Updated on: August 16, 2017

BREAKING NEWS: 2018 ICD-10-CM Official Coding and Reporting Guidelines Released

By
Original story posted on: August 10, 2017
Just released on Thursday, Aug. 10 are the Official ICD-10-CM/PCS Coding and Reporting Guidelines for the 2018 fiscal year, totaling 117 pages. The National Center for Health Statistics, via the CDC (Centers for Disease Control and Prevention), has posted the guidelines on its website here: https://www.cdc.gov/nchs/data/icd/10cmguidelines_fy2018_final.pdf.

Readers should note that the time frame to which these guidelines apply to is Oct. 1, 2017 to Sept. 30, 2018.

When you review the guidelines for this coming fiscal year, please note the following:

  • Narrative changes appear in bold text
  • Items underlined have been moved within the guidelines since the FY 2017 version
  • Italics are used to indicate revisions to heading changes

The conventions for ICD-10-CM are the general rules for use of the classification independent of the guidelines, and there remain 19 of these conventions, as in the FY 2017 guidelines. Convention No. 15, “with,” does have some revised narrative, so every coding professional should read this over carefully. Here’s a portion of this revision, highlighted in blue font:

The word “with” or “in” should be interpreted to mean “associated with” or “due to” when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List.

These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated or when another guideline exists that specifically requires a documented linkage between two conditions (e.g., sepsis guideline for “acute organ dysfunction that is not clearly associated with the sepsis”).

For conditions not specifically linked by these relational terms in the classification or when a guideline requires that a linkage between two conditions be explicitly documented, provider documentation must link the conditions in order to code them as related.

In convention No. 17, the “code also” note, there is also a revision to note:

A “code also” note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. The sequencing depends on the circumstances of the encounter.

Again, each coding professional in every setting and role should read over the full set of guidelines. This not only is a duty and responsibility, but it also will assist in coding accurately. Reference: https://www.cdc.gov/nchs/data/icd/10cmguidelines_fy2018_final.pdf


PROGRAM NOTE:
Make certain that your facility will be in compliance with the new ICD-10 code changes being made effective Oct. 1, 2017. Register now to attend a three-part webcast workshop series, with installments scheduled for Aug. 16, 23, and 30. Produced by ICD10monitor, the series will feature Scot Nemchik, CCS, and Janice Tarlecki, MBA, RHIA, CCS, both with Ciox Health. Register now.

Also, listen to Talk Ten Tuesdays, Aug. 15, 10-10:30 a.m ET, featuring Gloryanne Bryant.
Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer

Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICd-10-CM/PCS Trainer, is a 40-year HIM coding professional, focusing on compliance and ethics. She is a member of the ICD10monitor editorial board, and a popular panelist on Talk Ten Tuesdays.

Related Stories

  • AHIMA: As Coding Evolves, So Must We
    A new white paper from the industry bellwether looks back, forward in framing big picture of coding. Benchmarking, the term that encompasses performance measurement in the healthcare industry, will be key for providers seeking to refine their efforts to master…
  • Polar Vortex Hastens Need for ICD-10 Cold Codes
    There are ICD-10 codes for cold weather injuries.The weather has been rough for the people living in the Midwest and Northeast. The reported temperatures have been as low as -60 with the wind chill factor applied. Such severity of temperatures…
  • ICD-10-CM Guideline I.A. 19: The Controversy Continues
    The code assignment is not based on clinical criteria used by the provider to establish the diagnosis. Referring to the contentious ICD-10-CM Guideline I.A.19, which indicates that assignment of a diagnosis code is based on the provider’s diagnostic statement that…