ICD 10 CM Chapter Specific Guidelines I. C17

Dr. Lisa L Campbellยฎ
12 Feb 201903:31
EducationalLearning
32 Likes 10 Comments

TLDRIn this informative session, Dr. Kamble discusses ICD-10-CM Chapter 17 coding guidelines for congenital malformations, deformations, and chromosomal abnormalities. The codes, ranging from Q00 to Q99, can be assigned as principal or secondary based on the encounter's context. It's clarified that while inherent manifestations of an abnormality shouldn't be coded separately, additional codes are needed for non-inherent manifestations. The video also addresses the use of personal history codes for corrected malformations and the importance of coding based on the patient's diagnosis, not just at birth. Dr. Kamble wraps up with a reminder that the sequencing of these codes depends on the encounter's circumstances.

Takeaways
  • ๐Ÿ“š ICD-10-CM Chapter 17 focuses on congenital malformations, deformations, and chromosomal abnormalities, categorized under the code family Q00 through Q99.
  • ๐Ÿฅ These codes are assigned when such conditions are documented in a patient's medical record and can be used as either principal or secondary codes based on the circumstances of the encounter.
  • ๐Ÿ”„ If a condition does not have a unique code, assign an additional code for any documented manifestations present.
  • ๐Ÿšซ Do not code separately for inherent components of the identified malformation, deformation, or abnormality; only code for additional manifestations not inherently included.
  • ๐Ÿ“ Chapter 17 codes can be used throughout a patient's life, even if the congenital condition has been corrected, by using a personal history code.
  • ๐Ÿ‘ถ For a newborn's day of admission, prioritize the Z38 code (encounter for antenatal screening) and then list any congenital anomalies with Q00-Q99 codes.
  • ๐Ÿค” Conditions present at birth may not be identified until later in life; code assignment should occur when a physician diagnoses the condition.
  • ๐ŸŽฏ The sequencing of these codes is governed by the specific circumstances of the encounter.
  • ๐Ÿ“ˆ Documentation in the medical record is crucial for accurate code assignment.
  • ๐Ÿ‘จโ€โš•๏ธ The physician's diagnosis is key in assigning the correct code from the Q00 through Q99 range.
  • ๐Ÿ“š The upcoming Chapter 18 will cover symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified.
Q & A
  • What is the ICD-10-CM chapter 17 focused on?

    -Chapter 17 of ICD-10-CM is focused on congenital malformations, deformations, and chromosomal abnormalities.

  • Which code range is used for congenital malformations, deformations, and chromosomal abnormalities?

    -The code range used for these conditions is from Q00 through Q99.

  • Can ICD-10-CM chapter 17 codes be assigned as either principal or secondary?

    -Yes, these codes can be assigned as either principal or secondary depending on the circumstances of the encounter.

  • What should be considered when a malformation, deformation, or chromosomal abnormality does not have a unique code?

    -If a condition does not have a unique code, an additional code for any manifestations present and documented in the medical record can be assigned.

  • What is the rule for coding inherent components of an abnormality?

    -Manifestations that are inherent components of the abnormality should not be coded separately.

  • When should additional codes be assigned according to the transcript?

    -Additional codes should be assigned for manifestations that are not an inherent component of the condition.

  • How are corrected congenital malformations or deformations coded?

    -For corrected congenital malformations or deformations, a personal history code that identifies the history of that particular malformation or deformity should be used.

  • At what point in a patient's life can chapter 17 codes be used?

    -Chapter 17 codes may be used throughout the life of the patient, even if the congenital condition was corrected.

  • What code should be used for the day of admission for a baby?

    -For the day of admission for a baby, the code from family Z38 should be used, followed by the Q00 through Q99 codes if there are any congenital anomalies.

  • How does the sequencing of these codes work?

    -The sequencing of these codes is governed by the circumstances of the encounter.

  • What happens if a congenital malformation or deformation is identified later in life?

    -If a congenital malformation or deformation is identified later in life, a code from Q00 through Q99 should be assigned at the time of diagnosis by the physician.

Outlines
00:00
๐Ÿ“š ICD-10-CM Coding Guidelines: Chapter 17 Overview

This paragraph introduces Dr. Kamble's discussion on ICD-10-CM coding guidelines, focusing on Chapter 17 which deals with congenital malformations, deformations, and chromosomal abnormalities (codes Q00 through Q99). It explains that these codes are assigned when such conditions are documented in the medical record and can be used as either principal or secondary codes, depending on the circumstances of the encounter. The sequence of coding is determined by the specific manifestations present and documented. If a condition doesn't have a unique code, additional codes can be assigned for any documented manifestations. The paragraph also distinguishes between inherent and additional manifestations, with the former not requiring separate coding if included in the primary code. It mentions the use of personal history codes for corrected malformations or deformations and notes that while these conditions are present at birth, they may not be identified until later in life. The importance of coding based on the circumstances of the encounter is emphasized.

Mindmap
Keywords
๐Ÿ’กICD-10-CM Coding
ICD-10-CM Coding refers to the standardized system of diagnostic codes used by healthcare professionals in the United States for documenting diseases, symptoms, and procedures. In the video, Dr. Kamble is reviewing guidelines for Chapter 17 of these codes, which specifically pertain to congenital malformations, deformations, and chromosomal abnormalities.
๐Ÿ’กCongenital Malformations
Congenital malformations are abnormalities that occur during the development of the fetus. They can involve any part of the body and may lead to physical or mental disabilities or health problems. In the context of the video, Dr. Kamble explains how to document and code these malformations using the ICD-10-CM system.
๐Ÿ’กDeformations
Deformations are physical changes in the shape or structure of the body that occur during fetal development due to mechanical forces such as pressure or constraint. Unlike malformations, deformations do not involve abnormal cell growth or development. The video explains how to differentiate between the two and code them accordingly.
๐Ÿ’กChromosomal Abnormalities
Chromosomal abnormalities are alterations in the number or structure of chromosomes that can lead to genetic disorders. These conditions are often identified at birth or during prenatal testing and can have a wide range of effects on an individual's health. The video provides insight into how to code for these abnormalities using the ICD-10-CM system.
๐Ÿ’กPrincipal or Secondary Codes
In the context of ICD-10-CM coding, principal codes are used to identify the main reason for a patient's visit or the primary condition being treated, while secondary codes can be used to document additional conditions that are related but not the primary focus of care. The video explains how the circumstances of the encounter determine which codes are assigned as principal or secondary.
๐Ÿ’กManifestations
Manifestations refer to the signs, symptoms, or physical changes that are evident in a patient with a particular condition. In the context of ICD-10-CM coding, it is important to distinguish whether a manifestation is an inherent part of a condition or not, as this affects whether it should be coded separately. The video clarifies when additional codes for manifestations should be assigned.
๐Ÿ’กPersonal History Code
A personal history code in ICD-10-CM is used to document a patient's past medical history, including conditions that may no longer be present but have had an impact on their health. The video explains that if a congenital malformation or deformation has been corrected, a personal history code should be used to indicate the history of that condition.
๐Ÿ’กZ Codes
Z codes in the ICD-10-CM system are used to classify factors influencing health status and contact with health services. In the video, Dr. Kamble mentions Z38 as the code for encounters related to childbirth. These codes are essential for capturing the context of why a patient is seeking medical care.
๐Ÿ’กSequence of Codes
The sequence of codes in ICD-10-CM is determined by the circumstances of the encounter and the clinical judgment of the healthcare provider. The order in which codes are listed can provide important information about the patient's health status and the focus of the medical encounter. The video emphasizes the importance of understanding these guidelines for proper documentation.
๐Ÿ’กAbnormal Clinical and Laboratory Findings
Abnormal clinical and laboratory findings refer to unexpected results from diagnostic tests or observations made during a medical examination. These findings can indicate underlying health issues or conditions that require further investigation or treatment. The video mentions Chapter 18, which is dedicated to coding such findings that are not classified elsewhere in the ICD-10-CM system.
๐Ÿ’กInherent Component
An inherent component is a characteristic or feature that is naturally a part of a condition or disorder. In the context of ICD-10-CM coding, if a manifestation is an inherent component of a congenital condition, it should not be coded separately. The video instructs coders on how to identify and handle inherent components when assigning codes.
Highlights

Today's topic is ICD-10-CM coding guidelines, specifically Chapter 17 on congenital malformations, deformations, and chromosomal abnormalities.

Codes in this chapter fall under the code family 0 through Q 99 and are assigned when such conditions are documented in the medical record.

These codes can be assigned as either principal or secondary, depending on the circumstances of the encounter.

If a condition does not have a unique code, an additional code can be assigned for any manifestations documented in the medical record.

Inherent manifestations of the malformation should not be coded separately; only additional, non-inherent manifestations require separate coding.

Chapter 17 codes may be used throughout the patient's life, even if the congenital condition has been corrected.

A personal history code should be used to identify the history of a malformation or deformity if it has been corrected.

Even though these conditions are present at birth, they may not be identified until later in life.

A code from Q00 through Q99 should be assigned upon diagnosis by a physician, regardless of when the condition is identified.

For a baby's day of admission, the code Z38 (encounter for antenatal screening) should be listed first, followed by any congenital anomaly codes from Q00 through Q99.

The sequencing of these codes is governed by the circumstances of the encounter.

The next chapter will cover symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified.

The presentation is a brief review of the ICD-10-CM coding guidelines for Chapter 17.

Coding for malformations and deformations should reflect the specific documentation in the medical record.

Manifestations not inherent in the coded malformation should be coded separately with additional codes.

The presence of a congenital malformation or deformation does not necessarily dictate the principal code; it depends on the reason for the encounter.

The upcoming chapter 18 will focus on coding for symptoms, signs, and abnormal findings that do not fit into other specific categories.

Transcripts
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