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ICD-10-CM Chapter 9: Diseasesof the Circulatory SystemRebecca Herrera, CCS, CCS-P, CPC, AHIMAApproved ICD-10-CM/PCS Trainer2013 Indian Health Partnerships ConferenceICD-10 InitiativeOffice of Information TechnologyAugust 13 - 15, 2013
Objectives Organization ICD-10 Differences in I-9 and I-10 Comparison I-9 and I-10 Case Study Guidelines References and Resources2
Organization of ICD-10-CMChapterChapter Description8.H60 - H95Diseases of the ear and mastoid process9.I00 – I99Diseases of the circulatory system10.J00 – J99Diseases of the respiratory system11.K00 – K95Diseases of the digestive system12.L00– L99Diseases of the skin and subcutaneous tissue13.M00 – M99Diseases of the musculoskeletal system and connective tissue14.N00 – N99Disease of the genitourinary system
ICD-9-CM Hypertension Table
Comparison of I-9 and I-10HypertensionI-9Malignant Benign UnspecifiedI-10 .9I10 Essential (primary) hypertensionwith CKDstage I-IV, orunspecified403.00403.10403.90I12.9 Hypertensive chronic kidneydisease with stage 1-4 CKD, orunspecified chronic kidney diseasewith CKDstage V orESRD403.01403.11403.91I12.0 Hypertensive chronic kidneydisease with stage 5 CKD or endstage renal diseaseHypertensiveHeart402.00402.10402.90I11.9 Hypertensive heart diseasewithout heart 0 Hypertensive heart andchronic kidney disease without heartfailure, with stage 1- 4 CKD, orunspecified CKD
Case StudyMaxwell is hospitalized with a diagnosis of congestiveheart failure due to hypertensive heart disease. Healso has Stage 5 chronic kidney failure. The patienthas been prescribed Lasix previously but admits heforgets to take his medication every day. This is due tohis advanced age. What are his diagnosis code(s)?6
congestive heart failure due to hypertensive heart disease. Healso has Stage 5 chronic kidney failure
Index and Tabular View
Tabular
ICD-10-CM Drug Table
Tabular
Index and Tabular
Case Study Answer I13.2 Disease, diseased, heart (organic), hypertensive – seeHypertension, heart. Hypertension, hypertensive (accelerated) (benign)(essential) (idiopathic) (malignant) (systemic), heart (disease) with kidneydisease (chronic) – see Hypertension, cardiorenal (disease), with heartfailure, with stage 5 or end stage renal disease The “use additional code” note indicates to identify the type of heartfailure The “use additional code” note indicates to identify the stage ofchronic kidney disease I50.9 Failure, heart (acute) (sudden), congestive (compensated)(decompensated). N18.5 Disease, diseased, kidney (functional) (pelvis), chronic, stage 5.T50.1x6A Refer to Table of Drugs and Chemicals, Lasix, underdosingZ91.130 Noncompliance, medication regimen, underdosing,unintentional, due to patient’s age-related debility
Guidelines True or False?If a patient has both acute systolic heart failure andhypertension, no causal condition relationship needs to bedocumented to use the combination code I11.0
Guidelines Answer: FalseRational: ICD-10-CM Coding Guideline I.C.9.a.1, Hypertensionwith heart disease, states “Heart conditions classified to I50.- orI51.9 are assigned to a code from category I11, Hypertensive heartdisease when a causal relationship is stated (due to hypertension) orimplied (hypertensive).Use an additional code from category I50, heart failure, to identifythe type of heart failure in those patients with heart failure. The sameheart conditions with hypertension, but without a stated relationship,are coded separately.”
Guidelines True or False?Uncontrolled hypertension and controlled hypertension havedifferent codes in ICD-10-CM16
Guidelines Answer: FalseRational: ICD-10-CM does not differentiate between uncontrolledand controlled hypertension.
References and Resources n.pdf http://www.montanahima.net/pdf/ICD-10-CM spring 2011handout.ppt AHIMA ICD-10-CM Coder Training Manual 2013 Instructor’s Edition18
Questions?Thank you!19
disease (chronic) - see Hypertension, cardiorenal (disease), with heart failure, with stage 5 or end stage renal disease The "use additional code" note indicates to identify the type of heart failure The "use additional code" note indicates to identify the stage of chronic kidney disease I50.9 Failure, heart (acute) (sudden .
