Pathway of ICD codes chapterwise.pptx ,medical

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1. Pathway of ICD codes ICD-10-CM CODING PATHWAY Step 1: Review Documentation Read the provider’s note carefully. Identify the main diagnosis, symptoms, conditions, external causes, and other relevant details. Check for laterality, specificity, acuity, stage, episode of care, etc. Step 2: Locate Main Term in Alphabetic Index Open the ICD-10 Alphabetic Index. Find the main condition (example: "Pneumonia"). Look for subterms for specificity (e.g., organism, type, complication).

2. Pathway of ICD codes ICD-10-CM CODING PATHWAY Step 3: Verify in Tabular List Confirm the code in the Tabular List. Follow chapter-specific guidelines, instructional notes, excludes notes, “use additional code” notes, etc. Assign the most specific code. Step 4: Apply Coding Guidelines Use conventions: Excludes1 vs Excludes2 Code first/Use additional code Combination codes Apply General Guidelines (Section I of ICD-10-CM Official Guidelines).

3. Chapter 1 (A00–B99): Certain Infectious & Parasitic Diseases Identify infectious agent (bacteria, virus, parasite). Code organism-specific infection (e.g., B20 HIV, A15 TB). If sepsis → code underlying infection first, then severe sepsis (R65.2-). Chapter 2 (C00–D49): Neoplasms Identify site + laterality + behavior (malignant, benign, in situ, uncertain). Code primary site first, then secondary/metastatic. If chemotherapy, radiation, or immunotherapy → use Z51.0–Z51.12 first, followed by cancer diagnosis. Chapter 3 (D50–D89): Blood & Immune Disorders Look for type of anemia (iron deficiency, chronic disease, chemotherapy-related). Certain anemias secondary to chronic disease/cancer → code underlying first. CHAPTER-WISE ICD-10-CM CODING FLOW

4. Chapter 4 (E00–E89): endocrine, nutritional & metabolic Diabetes: Identify type (1, 2, other) + complication (renal, ophthalmic, neuropathy, etc.). Thyroid, obesity, malnutrition coded with cause + complication. Chapter 5 (f01–f99): mental & behavioral disorders Code by specific disorder (depression, schizophrenia, substance use). Substance use codes: pick use/abuse/dependence and any associated complications. Chapter 6 (g00–g99): nervous system Stroke: code type + laterality + residual deficits (use I69.- For sequelae ). Epilepsy: specify type + controlled/uncontrolled. CHAPTER-WISE ICD-10-CM CODING FLOW

5. Chapter 7 (H00–H59 / H60–H95): Eye & Ear Disorders Code by laterality (right, left, bilateral, unspecified). Chronic vs acute, type of glaucoma, hearing loss, etc. Chapter 9 (I00–I99): Circulatory System MI: acute vs old, initial vs subsequent. Hypertension: specify with/without heart/kidney involvement. Use combination codes when possible. Chapter 10 (J00–J99): Respiratory Pneumonia: organism specific if available. COPD/asthma: specify type, severity, with/without exacerbation. CHAPTER-WISE ICD-10-CM CODING FLOW

6. Chapter 11 (K00–K95): Digestive Ulcers: specify site, acute/chronic, with/without hemorrhage/perforation. Liver disease: specify cause (alcoholic, viral, etc.). Chapter 12 (L00–L99): Skin Cellulitis : site + laterality. Pressure ulcers: site + stage. Chapter 13 (M00–M99): Musculoskeletal Arthritis: rheumatoid, osteoarthritis, gout – specify site + laterality. Fractures: identify site, laterality, episode of care (initial, subsequent, sequela ). Chapter 14 (N00–N99): Genitourinary Kidney failure: acute vs chronic vs acute on chronic. Pregnancy complications: use Chapter 15 first if patient is pregnant . CHAPTER-WISE ICD-10-CM CODING FLOW

7. Chapter 15 (O00–O9A): Pregnancy, Childbirth & Puerperium Always code O-codes first when applicable. Include weeks of gestation (Z3A.-). Follow sequencing rules (underlying condition, outcome of delivery, complications). Chapter 16 (P00–P96): Newborn Code by birth condition (prematurity, birth trauma, respiratory issues). Maternal conditions affecting newborn → P00–P04. Chapter 17 (Q00–Q99): Congenital Anomalies Code exact congenital anomaly. Multiple anomalies → code each. Chapter 18 (R00–R99): Symptoms & Signs Use when no definitive diagnosis is given. Do not code symptoms if they are part of a confirmed diagnosis. CHAPTER-WISE ICD-10-CM CODING FLOW

8. Chapter 19 (S00–T88): Injury, Poisoning Fractures, wounds: specify site + laterality + encounter (initial, subsequent, sequela ). Poisonings: drug + intent (accidental, intentional, adverse effect). Chapter 20 (V00–Y99): External Causes Use secondary codes only (never first). Provide cause of injury (fall, accident, assault). Chapter 21 (Z00–Z99): Factors Influencing Health Screening, aftercare, history of conditions, immunizations. Z-codes may be first-listed if reason for visit is not a current illness/injury. CHAPTER-WISE ICD-10-CM CODING FLOW

9. ✅ Final Step: Sequence the Codes Correctly Principal diagnosis: main reason for encounter. Secondary codes: additional conditions affecting care. Follow official ICD-10-CM guidelines for sequencing. CHAPTER-WISE ICD-10-CM CODING FLOW

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