Learning ICD-10-CM from the website icd10data.com Using ICD-10-CM as database Using google "site search" technology to facilitate searching

1. ICD-10-CM
⾃自學網站
http://icd10data.com/
http://quizlet.com/7731541/icd-10-cm-flash-cards/

2. What’s New in ICD 10 ?
時間 + 空間(解剖位置)

3. Format & Structure

4. The ICD-10-CM Tabular List contains
categories, subcategories and codes.

5. Tabular List (表格式)

6. Alphabetic Index (按⼦子⺟母)

7. Code Structure:
Basic categories:
⼀一個英⽂文字⺟母後接⼆二個阿拉伯數字 例: A00
⼩小數點之後爲 subcategory 和 subclassfication
例: A00.01

8. Sections: (group of three-character categories)
L00-L08 infection of skin and subcutaneous tissue
Categories (three-character code numbers)
L02, Cutaneous abscess, furuncle and carboncle
Subcategories (four-character code numbers)
L02.2, Cutaneous abscess, furuncle and carboncle of trunk
5.6.7 subclassifications
L02.211 , Cutaneous abscess of abdominal wall

9. http://www.icd10data.com/ICD10CM/Codes/L00-L99/L00-L08/L02-/L02.211
Section
Categorie

10. Sections: (group of three-character categories)
L00-L08 infection of skin and subcutaneous tissue
Categories (three-character code numbers)
L02, Cutaneous abscess, furuncle and carboncle
Subcategories (four-character code numbers)
L02.2, Cutaneous abscess, furuncle and carboncle of trunk
5.6.7 subclassifications
L02.211 , Cutaneous abscess of abdominal wall

11. http://www.icd10data.com/ICD10CM/Codes/L00-L99/L00-L08/L02-
subclassifications
Subcategories
(L02.2)

12. K29 Gastritis and duodenitis
(category)
K29.0 acute gastritis
(subcategory)
K29.00 acute gastritis without bleedings
(code)
http://www.icd10data.com/ICD10CM/Codes/K00-K95/K20-K31/K29-

14. Use of codes for reporting purposes

15. For reporting purposes only codes are
permissible, not categories or
subcategories, and any applicable 7th
character is required.

16. Placeholder character

17. The ICD-10-CM utilizes a placeholder
character "X". The "X" s used as a
placeholder at certain codes to allow for
future expansion.

18. T16 Foreign body in ear
Includes foreign body in auditory canal
T16.1 Foreign body in right ear
T16.2 Foreign body in left ear
T16.9 Foreign body in ear, unspecified ear
A Initial encounter
D subsequent encounter
S
sequela

19. 有一個小孩到急診, 主訴有一顆綠豆塞在右耳裏頭
T16.1 ?
T16.1XXA

20. 7th Character

21. Certain ICD-10-CM categories have
applicable 7th characters.

24. Includes Notes
This note appears immediately under a three character
code title to further define or give examples of, the
content of the category.

25. 有⼀一個病⼈人因為左側腦幹中⾵風住院, 經檢查發現,
左側腦幹有急性中⾵風,並且左側基底動脈完全堵塞,
因此我們的診斷如下:
left side brain stem stroke
left vertebral artery occlusion
brain stem stroke syndrome

27. 有⼀一個病⼈人因為頭暈, 做頸動脈檢查發現 “左側基
底動脈完全堵塞”, Brain MRI 沒有看到中⾵風, 因
此我們的診斷如下:
left vertebral artery occlusion

29. Excludes 1
A type 1 Exclude note is a pure exclude note. It means
"NOT CODED HERE!" An Exclude 1 note indicates that
the code excluded should never be used at the same
time as the code above the Exclude 1 note.

30. NOT CODED HERE !

32. Excludes 2
A type 2 excludes note represents "Not included
here". An excludes 2 note indicates that the condition
excluded is not part of the condition represented by
the code but a patient may have both conditions at
the same time. It is acceptable to use both the code
and the excluded code together, when appropriate.

34. NEC vs NOS

35. NEC :
"Not elsewhere classifiable" This abbreviation
represents "other specified". When a specific
code is not available for a condition.
!
NOS :
"Not otherwise specified" This abbreviation is
the equivalent of unspecified.

36. [ ] Brackets

37. Brackets are used in the Tabular List to enclose
synonyms, alternative wording or explanatory
phrases. Brackets are used in the Alphabetic
Index to identify manifestation codes.

39. ( ) Parentheses

40. Parentheses are used in both the Alphabetic Index
and Tabular List to enclose supplementary words
that may be present or absent in the statement of a
disease or procedure without affecting the code
number to which it assigned. The terms within the
parentheses are referred to as nonessential
modifiers.

42. : Colons

43. Colons are used in the Tabular List after an
incomplete term which needs one or more
of the modifiers following the colon to
make it assignable to a given category.

44. “and"
When the term "and" is used in a narrative
statement it represents and/or.

45. "Other"
Codes titled "other" or "other specified" are for use
when the information in the medical record provides
detail for which a specific code does not exist.

46. "Unspecified"
Codes titled "unspecified" are for use when the
information in the medical record is insufficient to
assign a more specific code.

47. “With"
The word "with" should be interpreted to mean
"associated with" or "due to" when it appears in
a code title, the Alphabetic Index, or and
instructional not in the Tabular List.

49. Syndromes
Follow the Alphabetic Index guidance when
coding syndromes. In the absence of
Alphabetic Index guidance, assign codes for
the documented manifestations of the
syndromes.

52. Ramsay Hunt syndrome

53. Ramsay-Hunt disease or syndrome

55. Signs and symptoms
Codes that describe symptoms and signs,
as opposed to diagnosis, are acceptable for
reporting purposes when a related
definitive diagnosis has not been
established (confirmed) by the provider.

56. Multiple coding
For a single conditionIn addition to the
etiology/manifestation convention that
requires two codes to fully describe a single
condition that affects multiple body systems,
there are other single conditions that also
require more than one code.

57. Malignant carcinoid tumor of
the sigmoid colon & rectum
C7A.025 & C7A.026

59. 這麼複雜, 誰記得住 ?

60. 時代不一樣了,只要會查即可!

61. Paradigm shift 典範轉移

62. Ask Google !!!

63. ICD 10 直接查詢 Google + site:icd10data.com
優點:
放棄背, 直接查
從查詢中快速學習 ICD 10 編碼原則
更清楚依照病人事實編碼
缺點:
似乎有點耗時
大量倚靠 ”網路”

64. ICD 10 直接查詢 Google + site:icd10data.com
搜尋方法:
於搜尋窗內: keyword site:icd10data.com
通常第一個就是 !
點進去 (next slide)

65. 可瀏覽樹狀圖
此碼的定義
提供US DRG 作參考
提供常用醫學名詞
供搜尋比對

66. ICD 10 直接查詢 Google + site:icd10data.com
點選C16 可看到完整編碼樹狀圖
其他可能的診斷
點C7A.092(next slide)
瀏覽C16 樹狀圖

67. ICD 10 直接查詢 Google + site:icd10data.com
想知道 C7A.092 是什麼? 為什麼不和其他Gastric tumor擺在一起?
可瀏覽樹狀圖, 點選可得知C7A之樹狀圖

69. ICD 10 直接查詢 Google + site:icd10data.com
真的很慢嗎? 可以用同法查詢以下診斷
Carpal tunnel syndrome(G56.01), aortic dissection (I71)
Hyponatremia(E87.1), renal artery stenosis(I70.1 or Q27.1)
ESRD, COPD, CKD, AMI, STEMI, STEMI+LAD(I21.02)
traumatic SAH (S06) vs nontraumatic SAH(I60)
tibial fracture (S82)
Right MCA embolic infarction (I63.412)

70. http://www.icd10data.com/ICD10CM/Table_Of_Neoplasms

72. http://www.icd10data.com/ICD10CM/Table_Of_Drugs