As any coder knows, the ICD code sets are updated every Fall. This year however, Oct. 1 will bring with it the implementation of an unprecedented number of coding changes. Changes that range from the addition of a code for the Zika virus to coding guideline changes that completely contradict coding practices that have been in place for decades. A couple of changes are highlighted below.
Heart Failure and Hypertension
Until now it has been correct coding practice to require documentation of a link between heart disease and hypertension before a code for hypertensive heart disease could be assigned. After Oct 1, correct coding will be the exact opposite…if a patient has hypertension and heart disease, hypertensive heart disease will be presumed unless the provider has specifically documented a different cause.
“With” indicates a presumed relationship
Previously, the guidelines only indicated that the word “with” was interpreted to mean “associated with” or “due to” when it appeared in a code title, the Alphabetic Index or an instructional note. The guideline has been expanded for 2017 to clarify that a causal relationship is presumed between two conditions linked by this term, even in the absence of provider documentation, unless the documentation clearly states the conditions are unrelated. This is similar to coding practice for pregnancy related conditions and will make it easier to assign codes with greater specificity such as codes for diabetes with specified manifestations (e.g., diabetes with nephropathy) because a documented causal relationship will no longer be required in order to support code assignment.
To check out a larger, although not comprehensive, list of changes use the link below to review The ICD-10 Monitor’s Article, “Ten Things about Oct. 1 that Coders and CDI Specialists Need to Know Now!”