Wiki Coding guidelines ICD 10

Coding guidelines ICD-10

I recommend looking in the beginning under "Chapter Specific Guidelines". Chapter specific guidelines include both, acute and chronic diagnoses where applicable. Other advice would be to remember that the reason for the encounter/service is the diagnosis(es) code(s) that should be reported, whether it be acute or chronic. There are some LCDs and NCDs to concern yourself with for services, of course.
 
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https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2016-ICD-10-CM-Guidelines.pdf

It can be different from chapter to chapter. Sometimes there is a code for both acute and chronic. Sometimes you default to Acute if not specified. Sometimes you default to chronic if not specified. Sometimes the NOS code will be the choice if not known. Usually its up to the physician to state a condition is chronic for it to be chronic


Examples

Page 37

Postoperative Pain

The default for post-thoracotomy and other postoperative pain not specified as acute or chronic is the code for the acute form.

Chronic pain

Chronic pain is classified to subcategory G89.2. There is no time frame defining when pain becomes chronic pain. The provider’s documentation should be used to guide use of these codes.

Page 38

Neoplasm Related Pain

Code G89.3 is assigned to pain documented as being related, associated or due to cancer, primary or secondary malignancy, or tumor. This code is assigned regardless of whether the pain is acute or chronic.

Chronic pain syndrome

Central pain syndrome (G89.0) and chronic pain syndrome (G89.4) are different than the term “chronic pain,” and therefore codes should only be used when the provider has specifically documented this condition.

Page 49

Acute traumatic versus chronic or recurrent musculoskeletal conditions

Many musculoskeletal conditions are a result of previous injury or trauma to a site, or are recurrent conditions. Bone, joint or muscle conditions that are the result of a healed injury are usually found in chapter 13. Recurrent bone, joint or muscle conditions are also usually found in chapter 13. Any current, acute injury should be coded to the appropriate injury code from chapter 19. Chronic or recurrent conditions should generally be coded with a code from chapter 13. If it is difficult to determine from the documentation in the record which code is best to describe a condition, query the provider.
 
Thank you for your prompt responses. I really do appreciate your time taken to advise me on this subject.
 
Code for "No Injury"

I am coding Injuries on Malpractice Claims. Is there an ICD 10 code for "NO INJURY"? We insure physicians and a claim is opened that he didn't renew her prescription. She says it has affected her health. Thank you.
 
Is there a book on nothing but Guidelines that we can purchase?
1) It would usually be best to start a new thread, rather than post a new question in a post from 5 1/2 years ago.
2) I've never seen an ICD10 book that did not already include the guidelines.
3) https://www.cms.gov/medicare/icd-10/2022-icd-10-cm last link at the bottom has a pdf of the current guidelines. If you wanted it in book format, you could always check your local copy/print place or Staples or FedEx to find out about getting it bound
 
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