ICD-10 Putting Codes Into Practice

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

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providers

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