APMA News - April 2013 - (Page 36)

Reimbursement By Paul Kinberg, DPM, and David Freedman, DPM ICD-10: Conventions INCLUDES —Found in the ICD-10 Tabular List of Diseases and Injuries, the INCLUDES symbol can appear under a three-digit (one of the least descriptive) ICD-10 code to “further define, or give examples of, the content of the category.” An example of INCLUDES is: E11 Type 2 diabetes mellitus INCLUDES diabetes (mellitus) due to insulin secretory defect diabetes NOS insulin resistant diabetes (mellitus) Instructional Notes—Found in the ICD-10 Tabular List of Diseases and Injuries, instructional notes direct the coder to use both underlying etiology codes and multiple body system manifestation codes and define their proper sequencing (i.e., which is coded first). Instructional notes typically are typed in red font. An example of an instructional note is: E11 Type 2 diabetes mellitus INCLUDES diabetes (mellitus) due to insulin secretory defect 36 APMA News April 2013 diabetes NOS insulin resistant diabetes (mellitus) Use additional code to identify any insulin use (Z79.4) The instruction above for Z79.4 notes that: 1) it would need to be included on the claim, and 2) it would be sequenced as a secondary code (under the “E11” code—meaning the “E11” code would be primary). The corresponding instruction to “Use additional code” is “Code first.” When “Code first” is noted under an ICD-10 condition: 1) it would need to be included on the claim with the condition, and 2) it would be sequenced as the primary code. For example: C46 Karposi’s sarcoma Code first any human immunodeficiency virus [HIV] disease (B20) EXCLUDES1 —ICD-10 uses two types of EXCLUDES notes. EXCLUDES1 —Type 1 note indicates that the list code following EXCLUDES1 should never be used at the same time as the code preceding the EXCLUDES1 symbol. To the point, the two codes represent conditions that cannot occur together (for example, a chronic version of the condition and an acute version of the condition occurring in the same patient at the same time). Another example would be primary diabetes mellitus and secondary diabetes mellitus. An example of EXCLUDES1 is: M10 Gout Acute gout Gout attack Gout flare Gout NOS Podagra Use additional code to identify: Paul Kinberg, DPM, chair, Coding Committee, left, and David Freedman, DPM, team leader, ICD-10 It is not unusual at APMA Coding Seminars to hear attendees are dreading the transition to ICD-10. They are concerned about not only learning a completely new set of diagnosis codes, but also figuring out how the ICD-10 guidelines differ from ICD-9 guidelines. Interestingly, very few of those attendees admit to ever having read the ICD-9 guidelines. Most picked up a guideline here and there at seminars or through trial and error (i.e., claim denials). The good news is you have time—a year or so—to sit down and read the ICD-10 guidelines so you are comfortable with them prior to the October 1, 2014, implementation date. Even better news is that ICD-10 and ICD-9 guidelines are very similar, if not identical. The following is a brief description of ICD10 guidelines. The bolded text below represents important terms that define, add, exclude, or better clarify the coding found in ICD-10. These terms are known as “conventions for the ICD-10,” which are rules for use of the code classification.

Table of Contents for the Digital Edition of APMA News - April 2013

APMA News - April 2013
President’s Message
Contents
Beat Bunion Blues: APMA’s Spring PR Campaign
Matthew G. Garoufalis, DPM: Presidential Inaugural Speech to the APMA House of Delegates
Nuts and Bolts of the House of Delegates and Resoultions Outcomes
State Advocacy in Focus: Building Relationships
Medicare Advantage: Answering Questions about Coverage
2012 Podiatric Practice Survey: Corporation Type
Podiatric Medical Assistants’ Program at The National Promotes Team Learning
Annual Scientifi c Meeting Registration Forms
Annual Scientifi c Meeting Sponsors
Team APMA 5K Run/Walk
Seeking Award Nominations
Reimbursement
Federal Advocacy Forum
APMAPAC Chair Report
IT Consultant
Inside APMA’s Social Media
Website Wisdom
On the Road with APMA
Small Business 101
CPME Update
In Short
Worthy of Note
Insurance Advisor
New Members
Death Notices
APMAPAC Update
Development Update
Classifi ed Advertising
Dates to Remember
Advertising Index
10 Questions
Your APMA

APMA News - April 2013