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2019

ICD-10-CM Professional for Physicians The complete official code set

Codes valid from October 1, 2018 through September 30, 2019

ICD

-10-C

M Professional

for Physicians

PROFESSIONAL

ITPB_ITPB19_CVR.indd 1 12/4/17 2:13 PM

ICD-10-CM 2019 i

ContentsPreface ................................................................................ iii

ICD-10-CM Official Preface ........................................................................ iiiCharacteristics of ICD-10-CM .................................................................... iii

What’s New for 2019 ........................................................... ivOfficial Updates ............................................................................................ ivProprietary Updates .................................................................................... vi

Introduction ...................................................................... viiHistory of ICD-10-CM ................................................................................vii

How to Use ICD-10-CM Professional for Physicians 2019 ................................................................. viii

Use of Official Sources ..............................................................................viiiSteps to Correct Coding ..........................................................................viiiOrganization ...............................................................................................viii

Introduction ........................................................................................viiiOfficial ICD-10-CM Conventions and Guidelines........................viiiAlphabetic Index to Diseases ..........................................................viiiNeoplasm Table..................................................................................viiiTable of Drugs and Chemicals ........................................................viiiIndex to External Causes ..................................................................viiiTabular List of Diseases ....................................................................viiiIllustrations ..........................................................................................viii

Overview of ICD-10-CM Official Conventions .................... ixFormat ............................................................................................................ ixPunctuation .................................................................................................. ixAbbreviations ............................................................................................... ix

NEC .......................................................................................................... ixNOS.......................................................................................................... ix

Typeface ......................................................................................................... ixGeneral Notes .............................................................................................. ix

Includes Notes ...................................................................................... ixInclusion Terms..................................................................................... ixExcludes Notes...................................................................................... ixNote .......................................................................................................... xDefault Codes......................................................................................... xSyndromes.............................................................................................. xAnd ........................................................................................................... xWith .......................................................................................................... xSee and See Also ................................................................................... xInstructional Notes Used in the Tabular List .................................. xCode Assignment and Clinical Criteria ............................................ x

Additional Annotations ...................................................... xiCode-Level Notations ................................................................................. xi

Italics ...................................................................................................... xiColor Coding/Symbols ....................................................................... xiOther Code-Level Notations............................................................. xii

Chapter-Level Notations ........................................................................... xiiChapter-Specific Guidelines with Coding Examples .................. xiiMuscle and Tendon Table................................................................. xii

Index Notations ......................................................................................... xiiiFollowing References ........................................................................xiii

ICD-10-CM Official Guidelines for Coding and Reporting ...................................... Coding Guidelines–1

ICD-10-CM Index to Diseases and Injuries .......................... 1

ICD-10-CM Neoplasm Table ............................................ 331

ICD-10-CM Table of Drugs and Chemicals ...................... 349

ICD-10-CM Index to External Causes ............................... 397

ICD-10-CM Tabular List of Diseases and Injuries ............ 433Chapter 1. Certain Infectious and Parasitic Diseases

(A00-B99) .........................................................................433

Chapter 2. Neoplasms (C00-D49) ...................................................457

Chapter 3. Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) ..................................................495

Chapter 4. Endocrine, Nutritional and Metabolic Diseases(E00-E89) ..........................................................................505

Chapter 5. Mental, Behavioral, and Neurodevelopmental Disorders (F01-F99) .......................................................525

Chapter 6. Diseases of the Nervous System (G00-G99) ............549

Chapter 7. Diseases of the Eye and Adnexa (H00-H59) ............569

Chapter 8. Diseases of the Ear and Mastoid Process(H60-H95) ........................................................................605

Chapter 9. Diseases of the Circulatory System (I00-I99) ...........617

Chapter 10. Diseases of the Respiratory System (J00-J99) .........657

Chapter 11. Diseases of the Digestive System (K00-K95) ...........671

Chapter 12. Diseases of the Skin and Subcutaneous Tissue(L00-L99) ..........................................................................693

Chapter 13. Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) ....................................713

Chapter 14. Diseases of the Genitourinary System (N00-N99) ........................................................................801

Chapter 15. Pregnancy, Childbirth, and the Puerperium(O00-O9A) ........................................................................819

Chapter 16. Certain Conditions Originating in the Perinatal Period (P00-P96) ............................................................857

Chapter 17. Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99) .................869

Chapter 18. Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) .......................................................887

Chapter 19. Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) .......................................907

Chapter 20. External Causes of Morbidity (V00-Y99)................. 1113

Chapter 21. Factors Influencing Health Status and Contact With Health Services (Z00-Z99) ............................... 1175

Illustrations ................................................... Illustrations–1Chapter 3. Diseases of the Blood and Blood-forming Organs and

Certain Disorders Involving the Immune Mechanism (D50–D89) .............................. Illustrations–1Red Blood Cells ............................................ Illustrations–1White Blood Cell .......................................... Illustrations–1Platelet .......................................................... Illustrations–2Coagulation .................................................. Illustrations–2Spleen Anatomical Location and

External Structures ............................. Illustrations–3Spleen Interior Structures ......................... Illustrations–3

Sample

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Lymphangitis — continuedacute — continued

hip — see Lymphangitis, acute, lower limbjaw (region) L03.212knee — see Lymphangitis, acute, lower limbleg — see Lymphangitis, acute, lower limblower limb L03.12- S

toe — see Lymphangitis, acute, toenavel L03.326neck (region) L03.222orbit, orbital — see Cellulitis, orbitpectoral (region) L03.323perineal, perineum L03.325scalp (any part) L03.891shoulder — see Lymphangitis, acute, upper limbspecified site NEC L03.898thigh — see Lymphangitis, acute, lower limbthumb (intrathecal) (periosteal) (subcutaneous)

(subcuticular) — see Lymphangitis, acute,finger

toe (intrathecal) (periosteal) (subcutaneous) (sub-cuticular) L03.04- S

trunk L03.329abdominal wall L03.321back (any part) L03.322buttock L03.327chest wall L03.323groin L03.324perineal, perineum L03.325umbilicus L03.326

umbilicus L03.326upper limb L03.12- S

axilla — see Lymphangitis, acute, axillafinger — see Lymphangitis, acute, fingerthumb — see Lymphangitis, acute, finger

wrist — see Lymphangitis, acute, upper limbbreast

gestational — see Mastitis, obstetricchancroidal A57chronic (any site) I89.1due to

Brugia (malayi) B74.1timori B74.2

Wuchereria bancrofti B74.0following ectopic or molar pregnancy O08.89penis

acute N48.29gonococcal (acute) (chronic) A54.09

puerperal, postpartum, childbirth O86.89strumous, tuberculous A18.2subacute (any site) I89.1tuberculous — see Tuberculosis, lymph gland

Lymphatic (vessel) — see conditionLymphatism E32.8Lymphectasia I89.0Lymphedema (acquired) (see also Elephantiasis)

congenital Q82.0hereditary (chronic) (idiopathic) Q82.0postmastectomy I97.2praecox I89.0secondary I89.0surgical NEC I97.89

postmastectomy (syndrome) I97.2Lymphoblastic — see conditionLymphoblastoma (diffuse) — see Lymphoma, lym-

phoblastic (diffuse)giant follicular — see Lymphoma, lymphoblastic (dif-

fuse)macrofollicular — see Lymphoma, lymphoblastic

(diffuse)Lymphocele I89.8Lymphocytic

chorioencephalitis (acute) (serous) A87.2choriomeningitis (acute) (serous) A87.2meningoencephalitis A87.2

Lymphocytoma, benign cutis L98.8Lymphocytopenia D72.810Lymphocytosis (symptomatic) D72.820

infectious (acute) B33.8Lymphoepithelioma — see Neoplasm, malignant, by

siteLymphogranuloma (malignant) (see also Lymphoma,

Hodgkin)chlamydial A55inguinale A55venereum (any site) (chlamydial) (with stricture of

rectum) A55

Lymphogranulomatosis (malignant) (see also Lym-phoma, Hodgkin)

benign (Boeck's sarcoid) (Schaumann's) D86.1Lymphohistiocytosis, hemophagocytic (familial) D76.1Lymphoid — see conditionLymphoma (of) (malignant) C85.90

adult T-cell (HTLV-1-associated) (acute variant)(chronic variant) (lymphomatoid variant)(smouldering variant) C91.5- S

anaplastic large cellALK-negative C84.7- SALK-positive C84.6- SCD30-positive C84.6- Sprimary cutaneous C86.6

angioimmunoblastic T-cell C86.5BALT C88.4B-cell C85.1- Sblastic NK-cell C86.4blastic plasmacytoid dendritic cell neoplasm (BPDCN)

C86.4B-precursor C83.5- Sbronchial-associated lymphoid tissue [BALT-lym-

phoma] C88.4Burkitt (atypical) C83.7- SBurkitt-like C83.7- Scentrocytic C83.1- Scutaneous follicle center C82.6- Scutaneous T-cell C84.A- S (following C84.7)diffuse follicle center C82.5- Sdiffuse large cell C83.3- S

anaplastic C83.3- SB-cell C83.3- SCD30-positive C83.3- Scentroblastic C83.3- Simmunoblastic C83.3- Splasmablastic C83.3- Ssubtype not specified C83.3- ST-cell rich C83.3- S

enteropathy-type (associated) (intestinal) T-cell C86.2extranodal marginal zone B-cell lymphoma of mucosa-

associated lymphoid tissue [MALT-lymphoma]C88.4

extranodal NK/T-cell, nasal type C86.0follicular C82.9- S

gradeI C82.0- SII C82.1- SIII C82.2- SIIIa C82.3- SIIIb C82.4- S

specified NEC C82.8- Shepatosplenic T-cell (alpha-beta) (gamma-delta) C86.1histiocytic C85.9- S

true C96.A (following C96.6)Hodgkin C81.9 S

lymphocyte depleted (classical) C81.3- Slymphocyte-rich (classical) C81.4- Smixed cellularity (classical) C81.2- Snodular

lymphocyte predominant C81.0- Ssclerosis (classical) C81.1- S

nodular sclerosis (classical) C81.1- Sspecified NEC (classical) C81.7- S

intravascular large B-cell C83.8- SLennert's C84.4- Slymphoblastic (diffuse) C83.5- Slymphoblastic B-cell C83.5- Slymphoblastic T-cell C83.5- Slymphoepithelioid C84.4- Slymphoplasmacytic C83.0- S

with IgM-production C88.0MALT C88.4mantle cell C83.1- Smature T-cell NEC C84.4- Smature T/NK-cell C84.9- S

specified NEC C84.Z- S (following C84.7)mediastinal (thymic) large B-cell C85.2- SMediterranean C88.3mucosa-associated lymphoid tissue [MALT-lymphoma]

C88.4NK/T cell C84.9- Snodal marginal zone C83.0- Snon-follicular (diffuse) C83.9- S

specified NEC C83.8- Snon-Hodgkin (see also Lymphoma, by type) C85.9- S

specified NEC C85.8- S

Lymphoma — continuednon-leukemic variant of B-CLL C83.0- Speripheral T-cell, not classified C84.4- Sprimary cutaneous

anaplastic large cell C86.6CD30-positive large T-cell C86.6

primary effusion B-cell C83.8- SSALT C88.4skin-associated lymphoid tissue [SALT-lymphoma]

C88.4small cell B-cell C83.0- Ssplenic marginal zone C83.0- Ssubcutaneous panniculitis-like T-cell C86.3T-precursor C83.5- Strue histiocytic C96.A (following C96.6)

Lymphomatosis — see LymphomaLymphopathia venereum, veneris A55Lymphopenia D72.810Lymphoplasmacytic leukemia — see Leukemia,

chronic lymphocytic, B-cell typeLymphoproliferation, X-linked disease D82.3Lymphoreticulosis, benign (of inoculation) A28.1Lymphorrhea I89.8Lymphosarcoma (diffuse) (see also Lymphoma)

C85.9- SLymphostasis I89.8Lypemania — see MelancholiaLysine and hydroxylysine metabolism disorder E72.3Lyssa — see Rabies

MMacacus ear Q17.3Maceration, wet feet, tropical (syndrome) T69.02- SMacLeod's syndrome J43.0Macrocephalia, macrocephaly Q75.3Macrocheilia, macrochilia (congenital) Q18.6Macrocolon (see also Megacolon) Q43.1Macrocornea Q15.8

with glaucoma Q15.0Macrocytic — see conditionMacrocytosis D75.89Macrodactylia, macrodactylism (fingers) (thumbs)

Q74.0toes Q74.2

Macrodontia K00.2Macrogenia M26.05Macrogenitosomia (adrenal) (male) (praecox) E25.9

congenital E25.0Macroglobulinemia (idiopathic) (primary) C88.0

monoclonal (essential) D47.2Waldenström C88.0

Macroglossia (congenital) Q38.2acquired K14.8

Macrognathia, macrognathism (congenital)(mandibular) (maxillary) M26.09

Macrogyria (congenital) Q04.8Macrohydrocephalus — see HydrocephalusMacromastia — see Hypertrophy, breastMacrophthalmos Q11.3

in congenital glaucoma Q15.0Macropsia H53.15Macrosigmoid K59.39

congenital Q43.2Macrospondylitis , acromegalic E22.0Macrostomia (congenital) Q18.4Macrotia (external ear) (congenital) Q17.1Macula

cornea, corneal — see Opacity, corneadegeneration (atrophic) (exudative) (senile) (see also

Degeneration, macula)hereditary — see Dystrophy, retina

Maculae ceruleae B85.1Maculopathy, toxic — see Degeneration, macula, toxicMadarosis (eyelid) H02.729

left H02.726lower H02.725upper H02.724

right H02.723lower H02.722upper H02.721

Madelung'sdeformity (radius) Q74.0disease

radial deformity Q74.0symmetrical lipomas, neck E88.89

Madness — see Psychosis

Lymphangitis—

Madness

Index

215S Additional Character Required — Refer to the Tabular List for Character Selection2 Subterms under main terms may continue to next column or page

MadnessICD-10-CM 2019

Sample

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Chapter 3. Disease of the Blood and Blood-Form

ing Organs

D63–D

68.311ICD-10-CM 2019 Chapter 3. Disease of the Blood and Blood-Forming Organs D63–D68.311

g Placeholder Alert Manifestation <CMS-HCC Condition BUnspecified Code wx Revised Text l New Code s Revised Code TitleS Additional Character Req

ICD-10-CM 2019 499

b D63 Anemia in chronic diseases classified elsewhereD63.0 Anemia in neoplastic disease

Code first neoplasm (C00-D49)1 anemia due to antineoplastic chemotherapy (D64.81)

aplastic anemia due to antineoplastic chemotherapy (D61.1)

2wanemia due to antineoplastic chemotherapy (D64.81)x

D63.1 Anemia in chronic kidney diseaseErythropoietin resistant anemia (EPO resistant anemia)Code first underlying chronic kidney disease (CKD) (N18.-)

D63.8 Anemia in other chronic diseases classified elsewhereCode first underlying disease, such as:

diphyllobothriasis (B70.0)hookworm disease (B76.0-B76.9)hypothyroidism (E00.0-E03.9)malaria (B50.0-B54)symptomatic late syphilis (A52.79)tuberculosis (A18.89)

b D64 Other anemias1 refractory anemia (D46.-)

refractory anemia with excess blasts in transformation [RAEB T] (C92.0-)

D64.0 Hereditary sideroblastic anemia <Sex-linked hypochromic sideroblastic anemia

D64.1 Secondary sideroblastic anemia due to disease <

Code first underlying diseaseD64.2 Secondary sideroblastic anemia due to drugs and toxins <

Code first poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4 or 6)

Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

D64.3 Other sideroblastic anemias <Sideroblastic anemia NOSPyridoxine-responsive sideroblastic anemia NEC

D64.4 Congenital dyserythropoietic anemiaDyshematopoietic anemia (congenital)1 Blackfan-Diamond syndrome (D61.01)

Di Guglielmo's disease (C94.0)

c D64.8 Other specified anemiasD64.81 Anemia due to antineoplastic chemotherapy

Antineoplastic chemotherapy induced anemia1 aplastic anemia due to antineoplastic

chemotherapy (D61.1)2 anemia in neoplastic disease (D63.0)AHA: 2014, 4Q, 22DEF: Reversible adverse effect of chemotherapy, causing inhibition of bone marrow production; decrease in red blood cell production prevents adequate oxygenation of the tissues and organs causing fatigue, SOB, and exacerbation of other medical conditions.

D64.89 Other specified anemiasInfantile pseudoleukemia

D64.9 Anemia, unspecified BAHA: 2017, 1Q, 7

Coagulation defects, purpura and other hemorrhagic conditions (D65-D69)

D65 Disseminated intravascular coagulation [defibrination <syndrome]

Afibrinogenemia, acquiredConsumption coagulopathyDiffuse or disseminated intravascular coagulation [DIC]Fibrinolytic hemorrhage, acquiredFibrinolytic purpuraPurpura fulminans1 disseminated intravascular coagulation (complicating):

abortion or ectopic or molar pregnancy (O00-O07, O08.1)in newborn (P60)pregnancy, childbirth and the puerperium (O45.0, O46.0,

O67.0, O72.3)

D66 Hereditary factor VIII deficiency <Classical hemophiliaDeficiency factor VIII (with functional defect)Hemophilia AHemophilia NOS1 factor VIII deficiency with vascular defect (D68.0)DEF: Hereditary, sex-linked lack of antihemophilic globulin (AHG) (factor VIII); causes abnormal coagulation characterized by increased bleeding, large bruises of skin, bleeding in mouth, nose, gastrointestinal tract; hemorrhages into joints, resulting in swelling and impaired function.

D67 Hereditary factor IX deficiency <Christmas diseaseFactor IX deficiency (with functional defect)Hemophilia BPlasma thromboplastin component [PTC] deficiency

b D68 Other coagulation defects1 abnormal coagulation profile (R79.1)

coagulation defects complicating abortion or ectopic or molar pregnancy (O00-O07, O08.1)

coagulation defects complicating pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)

AHA: 2016, 1Q, 14D68.0 Von Willebrand's disease <

AngiohemophiliaFactor VIII deficiency with vascular defectVascular hemophilia1 capillary fragility (hereditary) (D69.8)

factor VIII deficiency NOS (D66)factor VIII deficiency with functional defect (D66)

DEF: Abnormal blood coagulation caused by deficient blood factor VII; congenital; symptoms include excess or prolonged bleeding.

D68.1 Hereditary factor XI deficiency <Hemophilia CPlasma thromboplastin antecedent [PTA] deficiencyRosenthal’s disease

D68.2 Hereditary deficiency of other clotting factors <AC globulin deficiencyCongenital afibrinogenemiaDeficiency of factor I [fibrinogen]Deficiency of factor II [prothrombin]Deficiency of factor V [labile]Deficiency of factor VII [stable]Deficiency of factor X [Stuart-Prower]Deficiency of factor XII [Hageman]Deficiency of factor XIII [fibrin stabilizing]Dysfibrinogenemia (congenital)HypoproconvertinemiaOwren's diseaseProaccelerin deficiency

c D68.3 Hemorrhagic disorder due to circulating anticoagulantsd D68.31 Hemorrhagic disorder due to intrinsic circulating

anticoagulants, antibodies, or inhibitorsD68.311 Acquired hemophilia <

Autoimmune hemophiliaAutoimmune inhibitors to clotting factorsSecondary hemophilia

Red blood cells

White blood cell

Platelets

Fibrin

Injury site

Coagulation

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Chapter 10. Diseases of the Respiratory System

ICD-10-CM 2019 Chapter 10. Diseases of the Respiratory System Guidelines and Examples

ICD-10-CM 2019 657

Chapter 10. Diseases of the Respiratory System (J00–J99)

Chapter Specific Guidelines with Coding ExamplesThe chapter specific guidelines from the ICD-10-CM Official Guidelines for Coding and Reporting have been provided below. Along with these guidelines are coding examples, contained in the shaded boxes, that have been developed to help illustrate the coding and/or sequencing guidance found in these guidelines.

a. Chronic obstructive pulmonary disease [COPD] and asthma1) Acute exacerbation of chronic obstructive bronchitis and asthma

The codes in categories J44 and J45 distinguish between uncomplicated cases and those in acute exacerbation. An acute exacerbation is a worsening or a decompensation of a chronic condition. An acute exacerbation is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection.

b. Acute respiratory failure1) Acute respiratory failure as principal diagnosis

A code from subcategory J96.0, Acute respiratory failure, or subcategory J96.2, Acute and chronic respiratory failure, may be assigned as a principal diagnosis when it is the condition established after study to be chiefly responsible for occasioning the admission to the hospital, and the selection is supported by the Alphabetic Index and Tabular List. However, chapter-specific coding guidelines (such as obstetrics, poisoning, HIV, newborn) that provide sequencing direction take precedence.

2) Acute respiratory failure as secondary diagnosisRespiratory failure may be listed as a secondary diagnosis if it occurs after admission, or if it is present on admission, but does not meet the definition of principal diagnosis.

3) Sequencing of acute respiratory failure and another acute conditionWhen a patient is admitted with respiratory failure and another acute condition, (e.g., myocardial infarction, cerebrovascular accident, aspiration pneumonia), the principal diagnosis will not be the same in every situation. This applies whether the other acute condition is a respiratory or nonrespiratory condition. Selection of the principal diagnosis will be dependent on the circumstances of admission. If both the respiratory failure and the other acute condition are equally responsible for occasioning the admission to the hospital, and there are no chapter-specific sequencing rules, the guideline regarding two or more diagnoses that equally meet the definition for principal diagnosis (Section II, C.) may be applied in these situations.If the documentation is not clear as to whether acute respiratory failure and another condition are equally responsible for occasioning the admission, query the provider for clarification.

c. Influenza due to certain identified influenza virusesCode only confirmed cases of influenza due to certain identified influenza viruses (category J09), and due to other identified influenza virus (category J10). This is an exception to the hospital inpatient guideline Section II, H. (Uncertain Diagnosis).In this context, “confirmation” does not require documentation of positive laboratory testing specific for avian or other novel influenza A or other identified influenza virus. However, coding should be based on the provider’sdiagnostic statement that the patient has avian influenza, or other novel influenza A, for category J09, or has another particular identified strain of influenza, such as H1N1 or H3N2, but not identified as novel or variant, for category J10.If the provider records “suspected” or “possible” or “probable” avian influenza, or novel influenza, or other identified influenza, then the appropriate influenza code from category J11, Influenza due to unidentified influenza virus, should be assigned. A code from category J09, Influenza due to certain identified influenza viruses, should not be assigned nor should a code from category J10, Influenza due to other identified influenza virus.

Acute streptococcal bronchitis with acute exacerbation of COPD

J20.2 Acute bronchitis due to streptococcus

J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection

J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation

Explanation: ICD-10-CM uses combination codes to create organism-specific classifications for acute bronchitis. Category J44 codes include combination codes with severity components, which differentiate between COPD with acute lower respiratory infection (acute bronchitis), COPD with acute exacerbation, and COPD without mention of a complication (unspecified).

An acute exacerbation is a worsening or a decompensation of a chronic condition. An acute exacerbation is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection, as in this example.

Exacerbation of moderate persistent asthma with status asthmaticus

J45.42 Moderate persistent asthma with status asthmaticus

Explanation: Category J45 Asthma includes severity-specific subcategories and fifth-character codes to distinguish between uncomplicated cases, those in acute exacerbation, and those with status asthmaticus.

Acute hypoxic respiratory failure due to exacerbation of chronic obstructive bronchitis

J96.01 Acute respiratory failure with hypoxia

J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation

Explanation: Category J96 classifies respiratory failure with combination codes that designate the severity and the presence of hypoxia and hypercapnia. Code J96.01 is sequenced as the first-listed diagnosis, as the reason for the encounter. Respiratory failure may be assigned as a principal diagnosis when it is the condition established after study to be chiefly responsible for occasioning the encounter and the selection is supported by the Alphabetic Index and Tabular List.

Acute respiratory failure due to accidental oxycodone overdose

T40.2X1A Poisoning by other opioids, accidental (unintentional), initial encounter

J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia

Explanation: Respiratory failure may be assigned as a principal diagnosis when it is the condition established after study to be chiefly responsible for occasioning the encounter, and the selection is supported by the Alphabetic Index and Tabular List. However, chapter-specific coding guidelines, such as poisoning, that provide sequencing direction take precedence. When coding a poisoning or reaction to the improper use of a medication (e.g. overdose, wrong substance given or taken in error, wrong route of administration), first assign the appropriate code from categories T36–T50. Use additional code(s) for all manifestations of the poisoning. In this instance, the respiratory failure is a manifestation of the poisoning and is sequenced as a secondary diagnosis.

Patient presents with acute pneumococcal pneumonia and acute respiratory failure

J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia

J13 Pneumonia due to Streptococcus pneumoniae

Explanation: When a patient is seen for respiratory failure and another acute condition, such as a bacterial pneumonia, the principal or first-listed diagnosis is not the same in every situation. This applies whether the other acute condition is a respiratory or nonrespiratory condition. The principal diagnosis depends on the problem chiefly responsible for the encounter.

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S05.5–S06.303 Chapter 19. Injury, Poisoning, and Certain Other Consequences of External Causes ICD-10-CM 2019S0

5.5–

S06.

303

Chap

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9. In

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1 Not coded here 2 Not included here 8 Newborn Age: 0 9 Pediatric Age: 0-17 x Maternity Age: 12-55 y Adult Age: 15-124 920 ICD-10-CM 2019

c S05.5 Penetrating wound with foreign body of eyeball2 retained (old) intraocular foreign body (H44.6-, H44.7)

g S05.50 Penetrating wound with foreign body of Bunspecified eyeball

g S05.51 Penetrating wound with foreign body of right eyeball

g S05.52 Penetrating wound with foreign body of left eyeballc S05.6 Penetrating wound without foreign body of eyeball

Ocular penetration NOSg S05.60 Penetrating wound without foreign body of B

unspecified eyeballg S05.61 Penetrating wound without foreign body of right

eyeballg S05.62 Penetrating wound without foreign body of left

eyeballc S05.7 Avulsion of eye

Traumatic enucleationg S05.70 Avulsion of unspecified eye Bg S05.71 Avulsion of right eyeg S05.72 Avulsion of left eye

c S05.8 Other injuries of eye and orbitLacrimal duct injury

d S05.8X Other injuries of eye and orbite S05.8X1 Other injuries of right eye and orbite S05.8X2 Other injuries of left eye and orbite S05.8X9 Other injuries of unspecified eye B

and orbitc S05.9 Unspecified injury of eye and orbit

Injury of eye NOSg S05.90 Unspecified injury of unspecified eye and orbit Bg S05.91 Unspecified injury of right eye and orbit Bg S05.92 Unspecified injury of left eye and orbit B

b S06 Intracranial injury0 w7th characters D and S do not apply to codes in category S06

with 6th character 7 – death due to brain injury prior to regaining consciousness, or 8 – death due to other cause prior to regaining consciousnessx

1 traumatic brain injuryCode also any associated:

open wound of head (S01.-)skull fracture (S02.-)

1 head injury NOS (S09.90)AHA: 2017, 1Q, 42; 2015, 3Q, 37

c S06.0 ConcussionCommotio cerebri1 concussion with intracranial injuries classified in

subcategories S06.1- to S06.6-, S06.81-, S06.82-code to specified intracranial injury

d S06.0X Concussion3 e S06.0X0 Concussion without loss of <

consciousness3 e S06.0X1 Concussion with loss of <

consciousness of 30 minutes or less3 e S06.0X9 Concussion with loss of <B

consciousness of unspecified durationConcussion NOS

c S06.1 Traumatic cerebral edemaDiffuse traumatic cerebral edemaFocal traumatic cerebral edema

d S06.1X Traumatic cerebral edema2 e S06.1X0 Traumatic cerebral edema without <

loss of consciousness2 e S06.1X1 Traumatic cerebral edema with loss of <

consciousness of 30 minutes or less2 e S06.1X2 Traumatic cerebral edema with loss of <

consciousness of 31 minutes to 59 minutes

2 e S06.1X3 Traumatic cerebral edema with loss of < consciousness of 1 hour to 5 hours 59 minutes

2 e S06.1X4 Traumatic cerebral edema with loss of < consciousness of 6 hours to 24 hours

2 e S06.1X5 Traumatic cerebral edema with loss of < consciousness greater than 24 hours with return to pre-existing conscious level

2 e S06.1X6 Traumatic cerebral edema with loss of < consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving

e S06.1X7 Traumatic cerebral edema with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness

e S06.1X8 Traumatic cerebral edema with loss of consciousness of any duration with death due to other cause prior to regaining consciousness

2 e S06.1X9 Traumatic cerebral edema with loss <B of consciousness of unspecified duration

Traumatic cerebral edema NOSc S06.2 Diffuse traumatic brain injury

Diffuse axonal brain injury1 traumatic diffuse cerebral edema (S06.1X-)

d S06.2X Diffuse traumatic brain injury2 e S06.2X0 Diffuse traumatic brain injury <

without loss of consciousness2 e S06.2X1 Diffuse traumatic brain injury with <

loss of consciousness of 30 minutes or less

2 e S06.2X2 Diffuse traumatic brain injury with <loss of consciousness of 31 minutes to 59 minutes

2 e S06.2X3 Diffuse traumatic brain injury with <loss of consciousness of 1 hour to 5 hours 59 minutes

2 e S06.2X4 Diffuse traumatic brain injury with <loss of consciousness of 6 hours to 24 hours

2 e S06.2X5 Diffuse traumatic brain injury with <loss of consciousness greater than 24 hours with return to pre-existing conscious levels

2 e S06.2X6 Diffuse traumatic brain injury with <loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving

e S06.2X7 Diffuse traumatic brain injury with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness

e S06.2X8 Diffuse traumatic brain injury with loss of consciousness of any duration with death due to other cause prior to regaining consciousness

2 e S06.2X9 Diffuse traumatic brain injury with <Bloss of consciousness of unspecified duration

Diffuse traumatic brain injury NOS

c S06.3 Focal traumatic brain injury1 any condition classifiable to S06.4-S06.6

focal cerebral edema (S06.1)

d S06.30 Unspecified focal traumatic brain injury2 e S06.300 Unspecified focal traumatic brain <B

injury without loss of consciousness2 e S06.301 Unspecified focal traumatic brain <B

injury with loss of consciousness of 30 minutes or less

2 e S06.302 Unspecified focal traumatic brain <Binjury with loss of consciousness of 31 minutes to 59 minutes

2 e S06.303 Unspecified focal traumatic brain <Binjury with loss of consciousness of 1 hour to 5 hours 59 minutes

The appropriate 7th character is to be added to each code from category S06.A initial encounterD subsequent encounterS sequela

2 HCC with 7th character indicating initial encounter (A or B - specific to category) OR sequela.3 HCC with 7th character indicating sequela.

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ICD-10-CM 2019 Illustrations

ICD-10-CM 2019 Illustrations–27

Chapter 10. Diseases of the Respiratory System (J00–J99)

Respiratory System

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