2017 ICD-10-CM Guidelines Released

2017 ICD-10-CM Guidelines Released

The 2017 ICD-10-CM Official Guidelines for Coding and Reporting is now available for download on the Centers for Medicare & Medicaid Services (CMS) website. This latest version includes several changes worth noting.

The guidelines are usually released long after publishers’ books have been sent to the printer. This year’s guidelines help explain the significant changes to the code set.

Excludes1 Clarified

For example, in Section I.A.12(a), a new paragraph explains an exception to the Excludes1 definition. CMS defines an Excludes1 note as an indication “that the code excluded should never be used at the same time as the code above the Excludes1 note.”

CMS adds for 2017:

“An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for ‘sleep related teeth grinding (G47.63),’ because ‘teeth grinding’ is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.”

The 2016-2017 guidelines also expand on the meaning of “with;” and clarify in a new paragraph (Section I.A.19) that code assignment should be based on the provider’s diagnostic statement that the condition exits and not on clinical criteria used to establish the diagnosis.

Laterality Clarified

CMS also clarifies the meaning of “laterality;” expands on hypertension coding in Chapter 9: Diseases of the Circulatory System (I00-I99); revises guidelines for prenatal outpatient visits for high-risk patients (Section I.C.15(b)2); and more. Make sure to download the new guidelines and read all of the changes carefully.

Also available on the CMS website are 2017 General Equivalence Mappings for diagnosis and procedure codes, the 2017 ICD-10-PCS Official Guidelines for Coding and Reporting, and 2017 present-on-admission exempt codes.

Remember: 2017 ICD-10 codes and guidelines take effect Oct. 1, 2016.

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Renee Dustman

Renee Dustman

Renee Dustman is executive editor at AAPC. She has a Bachelor of Science degree in Journalism and a long history of writing just about anything for just about every kind of publication there is or ever has been. She’s also worked in production management for print media, and continues to dabble in graphic design.
Renee Dustman

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Renee Dustman is executive editor at AAPC. She has a Bachelor of Science degree in Journalism and a long history of writing just about anything for just about every kind of publication there is or ever has been. She’s also worked in production management for print media, and continues to dabble in graphic design.

2 Responses to “2017 ICD-10-CM Guidelines Released”

  1. Franz Dinar Osida says:

    I read them when they were first released and oh my gosh… they’re gonna shake up what we have known for the longest time lol!

  2. Michele says:

    “With” 2017 guidelines:
    “The word “with” should be interpreted to mean “associated with” or “due to”
    when it appears in a code title, the Alphabetic Index, or an instructional note in the
    Tabular List. The classification presumes a causal relationship between the
    two conditions linked by these terms in the Alphabetic Index or Tabular List.
    These conditions should be coded as related even in the absence of
    provider documentation explicitly linking them, unless the documentation
    clearly states the conditions are unrelated. For conditions not specifically
    linked by these relational terms in the classification, provider
    documentation must link the conditions in order to code them as related.”
    This to me sounds like we can code a relationship of anything such as diabetes “with” in the list of the alphabetic to tabular listings without documentation associating it. That is not what it sounds like you said in you article? This DOES change things. It’s a bit scary really.

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