Putting ICD-10 into Practice: Coding exercises and scenarios (Exercise/Scenario #1)

December 28, 2012

The ICD-10 Spotlight: Know the codes feature that appeared in Partners in Health Update throughout 2012 was designed to communicate various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10. These conventions and guidelines are rules and instructions that must be followed to classify and assign the most appropriate code. As with ICD-9, adherence to these guidelines is required under the Health Insurance Portability and Accountability Act (HIPAA). This year, we are introducing a new feature called Putting ICD-10 into Practice: Coding exercises and scenarios. Each month this feature will help you put the new guidelines and conventions you learned about last year into practice. If needed, use the ICD-10 Spotlight: Know the codes booklet for assistance with these exercises. An answer key is provided below so you can verify if your answers are correct. In addition, a list of code narratives is included to describe each ICD-10 code.

Coding exercises

Code the following conditions according to ICD-10 coding conventions and guidelines: 1. Varicose vein of heel and mid-foot with presence of ulceration and swelling 2. Premature menopause with headache 3. Acute myocardial infarction of the anterolateral wall 4. Subsequent encounter for obesity resulting from the prescription drug Tryptanol? 5. Crohn?s disease of ileum with rectal bleeding and abscess 6. Bilateral central corneal ulcer 7. Severe generalized abdominal pain with abdominal rigidity 8. Female with bilateral breast cancer of lower outer quadrant 9. Acute nonsuppurative otitis media of the right ear 10. Initial encounter for concussion and edema of the thoracic spine 11. Initial encounter for third degree burn of the right thigh by gasoline to fifteen percent of the total body surface area

Coding scenario

Code the following scenario according to ICD-10 coding conventions and guidelines: While chopping vegetables in the kitchen of his mobile home for the local food bank?s Thanksgiving dinner, John Doe lacerated his right thumb causing injury to the nail.

Answers to coding exercises: 1) I83.224 2) E28.310 3) I21.09 4) E66.1, T43.015D 5) K50.011, K50.014 6) H16.013 7) R10.0 8) C50.511, C50.512
9) H65.191 10) S24.0xxA 11) T24.711A, T32.10, T52.0x1A
Answer to coding scenario: S61.111A, W26.0xxA, Y92.020, Y93.G1, Y99.2

Narratives

The following are the corresponding code narratives for each of the ICD-10 codes in the answer key: I83.224: Varicose veins of left lower extremity with both ulcer of heel and midfoot and inflammation E28.310: Symptomatic premature menopause I21.09: ST elevation myocardial infarction (STEMI) involving other coronary artery of anterior wall E66.1: Drug-induced obesity T43.015D: Adverse effect of tricyclic antidepressants, subsequent encounter K50.011: Crohn?s disease of small intestine with rectal bleeding K50.014: Crohn?s disease of small intestine with abscess H16.013: Central corneal ulcer, bilateral R10.0: Acute abdomen C50.511: Malignant neoplasm of lower-outer quadrant of right female breast C50.512: Malignant neoplasm of lower-outer quadrant of left female breast H65.191: Other acute nonsuppurative otitis media, right ear S24.0xxA: Concussion and edema of thoracic spinal cord, initial encounter T24.711A: Corrosion of third degree of right thigh, initial encounter T52.0x1A: Toxic effect of petroleum products, accidental (unintentional), initial encounter T32.10: Corrosions involving 10%?19% of body surface with 0%?9% third degree corrosion Y93.G1: Activity, food preparation and clean up W26.0xxA: Contact with knife, initial encounter S61.111A: Laceration without foreign body of right thumb with damage to nail, initial encounter Y92.020: Kitchen in mobile home as the place of occurrence of the external cause Y99.2: Volunteer activity For additional information related to IBC?s transition to ICD-10, please visit the ICD-10 section of our website. On this site you will find examples of how ICD-9 codes will translate to ICD-10 codes in the ICD-10 Spotlight: Know the codes booklet.