ICD-10 Training For Chiropractic

PowerPoint Presentation

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ICD-10 can be overwhelming, but, with some strategizing and planning it can be managed. In this presentation we will look at a few ICD-10 fundamentals, then familiarize ourselves with three methods for finding the right ICD-10 code. Each one is a different path, but all lead to the same destination: the right code.1Dr. Evan GwilliamEducationBachelors of Science, Accounting - Brigham Young UniversityMasters of Business Administration - Broadview UniversityDoctor of Chiropractic, Valedictorian - Palmer College of ChiropracticCertificationsCertified Professional Coder (CPC) - AAPCNationally Certified Insurance Coding Specialist (NCICS) - NCCTCertified Chiropractic Professional Coder (CCPC) - AAPCChiroCode Certified Chiropractic Professional Coder (CCCPC) - ChiroCodeCertified Professional Coder Instructor (CPC-I) - AAPCMedical Compliance Specialist Physician (MCS-P) - MCSCertified Professional Medical Auditor (CPMA) AAPC, NAMASCertified ICD-10 Trainer - AAPC2

OverviewPart 1 - ICD-10 fundamentals and navigationPart 2 - Coding conventions and guidelinesPart 3 - ICD-10 code selection strategiesPart 4 - Documentation improvement***Specialty specific training

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739.1 Segmental and somatic dysfunction, cervical739.3 Segmental and somatic dysfunction, lumbar739.2 Segmental and somatic dysfunction, thoracic724.2 Lumbago723.1 Cervicalgia728.85 Spasm of muscle724.1 Pain in the thoracic spine729.1 Myalgia and myositis, unspecified847.0 sprains and strains of neck

4Top ICD-9 codes for DCsConfirm the code5Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary1. Common Codes

6Page50Confirm the code7Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary8

739- segmental and somatic dysfunctionGEMs code mapPage96

9739- segmental and somatic dysfunctionGEMs code mapConfirm the code10Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary739- segmental and somatic dysfunctionAlphabetic Index11Page470

739- segmental and somatic dysfunctionAlphabetic Index

12Page471Confirm the code13Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary14739- segmental and somatic dysfunctionTabular ListPage 252

15739- segmental and somatic dysfunctionTabular List

Page 279Confirm the code16Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary17739- segmental and somatic dysfunctionTabular ListPage 252

18739- segmental and somatic dysfunctionTabular ListPages 278-279

Confirm the code19Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary20S13.1- Subluxation of cervical vertebra Backwards code map

M99.0- Segmental and somatic dysfunction is the most likely ICD-10 replacementDont code this if there is a better option (there isnt)Ten optionsM99.1- Subluxation complex (vertebral) is a possibility tooBut payers are not expected to like this codeTen optionsS13.1- Subluxation and dislocation of cervical vertebra backwards maps to 839- Closed dislocation of cervical vertebra, so it is probably a better match for that ICD-9 codeThis code has many inclusion and exclusion notes, and a seventh character to be investigatedFifty-four options21739- segmental and somatic dysfunctionSummaryConfirm the code22Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessaryConfirm the code23Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary24724.2 lumbagoCommon codes list

Common codes - Page 50Confirm the code25Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary26

724.2 lumbagoGEMs code mapCode Map - Page 8327

724.2 lumbagoGEMs code mapChiroCode.com members onlyConfirm the code28Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary29

724.2 lumbagoAlphabetic IndexIndex - Page 470

30724.2 lumbagoAlphabetic IndexIndex - Page 458Confirm the code31Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessary32

724.2 lumbagoTabular ListTabular Page 222M54.5 Low back pain is probably the best ICD-10 replacement codeLoin pain or Lumbago would work tooConsider these codes instead (Excludes1)S39.012_ low back strainThree optionsM51.2- lumbago due to intervertebral disc displacementFour optionsM54.4- lumbago with sciaticaThree optionsOr consider this one (Excludes1)F45.41 Pyschogenic dorsalgia33724.2 lumbagoSummaryConfirm the code34Use the three strategies to get startedCommon codes listGEMsAlphabetic IndexWithin the Tabular List, identify the meaning of the 4th, 5th, 6th characters, if applicable.Within the Tabular List, look at the following:NotesIncludes and alternative wordingExcludes1Excludes2Code Also, Code First, Use AdditionalSeventh character extensionsReverse map for confirmation if necessaryM54.2 cervicalgia is probably the best ICD-10 replacement codeConsider this category instead (Excludes1)M50.- cervicalgia due to intervertebral disc disorder24 code options (specify type and region)Or consider this one (Excludes1)F45.41 Pyschogenic dorsalgia35723.1 cervicalgiaSummaryM54.6 Pain in the thoracic spine is probably the best ICD-10 replacement codeConsider this category instead (Excludes1)M51.- pain in the thoracic spine due to intervertebral disc disorder13 code options (specify type and regions)Or consider this one (Excludes1)F45.41 Pyschogenic dorsalgia36724.1 pain in the thoracic spineSummaryM62.830 Muscle spasm of back is probably the best ICD-10 replacement codeAlso consider these codes (GEMs)M62.4- Contracture of muscle or tendon (sheath)Up to 24 optionsM62.831 Muscle spasm of calf, including charlie horseM62.838 Other muscle spasmOr consider these codes instead (Excludes1)R25.2 Cramp and spasmM79.1 Myalgia, myofascial pain syndromeAnd consider adding this code (Excludes2)M79.81 Nontraumatic hematoma of muscles

37728.85 spasm of muscleSummary38Code mapPage 87

Tabular listPage 230M60.88 Other Myositis, other site is probably the best choiceThere are 110 or so myositis codes, and most imply some sort of infection. None are for the spine.M79.1 Myalgia suggested by GEMsAKA myofascial pain syndromeConsider instead (Excludes1):M79.7 FibromyalgiaM60.- Myositis F45.8 Psychogenic rheumatismF45.41 Soft tissue pain syndromeM79.7 Fibromyalgia suggested by GEMsAKA fibromyositis, myofibromyositis, or fibrositisConsider instead (Excludes1):F45.8 Psychogenic rheumatismF45.41 Soft tissue pain syndrome39729.1 myalgia and myositis, unspecifiedSummary40

Code map-Page 8841

Tabular list - pages 223, 245, 246S13.4xx_ Sprain of ligaments of cervical spine is probably the best ICD-10 replacement code (GEMs)Sprain of ALL, atlanto-axial joints, atlanto-occipital joints or whiplash (and several other phrases) would work tooThe seventh character can be A, D, or SS13.8xx_ Sprain of joints and ligaments of other parts of neck should be considered as well (GEMs)S16.1xx_ Strain of muscle, fascia and tendon at neck level should be considered in addition (Excludes2)Code also any associated open woundUse an external cause code, if applicable42847.0 sprains and strains of neckSummary43

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More than 40 pages which teachConventionsGuidelinesImplementation stepsDocumentation strategiesCommon Codes for DCsSpecialty specificGEMs mappingAlpha IndexAbridged Tabular List

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The examples shown to you were from the InstaCode ICD-10 specialty books. There are 24 different specialties, each with their own customized ICD-10 guide and Tabular List. Come to our booth to see some examples and get a flyer. We have special pricing available for those who wish to order one today. 4546

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