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Issue #30 - December 12, 2012

AAPC ICD-10 Newsletter


Featured Article
In the News
Coding Snapshot
ICD-10 Strategies
ICD-10 Resource


Boot Camps:

Atlanta, GA 12/13
Tulsa, OK 1/17
New Orleans, LA 1/24

Anatomy & Pathophysiology Online


Here is a lighter side of ICD-10, we hope you enjoy it!
Happy Holidays to all!

Samantha: I am Sam, Sam, you see, and I do so love this new ICD.
Provider: That ICD, that ICD, I do not like that ICD!
Samantha: Do you like to work for free?
Provider: Can you code injury in a house?
Can you code injury with a mouse?
Samantha: I can code it in a house (Y92.019).
I can code it with a mouse (W53.09XA).
Provider: Can you code injury on a plane?
Can you code injury on a train?
Samantha: I can code it on a plane (Y92.813).
I can code it on a train (Y92.815).
I can code it in a house (Y92.019).
I can code it with a mouse (W53.09XA).
I do so love this ICD; it's so much better,
can't you see?
Provider: Can you code being hit by a baseball?
Can you code falling down the stairs at the mall?
Samantha: I can code being hit by a baseball (W21.03XA).
I can code falling down the stairs at the mall (W10.9XXA, Y92.59).
I can code it on a plane (Y92.813).
I can code it on a train (Y92.815).
I can code it in a house (Y92.019).
I can code it with a mouse (W53.09XA).
I do so love this ICD; it's so much better,
can't you see?
Provider: Now I see, this ICD.
You have made it clear to me.
We'll have clean claims and payment fast!
ICD-10 is here at last!


Version 30 ICD-10 MS-DRG files have now been posted on the CMS website. These files are an ICD-10 version of the FY 2013 MS-DRGs now in use for the inpatient prospective payment system. The new files are posted on the Downloads section of the web page and include the following:

  • ICD-10-CM/PCS MS-DRG v30 Definitions Manual Table of Contents – Full Titles – Text Version
  • ICD-10 Medicare Code Editor v30
  • ICD-10 MS-DRG v29 and v30 Comparison Files

The final ICD-10 version of the MS-DRGs will be subject to formal rulemaking.


A 68-year-old male has an enlarged prostate, nocturia, and daytime frequency. He otherwise appears to be doing reasonably well. No other associated symptoms or modifying factors. Severity is moderate. PSA stable over time.

Upon exam, abdomen is nontender to palpation. Liver and spleen not enlarged. No hernias appreciated. Normal male genitalia. No lesions appreciated on the penis. DRE showed the prostate of approximately 40 grams and no nodules.

After our discussion, it does appear that if he is not drinking close to going to bed, he notes that his nocturia has significantly decreased. At this juncture what I would like to do is to start with behavior modification. There were no other associated symptoms or modifying factors.

The patient will discontinue all caffeinated and carbonated beverages and any fluids three hours prior to going to bed. He already knows that this does decrease his nocturia. He will do this without medications to see how well he does and hopefully he may need no additional medications.

ICD-10-CM Codes:
N40.1 Enlarged prostate with lower urinary tract symptoms (LUTS)
R35.1 Nocturia
R35.0 Urinary frequency

Rationale: In ICD-10-CM, codes for enlarged prostate are broken down by whether the prostate is enlarged or nodular and whether LUTS exist. If LUTS are present, additional codes are necessary to indicate the associated symptoms. An instructional note under code N40.1, Enlarged prostate with lower urinary tract symptoms and N40.3, Nodular prostate with lower urinary tract symptoms states to use additional codes for associated symptoms, when specified:
Incomplete bladder emptying (R39.14)
Nocturia (R35.1)
Straining on urination (R39.16)
Urinary frequency (R35.0)
Urinary hesitancy (R39.11)
Urinary incontinence (N39.4-)
Urinary obstruction (N13.8)
Urinary retention (R33.8)
Urinary urgency (R39.48)
Weak urinary stream (R39.12)

In the case above, the patient is experiencing the lower urinary tract symptoms of nocturia and urinary frequency.


We will be sharing a number of strategies to help your practice successfully implement ICD-10-CM. Please remember to track your progress in your ICD-10 Implementation Tracker on AAPC's website.

Talking with Providers
In order to have a smooth transition to ICD-10, it is important to obtain provider "buy in" to the process. Make sure that meetings are held with providers to give them information on what is happening at the practice. Providers need to understand the importance of their participation in the transition to ICD-10. Let them know when and how they will receive education and get their input to the process. If you are at a large facility, select providers should be asked to sit on the appropriate committees to assist in the implementation. This will help foster the idea and feeling of a team approach to the transition of ICD-10.


Have something you want to post about ICD-10? Want to see what others are asking or saying about the coming of the new code set? Check out ICD-10 Forums. It runs like the AAPC coding discussion forums. The categories include ICD-10 timelines, ICD-10-CM and -PCS code sets, documentation for ICD-10, etc. The site is free but you will need to register to post questions or comments.

Featured Resource

ICD-10 Connect is offered as a benefit to AAPC members and we hope you find the information useful. If you'd rather not receive future issues of ICD-10 Connect, please log in to your account and change your email preferences.

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