Category Archives: ICD-10

International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10); ICD-10-CM, ICD-10-PCS; ICD-9-CM; ICD-10-CM Clinical Modification; inpatient coding standard; granular; granularity; specificity; GEMs; general equivalence mappings; transition to ICD-10; new coding rules; coding regulations

Dumb Ways to Die: The 8 Not Dumbest ICD-10 Codes

Yes, there are ICD-10 codes for exceedingly rare ways to die, and yes, they are easy to parody. This does not matter at all, since not many people are admitted to the hospital for a prolonged stay in a weightless environment.

What does matter is that preventable errors in hospital care are the third leading cause of death, after cancer and heart disease. Updated estimates in a 2013 study in the Journal of Patient Safety say that between 210,000 and 440,000 people die in US hospitals every year because some preventable harm was done to them. Continue reading

HIMagine That! Dual Coding

Sue: Happy New Year, Donna! Did you enjoy the holidays?

Donna: The holidays were wonderful, and you know I always feel reenergized in the new year!

Sue: Me, too! Instead of making New Year’s resolutions though, I focus on cleaning, straightening and getting organized.

Donna: Speaking of getting organized, I started making a list of what needs to be accomplished before ICD-10 goes live in October. Continue reading

Taking a Closer Look at the December ICD-10 Coding Challenge

CHALLENGE QUESTION:

 A 72 –year old male was admitted to the hospital with a chief complaint of a  fever with a temperature of 101° F and feeling ill with worsening chills, cough, nasal congestion and body aches that began two days prior to admission. A chest x-ray revealed bilateral infiltrates in both lower lobes of the lungs. A viral culture was positive for AH3N2 influenza.  The patient received antiviral medication and supportive care.  The patient recovered enough to be discharged three days later with a diagnosis of pneumonia due to AH3N2 influenza.

Assign ICD-10 diagnosis codes for the inpatient hospitalization. Continue reading

Three Resolutions Any Hospital Can Follow for Better Performance in 2015

There is plenty of speculation about the fate of hospitals and healthcare IT. The uncertainty could make it difficult for hospital executives to set strategies for the coming year. Yet, there are a few near-certainties as we go into 2015. Here are three resolutions hospital executives should make to keep pace with 2015 trends. Continue reading

ICD-10: Defining Clearer Boundaries

What makes a species distinct enough that it gets its own unique name? In my last blog, I discussed the taxonomy of living things developed by Carl Linnaeus in the 18th century. Like any classification system, Linnaeus’ conceptual framework for organizing and naming living things is an exercise in drawing boundaries. Similar things are grouped together, initially by laying out general boundaries—is it animal, vegetable, or mineral?—and making progressively finer distinctions.

All classification systems work in basically the same way, because all classification systems are products of the human mind. Classification is a profoundly human endeavor. We invent systems that allow us to organize and codify our understanding of the world and ourselves. Continue reading

Himagine That! A New Year, a New Coding System

Sue: Donna, you look reflective?

Donna: I guess I am. You know how you kind of take stock of everything as the year winds to a close?

Sue: Yes, I know what you mean.

Donna: Well, I was thinking about ICD-10 . . .

Sue: It was a roller coaster ride! Continue reading

Taking a Closer Look at the November ICD-10 Coding Challenge

CONTEST QUESTION:

A 49-year old female arrived in the trauma ED via helicopter in cardiac arrest after sustaining a stab wound to her upper torso. The patient was attacked by an unknown assailant with a knife (found at the scene) as she was walking to her car in a parking lot. The patient was unable to be resuscitated and expired. The Emergency Department physician documented the following diagnoses:

1. Penetrating laceration of anterior left thorax with near complete laceration of thoracic aorta
2. Hemopneumothorax

Assign diagnosis codes for this Emergency Department encounter. Continue reading

HIMagine That! Inter-Rater Reliability

Donna: Sue, have you heard people using the buzz word inter-rater reliability in the context of ICD-10?

Sue: Isn’t that a statistical formula used to determine agreement or consensus between two raters or judges?

Donna: Yes, but HIM professionals are using the term, not the formula, to compare the agreement rate between two or more coders coding a case in ICD-10. Continue reading

What Can an 18th Century Botanist Teach Us about 21st Century Healthcare?

Carl Linnaeus’s Systema Naturae, the taxonomy of living things he developed in the 18th century to classify living organisms, named only about 10,000 species of organisms, including roughly 6,000 plants and 4,000 animals. Linnaeus, a Swedish botanist, is reported to have stated categorically that there couldn’t possibly be more than 10,000 different plants in the whole world.

Even super smart guys like Linnaeus don’t know what they don’t know—there are currently 250,000 named plant species and 350,000 distinct species of beetles alone. The current estimate of the total number of species in the world is about 8.7 million. In other words, we have no idea how many kinds of living organisms there are, but we know we don’t know. And thanks to Linnaeus, we have a system that allows us to record what we learn as we learn it. Continue reading

Taking a Closer Look at the October ICD-10 Coding Challenge

CHALLENGE QUESTION:

A 70-year old man presented at an Ambulatory Surgery Center for an upper GI endoscopy to be evaluated for the cause of his recent complaints of some dysphagia. The patient received Midazolam 6mg IV and Fentanyl 100 mcg IV and Benzocaine spray was applied to the back of his throat. After obtaining informed consent, the endoscope was passed under direct vision. It was introduced through the mouth and advanced to the second part of the duodenum. A small hiatal hernia was present. A mild Schatzki ring was found at the gastroesophageal junction at 35 cm. A TTS dilator was passed through the scope. Dilation with at 15-16.5-18 mm x 240 cm CRE balloon (to a maximum balloon size of 18 mm) dilator was performed with mild treatment effect. The esophageal body mucosa appeared mildly corrugated. Biopsies were taken from the upper and lower esophagus. At that point, the patient went into cardiac arrest. We quickly removed the endoscope and began resuscitative efforts. The patient was emergently transferred to the local hospital. Postprocedure diagnoses: Schatzki ring, hiatal hernia, cardiac arrest. Continue reading