ICD-10 Spotlight: Know the codes (Combination codes)

March 1, 2012

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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: DIABETES AND PRESSURE ULCER

This example demonstrates how to code diabetes and pressure ulcers using "combination codes." A combination code is a single code used to clarify one of the following:

  • two diagnoses;
  • a diagnosis with an associated secondary process (manifestation);
  • a diagnosis with an associated complication.

The combination code should be documented only if the code fully identifies the diagnostic conditions involved.
All of the diagnostic conditions must be clearly documented.

The tables below show how multiple ICD-9 codes translate to new ICD-10 combination codes.

ICD-10 diabetes mellitus codes are combination codes that include:

  • type of diabetes mellitus;
  • body system affected;
  • the complication/manifestion affecting the body system.

ICD-9 coding table

ICD-10 coding table

  • 250.52 Diabetes with ophthalmic manifestations, type II or
    unspecified type, uncontrolled
  • 362.05 Moderate nonproliferative diabetic retinopathy
  • 362.07 Diabetic macular edema
  • E11.331 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with
    macular edema

ICD-10 pressure ulcer codes are combination codes that include:

  • the site (lower back) of the pressure ulcer;
  • the location (right/left) of the pressure ulcer;
  • the stage of the pressure ulcer.

ICD-9 coding table

ICD-10 coding table

  • 707.03 Pressure ulcer, lower back
  • 707.22 Pressure ulcer stage II
  • L89.132 Pressure ulcer of right lower back, stage 2
    OR
  • L89.142 Pressure ulcer of left lower back, stage 2
    OR
  • L89.152 Pressure ulcer of sacral region, stage 2*

*The sacral region (coccyx and sacrum) is uniquely identified in ICD-10. In ICD-9, that region is included in the code for the lower back (707.03).

For additional information related to IBC's transition to ICD-10, please visit the ICD-10 section of our website.

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