Health Information Management

News: Recently published Coding Clinic confirms some ICD-9 guidance still applicable

CDI Strategies, January 7, 2016

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The new AHA Coding Clinic for ICD-10-CM and ICD-10-PCS cleared up some confusion regarding use of prior ICD-9 guidance.

Back in 2010, the AHA stated that previous issues of Coding Clinic would not be translated to ICD-10-CM/PCS. The announcement led many to question if Coding Clinic advice could be applied to ICD-10 coding practices, and if auditors will deny claims based on advice from AHA Coding Clinic for ICD-9-CM.

Previously, the AHA responded stating that past advice has focused on what documentation could be used and has not been specific to a coding system. However, in the December 2015 Coding Clinic, the AHA wrote:

In general, clinical information and information on documentation best practices published in Coding Clinic were not unique to ICD-9-CM, and remain applicable to ICD-10-CM with some caveats. For example, Coding Clinic may still be useful to understand clinical clues when applying the guideline regarding not coding separately signs and symptoms that are integral to a condition. Users may continue to use that information, as clues—not clinical criteria.

As far as previously published advice on documentation is concerned, documentation issues would generally not be unique to ICD-9-CM, and so long as there is nothing new published in Coding Clinic for ICD-10-CM and ICD-10-PCS to replace it, the advance would stand.

 In response, Laurie Prescott, RN, MSN, CCDS, CDIP, AHIMA Approved ICD-10-CM/PCS Trainer, CDI Education Director at HCPro in Danvers, Massachusetts, says the AHA’s comment is consistent with what ACDIS Boot Camp instructors have been teaching all along.

“The ICD-9 Coding Clinics that describe clinical situations or general guidance that is consistent with the ICD-10-Cm/PCS Official Guidelines for Coding and Reporting can likely be applied,” she says. “Coders and CDI specialist need to stop and reflect when using ICD-9 Coding Clinic guidance if it still applies, meaning ‘does this ICD-9 guidance in any way conflict with the new code set, coding conventions, and guidelines?’”

If there is a conflict, do not rely on the ICD-9 Coding Clinic and instead follow the guidance within ICD-10-CM/PCS Official Guidelines for Coding and Reporting and look for any new Coding Clinic issued advice, Prescott says.

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