Is the Thought of Implementing ICD-10 Depressing?
Does the thought of all the planning and analysis that must be accomplished prior to ICD-10 implementation cause you to slump into a major depressive state? Has it only occurred once or does the condition reoccur frequently? Is it mild, moderate or severe? Do you have psychotic symptoms, and if yes, what are they? If you have answered yes to any of these questions, you are not alone. ICD-10 implementation will be challenging, but we can turn it into a positive and have fun with it as well. Let’s look at coding this scenario using ICD-10-CM.
Today is September 1, 2009. Mary Pleaser, a 45-year-old CPC coder/manager who is responsible for ICD-10-CM implementation in a 25-physician practice, is in a major depressive state. This has been on-going ever since she heard about the ICD-10 final rule in January. This past week the depression went from mild to moderate, and if she does not get some help, the depression may become severe. Her physicians have indicated that she can conduct all the steps to implement ICD-10-CM alone. Her boss, Dr. Bob, stated “The AAPC gave you the ICD-10 tracker, and you listened to the webinars; is that not enough?” “No,” declared Mary. “I need some help here. We went over the steps, Dr. Bob, but it will take a team and one of the experienced AAPC Trainers to train us on how to implement ICD-10. I really, really need the AAPC’s help.” “Well Mary,” Dr. Bob said thoughtfully. “If the three-day training can be on-site at the right price with the right curriculum and at the right time, I think we can all benefit from attending and maybe make this transition much easier for all of us. What do you think?” “Oh thank you, Dr. Bob,” exclaimed Mary. “This will truly put me on the road to recovery quickly so we can get this new coding system implemented on time.”
Now let’s code Mary’s current condition using ICD-10-CM
Mental and behavioral disorders are located in Chapter 5 of ICD-10-CM
Mood (affective) disorders are coded in category F30-F39
Major depression is coded in category F32-F33
Major depression for a singe episode is coded as F32.-
Major depression for a recurrent episode is coded as F33.-
This is how Mary’s condition is coded using ICD-10-CM
She is in a major depressive state which is recurrent F33
Her depression which was previously mild is now moderate F33.1
The correct ICD-10-CM code is F33.1
Tip: When an ICD-10-CM code requires additional characters, it is reported using a dash (-) after the decimal.
By Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CEMC, COBGC, CPCD, CCS-P
Vice President, Strategic Development
American Academy of Professional Coders