AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 4; In this Issue
CHANGES TO THE ICD-10-CM OFFICIAL GUIDELINES FOR CODING AND REPORTING
A summary of the modifications to the ICD-10-CM Official Guidelines for Coding and Reporting are included below. The complete guidelines may be downloaded by visiting http://www.cdc.gov/nchs/icd/icd10cm.htm The modifications are published below using the following format: Narrative changes appear in bold text (e.g., severe sepsis) Items underlined were moved within the guidelines since October 1, 2020 (e.g., severe sepsis) Deletions are shown as strikeouts (e.g., severe sepsis) Italics are used to indicate revisions to heading changes Section I. Conventions, general coding guidelines and chapter specific guidelines B. General Coding Guidelines . . . 14. Documentation by Clinicians...
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Article Overview
This article reviews selected changes to the ICD-10-CM Official Guidelines for Coding and Reporting and is useful for coders, auditors, CDI professionals, and compliance teams who need to track official guideline updates. It focuses on chapter-specific revisions and related guidance across infectious disease, respiratory, endocrine, behavioral health, circulatory, genitourinary, obstetric, perinatal, symptom, and Z code sections. The article helps readers understand where the guidance was modified and how the affected guideline areas are organized within the official coding framework.
Why This Topic Matters
Official guideline updates can affect code assignment, sequencing, and documentation review across many common encounter types. Staying current with these changes supports consistent reporting and alignment with ICD-10-CM guidance.
Article Sections
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Section I. Conventions, general coding guidelines and chapter specific guidelines
This section addresses general documentation and coding guidance, including clinician documentation considerations and chapter-specific instructions. It also introduces changes related to infectious disease coding and other broad guideline updates.
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Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1
This section covers updates tied to infectious disease coding, including COVID-19-related guidance and related sequencing references. It also links to associated guidance in pregnancy, newborn, transplant, and sepsis contexts.
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Chapter 2: Neoplasms (C00-D49)
This section addresses guideline updates related to malignancy history and code assignment within the neoplasms chapter. It focuses on distinctions involving current and personal history documentation.
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Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00-E89)
This section covers diabetes-related guidance and treatment-related coding updates in the endocrine chapter. It includes discussion of long-term medication use and related documentation issues.
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Chapter 5: Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
This section discusses behavioral health coding updates involving psychoactive substance use and documentation requirements. It also addresses how unspecified substance-related categories are handled within the chapter.
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Chapter 9: Diseases of the Circulatory System (I00-I99)
This section covers hypertension-related guidance and associated chronic kidney disease considerations. It also addresses situations involving acute renal failure alongside chronic conditions.
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Chapter 10: Diseases of the Respiratory System (J00-J99), U07.0
This section discusses respiratory system guidance, including vaping-related disorders and related manifestations. It also includes the chapter reference for a special-purpose code tied to vaping-related conditions.
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Chapter 14: Diseases of Genitourinary System (N00-N99)
This section reviews chronic kidney disease staging guidance and related genitourinary coding updates. It includes severity-based classification information and end-stage renal disease references.
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Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)
This section covers obstetric guideline changes, including sepsis-related instructions and pregnancy-related infectious disease guidance. It also addresses sequencing considerations when an infectious condition is present during pregnancy or delivery-related care.
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Chapter 16: Certain Conditions Originating in the Perinatal Period (P00-P96)
This section discusses newborn and perinatal coding updates, including infection-related guidance for newborn records. It also references birth episode coding and related category use.
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Chapter 18: Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
This section covers symptom- and sign-related guidance, including coma scale coding in different clinical contexts. It also notes how these codes relate to trauma, neurologic conditions, and other non-trauma settings.
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Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
This section addresses Z code guidance, including contact and exposure categories, long-term therapy status, observation codes, and principal diagnosis limitations. It also includes references to social and health-status-related coding concepts.
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Chapter 22: Codes for Special Purposes (U00-U85)
This section provides references to special-purpose codes tied to vaping-related disorder and COVID-19. It serves as a cross-reference area within the guideline updates.
What You Will Learn
- How the ICD-10-CM Official Guidelines for Coding and Reporting were updated across multiple chapters
- Which sections of the guidelines were affected by infectious disease, pregnancy, newborn, chronic disease, symptom, and Z code revisions
- How the article organizes official guidance changes and cross-references between chapters
- What broad documentation and sequencing topics are addressed in the guideline updates
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation integrity professionals
- Compliance teams
- Revenue cycle professionals
- Healthcare administrators
Codes Discussed
Code Ranges Discussed
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