May 12, 2014

Memorizing ICD-10-CM by the Letters: Part 3

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EDITOR’S NOTE: This is the third of a three part series on tips for memorizing ICD-10 codes. Read Part 1 and Part 2

This article continues the series that aims to provide assistance in “memorizing” ICD-10-CM – maybe not to the exact code, but the process will get you close. Shall we continue?

Each ICD-10-CM code begins with a letter. Each letter can be associated with a specific ICD-10-CM chapter. Some chapters include more than one letter and some chapters share beginning letters.

 

Chapter 15 contains Pregnancy, Childbirth and Puerperium. In ICD-10-CM, the letter that begins these codes is O, which should not be confused with the number zero. These codes can be associated with the mnemonic of Obstetrics. This chapter contains factors including miscarriage, twin gestation, and outcome of delivery. The documentation concerns for this chapter are the trimester, malpresentation, whether the disorder impacts the fetus or newborn, and conditions related to the postpartum and puerperium periods.

Chapter 16 contains Certain Conditions that Originate in the Perinatal Period.   In ICD-10-CM, the letter that begins these codes is P. These codes can be associated with the mnemonic of Perinatal for perinatal disorders. This chapter contains conditions that originate in the fetal or perinatal period, even if the morbidity is manifested after the perinatal period, birth injury, prematurity, etc. The documentation concerns for this chapter include specifying the relationship between the condition and the perinatal period, determining the extent of prematurity, and citing specific birth injuries or infections acquired at birth or in the perinatal period.

Chapter 17 contains Congenital Malformations, Deformations, and Chromosomal Abnormalities. In ICD-10-CM, the letter that begins these codes is Q. These codes can be associated with the mnemonic of Quirky for congenital conditions. The documentation concerns in this chapter are specific chromosomal abnormalities such as trisomy, karyotype 47(XXX), and Down’s syndrome; specific organ malformations also are involved, such as double-outlet right ventricle, atrial septal defect, and cleft lip and/or palate.  

Chapter 18 contains Symptoms, Signs, and Abnormal Clinical and Laboratory Findings Not Elsewhere Classified. In ICD-10-CM, the letter that begins these codes is R. These codes can be associated with the mnemonic of Relative Symptoms for signs and symptoms. This chapter contains abnormal findings that are not associated with an established diagnosis, such as a non-specific low blood-pressure reading, tachycardia, abdominal pain, and coma. The documentation concerns in this chapter include the Glasgow coma information regarding the score for all parts of the coma scale (eyes open, best verbal response, and best motor response), specific quadrant for abdominal pain, specific cause for fever (post-procedural, drug-related, post-transfusion, post-vaccination), and systemic inflammatory response syndrome (SIRS) with or without septic shock. These conditions are frequently admitting diagnoses or reasons for a visit.

Chapter 19 contains the Injuries, Poisonings, and Certain Other Consequences of External Causes. In ICD-10-CM, the letters that begin these codes are S and T. The codes can be associated with the mnemonic of Simply Traumatic for the injuries and poisonings. This chapter contains fractures, dislocations, intracranial injuries, adverse effects of medications, underdosing, lacerations, nerve injuries, sprains, strains, traumatic amputations, and accidental and intentional poisonings. The documentation concerns in this chapter include time of loss of consciousness, displaced/non-displaced fractures, the Gustillo scale for open fracture, laterality, underdosing and underlying reasons (dementia, lack of funds, etc.), fracture type (torus, two-part fracture of surgical neck of humerus, etc.), depth of an injury, whether a visit is the first or subsequent visit, and any residual conditions from an illness or injury.

Please note that the letter U is unused by ICD-10-CM. This letter is available for future code set expansion.

Chapter 20 contains the External Causes of Morbidity.  In ICD-10-CM, the letters that begin these codes are V, W, X, and Y. The codes can be associated with the mnemonics of Vehicles, Whoops, eXposure, and whY for the circumstances of injuries. This chapter contains vehicular accidents, how falls occur, exposure to environmental events, and types of activities that the patient was participating in at the time of the injury/illness. The documentation concerns in this chapter include the specificity regarding activities going on when the illness/injury occurred; whether the patient was working, volunteering, or serving in the military when the accident occurred; circumstances of a vehicular accident (pedestrian, pedestrian conveyance, on a road, off-road, collision, etc.); what type of instrument caused a cut (knife, broken glass, power tools, etc.); and where an injury occured (private residence, bedroom, public facility, theater, baseball diamond, etc.).

Chapter 21 contains the Factors Influencing Health Status and Contact with Health Services. In ICD-10-CM, the letter that begins these codes is Z. The codes can be associated with the mnemonic of Zero Problems for the conditions that influence health status.This chapter contains absence of organs, presence of devices, newborn conditions, personal history, family history, body mass index (BMI), drug resistance, weeks of gestation, allergy status, etc. The documentation concerns in this chapter include history and/or current condition, encounters for transplant aftercare, body mass index (BMI), and transplant status.

Now that I said my ABCs, what do you think of me? Keep practicing your ICD-10-CM by the letters!

Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer

Laurie M. Johnson, MS, RHIA, FAHIMA is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an American Health Information Management Association (AHIMA) approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and makes frequent appearances on Talk Ten Tuesdays.