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 is an independent health information management (HIM) coding compliance consultant with more than 40 years of experience in the field. She appears on Talk Ten Tuesdays on a regular basis and is a member of the ICD10monitor editorial board.

Related Stories

  • National Coding Contest Indicates Outpatient Coding is Getting Worse, not Better
    More than 4,000 cases were coded in the 2019 contest focused on outpatient coding. ICD-10 is well-established, and we are already discussing and planning for ICD-11. However, where are the long-anticipated and promised increased accuracy and most definitive diagnoses? At…
  • Be a Success in Your Coding Career
    Success can cost you more than you thought it would. You might have heard the phrase, “everyone wants to be successful until they see what it actually takes.”  While I’m not sure where the quote originates, I’ve seen it attached…
  • Why this Holiday Could be Perilous for Some
    New Year’s thoughts and reflections. The holidays are times for people to connect with loved ones, including family and friends. I would ask that during this holiday season, please look out for our adolescents.    In October 2019, the Public Broadcasting…