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ICD-10 Spotlight: Know the codes (Laterality)

March 29, 2012

Each month, this section will feature an example of how ICD-9 codes will translate to ICD-10 codes. We will present coding examples from different specialties and popular disease categories to demonstrate the granularity that the new ICD-10 code set will provide. CONDITIONS: CENTRAL CORNEAL ULCER AND MALIGNANT NEOPLASM OF LOWER-OUTER QUADRANT OF FEMALE BREAST ?Laterality? (side of the body affected) is a new coding convention added to relevant ICD-10 codes to increase specificity. Designated codes for conditions such as fractures, burns, ulcers, and certain neoplasms will require documentation of the side/region of the body where the condition occurs. In ICD-10, laterality code descriptions include right, left, bilateral, or unspecified designations: Right side = character 1; Left side = character 2; Bilateral = character 3; Unspecified side/region = character 0 or 9 (depending on whether it is a 5th or 6th character). The tables below compare the lack of specificity in ICD-9 to the greater level of specificity in ICD-10 when coding a corneal ulcer and female breast cancer. [

ICD-9 coding table

ICD-10 coding table

  • 370.03 Central corneal ulcer
  • H16.011 Central corneal ulcer, right eye
    OR
  • H16.012 Central corneal ulcer, left eye
    OR
  • H16.013 Central corneal ulcer, bilateral
    OR
  • H16.019 Central corneal ulcer, unspecified

Condition: Malignant Neoplasm of Lower-Outer Quadrant of Female Breast

ICD-9 coding table

ICD-10 coding table

  • 174.5 Malignant neoplasm of lower-outer quadrant of female breast
  • C50.511 Malignant neoplasm of lower-outer quadrant of right female breast*
    AND/OR
  • C50.512 Malignant neoplasm of lower-outer quadrant of left female breast*
    OR
  • C50.519 Malignant neoplasm of lower-outer quadrant of unspecified female breast

*If a bilateral code does not exist and the condition is bilateral, assign separate codes for both the left and right side.

For additional information related to the AmeriHealth transition to ICD-10, please visit the ICD-10 page on the AmeriHealth website.

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