosing ? Diabetes Mellitus,
Hypoglycemia and Hyperglycemia ? Injuries
Clinical Scenarios
? Scenario 1: Diarrhea, Fever, and Vomiting
? Scenario 2: Physical for Preschool Entrance
? Headache ? Otitis Media ? Pain in Limb ? Routine Child Health
Examination ? Urinary Tract
Infection, Cystitis
? Well Child Exams and Screening
? Otitis Media ? Bronchitis and Bronchiolitis ? Feeding Problems
of the Newborn
? Scenario 3: Asthma and Atopic Dermatitis
? Scenario 4: Newborn Feeding
Common Codes
ICD-10 Compliance Date: October 1, 2015
Abdominal Pain (ICD-9-CM 789.00 to 789.09 range)
R10.0 R10.10 R10.11 R10.12 R10.13 R10.2 R10.30 R10.31 R10.32 R10.33 R10.84 R10.9*
Acute abdomen Upper abdominal pain, unspecified Right upper quadrant pain Left upper quadrant pain Epigastric pain Pelvic and perineal pain Lower abdominal pain Right lower quadrant pain Left lower quadrant pain Periumbilical pain Generalized abdominal pain Unspecified abdominal pain
*Codes with a greater degree of specificity should be considered first.
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Acute Bronchitis (ICD-9-CM 466.0, 466.11, 466.19)
[Note: Organisms should be specified where possible]
J20.0 J20.1 J20.2 J20.3 J20.4 J20.5 J20.6 J20.7 J20.8 J20.9*
Acute bronchitis due to Mycoplasma pneumoniae Acute bronchitis due to Hemophilus influenzae Acute bronchitis due to streptococcus Acute bronchitis due to coxsackievirus Acute bronchitis due to parainfluenza virus Acute bronchitis due to respiratory syncytial virus Acute bronchitis due to rhinovirus Acute bronchitis due to echovirus Acute bronchitis due to other specified organisms Acute bronchitis, unspecified
*Codes with a greater degree of specificity should be considered first.
Acute Pharyngitis (ICD-9-CM 034.0, 462)
J02.0 J02.8 J02.9*
Streptococcal pharyngitis Acute pharyngitis due to other specified organisms Acute pharyngitis, unspecified
*Codes with a greater degree of specificity should be considered first.
4
Allergic Inflammation of the Nasal Airways (ICD-9-CM 477.0 TO 477.9 range)
J30.0 J30.1 J30.2 J30.5 J30.81 J30.89 J30.9*
Vasomotor rhinitis Allergic rhinitis due to pollen Other seasonal allergic rhinitis Allergic rhinitis due to food Allergic rhinitis due to animal (cat) (dog) hair and dander Other allergic rhinitis Allergic rhinitis, unspecified
*Codes with a greater degree of specificity should be considered first.
Asthma (ICD-9-CM 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.81, 493.82 , 493.90, 493.91, 493.92)
J45.20 J45.21 J45.22 J45.30 J45.31 J45.32 J45.40 J45.41 J45.42 J45.50 J45.51 J45.52 J45.901* J45.902* J45.909* J45.990 J45.991 J45.998
Mild intermittent asthma, uncomplicated Mild intermittent asthma with (acute) exacerbation Mild intermittent asthma with status asthmaticus Mild persistent asthma, uncomplicated Mild persistent asthma with (acute) exacerbation Mild persistent asthma with status asthmaticus Moderate persistent asthma, uncomplicated Moderate persistent asthma with (acute) exacerbation Moderate persistent asthma with status asthmaticus Severe persistent asthma, uncomplicated Severe persistent asthma with (acute) exacerbation Severe persistent asthma with status asthmaticus Unspecified asthma with (acute) exacerbation Unspecified asthma with status asthmaticus Unspecified asthma, uncomplicated Exercise induced bronchospasm Cough variant asthma Other asthma
*Codes with a greater degree of specificity should be considered first.
5
Chest Pain (ICD-9-CM 786.50 TO 786.59 range)
R07.1 R07.2 R07.81 R07.82 R07.89 R07.9*
Chest pain on breathing Precordial pain Pleurodynia Intercostal pain Other chest pain Chest pain, unspecified
*Codes with a greater degree of specificity should be considered first.
Diabetes Mellitus (Select) (ICD-9-CM 250.00 to 250.03 range)
E10.65 E10.9 E11.65 E11.9
Type 1 diabetes mellitus with hyperglycemia Type 1 diabetes mellitus without complications Type 2 diabetes mellitus with hyperglycemia Type 2 diabetes mellitus without complications
*Codes with a greater degree of specificity should be considered first.
Headache (ICD-9-CM 784.0)
R51
Headache
*Codes with a greater degree of specificity should be considered first.
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Acute Serous Otitis Media (ICD-9-CM 381.01)
H65.00* H65.01 H65.02 H65.03 H65.04 H65.05 H65.06 H65.07*
Acute serous otitis media, unspecified ear Acute serous otitis media, right ear Acute serous otitis media, left ear Acute serous otitis media, bilateral Acute serous otitis media, recurrent, right ear Acute serous otitis media, recurrent, left ear Acute serous otitis media, recurrent, bilateral Acute serous otitis media, recurrent, unspecified ear
*Codes with a greater degree of specificity should be considered first.
Other Acute Nonsuppurative Otitis Media (ICD-9-CM 381.00, 381.02 to 381.06 range)
H65.111 H65.112 H65.113 H65.114 H65.115 H65.116 H65.117* H65.119* H65.191 H65.192 H65.193 H65.194 H65.195 H65.196 H65.197* H65.199*
Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), right ear Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), left ear Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), bilateral Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, right ear Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, left ear Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, bilateral
Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, unspecified ear Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), unspecified ear
Other acute nonsuppurative otitis media, right ear Other acute nonsuppurative otitis media, left ear Other acute nonsuppurative otitis media, bilateral Other acute nonsuppurative otitis media, recurrent, right ear Other acute nonsuppurative otitis media, recurrent, left ear Other acute nonsuppurative otitis media, recurrent, bilateral Other acute nonsuppurative otitis media recurrent, unspecified ear Other acute nonsuppurative otitis media, unspecified ear
*Codes with a greater degree of specificity should be considered first.
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Chronic Serous Otitis Media (ICD-9-CM 381.10, 381.19)
H65.20* H65.21 H65.22 H65.23
Chronic serous otitis media, unspecified ear Chronic serous otitis media, right ear Chronic serous otitis media, left ear Chronic serous otitis media, bilateral
*Codes with a greater degree of specificity should be considered first.
Chronic Mucoid Otitis Media (ICD-9-CM 381.20, 381.29)
H65.30* H65.31 H65.32 H65.33
Chronic mucoid otitis media, unspecified ear Chronic mucoid otitis media, right ear Chronic mucoid otitis media, left ear Chronic mucoid otitis media, bilateral
*Codes with a greater degree of specificity should be considered first.
Other Chronic Nonsuppurative Otitis Media (ICD-9-CM 381.3)
H65.411 H65.412 H65.413 H65.419* H65.491 H65.492 H65.493 H65.499*
Chronic allergic otitis media, right ear Chronic allergic otitis media, left ear Chronic allergic otitis media, bilateral Chronic allergic otitis media, unspecified ear Other chronic nonsuppurative otitis media, right ear Other chronic nonsuppurative otitis media, left ear Other chronic nonsuppurative otitis media, bilateral Other chronic nonsuppurative otitis media, unspecified ear
*Codes with a greater degree of specificity should be considered first.
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