AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2016 Issue 4
Changes to the ICD-10-CM Official Guidelines for Coding and Reporting
Effective October 1, 2016, there are changes to the ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting. The complete set of guidelines are not shown in their entirety; only those guidelines that have been added or modified are included below. The complete guidelines may be downloaded by visiting for ICD-10-CM guidelines and https://www.cms.gov/Medicare/Coding/ICD10/2017-ICD-10-PCS-and-GEMs.html for ICD-10-PCS guidelines. The modifications are published below using the following format: Narrative changes appear in bold text (e.g., severe sepsis)Items underlined have been moved within the guidelines since October 1, 2016 (e.g., severe sepsis)Deletions are shown as strikeouts (e...
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Article Overview
This article reviews selected changes to the ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting effective October 1, 2016. It is useful for coders, auditors, compliance staff, and clinical documentation teams who need to understand updated guidance across diagnosis coding, sequencing, laterality, secondary diagnoses, complication reporting, obstetric coding, injury coding, and present-on-admission rules. The article is organized by guideline section and chapter topic so readers can quickly find the areas most relevant to their work.
Why This Topic Matters
Official guideline updates affect diagnosis coding consistency, documentation review, claim preparation, and compliance processes across inpatient and outpatient settings. Understanding which sections changed helps coding professionals apply the current reporting framework correctly and locate the topics that apply to their specialty or setting.
Article Sections
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Section I. Conventions, General Coding Guidelines, and Chapter Specific Guidelines
Introduces selected updates to core ICD-10-CM conventions and broad coding principles. Also includes chapter-specific guidance for several diagnosis areas.
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Section II. Selection of Principal Diagnosis
Summarizes principal diagnosis guidance and the settings to which the related inpatient framework applies.
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Section III. Reporting Additional Diagnoses
Reviews the expanded application of additional diagnosis reporting concepts across non-outpatient settings and hospice care.
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Section IV. Diagnostic Coding and Reporting Guidelines for Outpatient Services
Covers outpatient application of the coding guidelines and clarifies the relationship between inpatient principal diagnosis concepts and outpatient services.
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Appendix I
Introduces the appendix material included with the guideline updates.
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Present on Admission Reporting Guidelines
Explains updates to present-on-admission reporting concepts, including how categories of conditions are treated and where exempt-code information is maintained.
What You Will Learn
- How the guideline update is structured and which sections were modified
- Which broad coding conventions are addressed in the update
- How chapter-specific guidance is organized across diagnosis areas
- How the article frames principal diagnosis, additional diagnosis, and outpatient reporting guidance
- How present-on-admission guidance is presented in the appendix material
Who Should Read This
- ICD-10-CM coders
- Inpatient coding staff
- Outpatient coding staff
- Coding auditors
- Compliance teams
- Clinical documentation improvement staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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