Putting ICD-10 into Practice: Coding exercises and scenarios

The ICD-10 Spotlight: Know the codes feature that appeared throughout Partners in Health Update last year 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).

As announced in the January 2013 edition of Partners in Health Update, we have introduced 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. Borderline glaucoma
2. Congestive heart failure due to hypertension
3. HIV positive status without symptom
4. Urinary frequency
5. Morbid obesity with a BMI of 42 in an adult
6. Congenital red cell aplastic anemia
7. Cleft palate involving both the soft and hard palate with bilateral cleft lip
8. Severe persistent asthma with acute exacerbation
9. Fatigue fracture of vertebra, lumbar region, and subsequent encounter for fracture with delayed healing
10. Interstitial cystitis due to E. coli with hematuria
11. Sleep-related teeth grinding
12. Non-conclusive HIV-test finding in infants

Coding scenario

Code the following scenario according to ICD-10 coding conventions and guidelines:

Jane and John Doe were shopping at the mall the day after Thanksgiving to take advantage of the sales. While rushing for the newest iPhone, John fell down the stairs. Thankfully, John sustained only minor abrasions to his right elbow.

Narratives

The following are the corresponding code narratives for each of the ICD-10 codes in the answer key for the coding
exercises and coding scenarios:

H40.001: Preglaucoma, unspecified, right eye
I11.0: Hypertensive heart disease with heart failure
Z21: Asymptomatic human immunodeficiency virus [HIV] infection status
R35.0: Frequency of micturition
E66.01: Morbid (severe) obesity due to excess calories
Z68.41: Body mass index (BMI) 40.0 – 44.9, adult
D61.01: Constitutional (pure) red blood cell aplasia
Q37.4: Cleft hard and soft palate with bilateral cleft lip
J45.51: Severe persistent asthma with (acute) exacerbation
M48.46xG: Fatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with delayed healing
N30.11: Interstitial cystitis (chronic) with hematuria
B96.20: Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhere
G47.63: Sleep-related bruxism
R75: Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
S50.311A: Abrasion of right elbow, initial encounter
W10.9xxA: Fall (on) (from) unspecified stairs and steps, initial encounter
Y92.59: Other trade areas as the place of occurrence of the external cause

For additional information related to IBC's transition to ICD-10, please visit the ICD-10 section 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. In addition, you will find examples of ICD-10 coding exercises and scenarios in the Putting ICD-10 into Practice: Coding exercises and scenarios booklet.

Answers to coding exercises:
1) H40.001 2) I11.0 3) Z21 4) R35.0 5) E66.01, Z68.41 6) D61.01 7) Q37.4 8) J45.51 9) M48.46xG 10) N30.11, B96.20 11) G47.63 12) R75

Answer to coding scenario:
S50.311A, W10.9xxA, Y92.59