ICD-10 Spotlight: Know the codes (Laterality)

March 29, 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: 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.

Condition: Central Corneal Ulcer

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 IBC transition to ICD-10, please visit the ICD-10 page on the IBC website.

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