Even though the ICD-10 is granular, many diseases/disorders are not listed in tabular list. Many concepts are listed in the Alphabetic Index. This will pose a challenge to ICD-10 coders.
Example: Mesenteric saponification is listed in the Alphabetic Index, but is not in the Tabular List.
Some of the diseases/disorders listed in ICD-9 Alphabetic Index as nonessential modifiers are listed in ICD-10 Tabular. Example: See Cirrhosis-biliary (cholangiolitic) (cholangitic) (cholestatic) (extrahepatic) (hypertrophic) (intrahepatic) (nonobstructive) (obstructive) (pericholangiolitic) (posthepatic) (primary) (secondary) (xanthomatous)
Primary and secondary biliary cirrhosis are listed as 2 separate codes in iCD-10 Tabular.
ICD-10 Specific codes
K74.3: Primary biliary cirrhosis
Chronic nonsuppurative destructive cholangitis
K74.4: Secondary biliary cirrhosis
Some of the essential modifiers listed in alphabetic index of ICD-9-CM are made to non-essential modifiers in ICD-10-CM
Example: Index entry for Agranulocytosis (see also Neutropenia) 288.09 in ICD-9-CM is linked with seven essential modifiers (chronic, cyclical, due to infection, genetic, infantile, periodic, pernicious), but index entry for Agranulocytosis (chronic) (cyclical) (genetic) (infantile) (periodic) (pernicious) (see also Neutropenia) D70.9 six essential modifiers of ICD-9-CM are made to non-essential modifiers
Some of the non-essential modifiers from ICD-9-CM are made to essential modifiers in ICD-10-CM and some of them are not mentioned at all in ICD-10-CM. What if physician uses the terminology which is abandoned in ICD-10-CM. How the coder should take decisions while assigning codes in such cases?
Example: The index entry of the the term “Aphasia” in ICD-9-CM and ICD-10-CM is as follows:
Aphasia (amnestic) (ataxic) (auditory) (Broca's) (choreatic) (classic) (expressive) (global) (ideational) (ideokinetic) (ideomotor) (jargon) (motor) (nominal) (receptive) (semantic) (sensory) (syntactic) (verbal) (visual) (Wernicke's) 784.3
Aphasia (amnestic) (global) (nominal) (semantic) (syntactic) R47.01
If a physician uses diagnostic statements as
ataxic aphasia or
Broca’s aphasia or
Choreatic apahsia or
Classic aphasia or
Expressive aphasia or
Ideational aphasia or
Ideokinetic aphasia or
Ideomotor aphasia or
Jargon aphasia or
Motor aphasia or
Receptive aphasia or
Verbal aphasia or
Visual aphasia or
What a coder should do in the above situation?
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