Updating query forms to meet ICD-10 documentation requirements as listed in Chapter 10: Diseases of the Respiratory System (J00?J99), should already be underway. For respiratory coding, the forms should ask providers whether the condition is acute, chronic, or recurrent, since this information is needed for coding in ICD-10-CM, said Tara L. Bell, RN, MSN, CCM, AHIMA-approved ICD-10-CM/PCS trainer and assistant manager of clinical documentation improvement services at UASI in Cincinnati. Bell spoke about changes to respiratory coding and documentation during HCPro's webcast "Transition to ICD-10-CM Respiratory Coding: Anatomy, Documentation, and Guidelines."
"The major hitters are the new indications for asthma and pneumonia," Bell said. One way to help coders on the back end is to ensure query forms address the key points needed for thorough documentation so that information can be included in the medical record, she said.