Wiki 2017 ICD-10 Book

camandak

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We just recently received our AAPC 2017 ICD-10 book. Going through it we noticed the symbol stating "unacceptable principal dx symbol per Medicare code edits". Does this mean we can't use a dx with this sympbol attached as our #1 dx?

Example Low Tension Glaucoma H40.12-

Patients come in with just this issue. Now how do we code it?
 
Principal diagnoses

This depends on whether you are coding in-patient or out-patient services. This is not a change for 2017, but the term principal diagnosis has been in ICD for some time. A principal diagnosis is (basically) the primary diagnosis used for in-patient facility coding. For out patient/physician coding ICD uses the term "First-listed" diagnosis. There are different rules/guidelines for in-patient facility coding vs. out-patient services. When you see an instruction that a code is not acceptable for principal diagnosis it does not mean you cannot use it for first-listed diagnosis. If you are not a hospital coder, you can ignore this convention.

Hope that helps,
Karen Hill, CPC, CPB, CPMA, CPC-I
 
I think this is a printing error, nearly all the Z codes have this symbol, like Z12.31 -screening mammogram, and all the screening codes which should be clearly Primary codes
 
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