decisionhealth Newsletters, Part B News - 2015 Issue 5 (May)
3 ways ICD-10-CM crosswalks can cause problems with your diagnosis coding
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Article Overview
This article explains common issues that can arise when using ICD-9-CM to ICD-10-CM crosswalks during transition planning. It is intended for coders and billing staff who rely on mapping tools and need to understand the broader categories of guidance involved, including laterality, encounter timing, and fracture-related coding considerations. The discussion focuses on why mapping outputs may not fully reflect the available ICD-10-CM options or the supporting documentation.
Why This Topic Matters
Crosswalk tools can speed up research, but they may also limit visibility into the full range of ICD-10-CM choices. Understanding the article helps coders evaluate when additional documentation review and code-set guidance are needed.
Article Sections
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3 ways the GEMs can trip you up
Introduces the main categories of problems discussed in the article and frames the limitations of mapping tools during ICD-10-CM transition work.
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Right versus left
Discusses laterality-related issues that can appear when moving from ICD-9-CM mapping results to more specific ICD-10-CM options.
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Initial versus subsequent
Reviews encounter-timing differences between the code sets and how mapping tools may present only part of the available ICD-10-CM structure.
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Fracture types
Covers fracture-related mapping concerns, including the broader coding considerations that may affect the resulting ICD-10-CM selection.
What You Will Learn
- The main limitations of relying on mapping tools for diagnosis code research
- How broad ICD-9-CM concepts may map to narrower ICD-10-CM options
- Why documentation review still matters when selecting ICD-10-CM diagnosis codes
- The categories of coding issues discussed in relation to laterality, encounter timing, and fractures
Who Should Read This
- Medical coders
- Billing staff
- Coding auditors
- Practice managers
- Physicians documenting diagnoses
Codes Discussed
Modifiers Discussed
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