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Diagnostic Coding

Diagnosis coding is used to translate written descriptions of diseases the official Health Information Portability and Accountability Act (HIPAA) approved a code set for diagnostic reporting.  International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is the United States’ adaption of the World Health Organization’s (WHO) ICD-10-CM codes. This “clinical modification” makes the codes (which are required for use on healthcare claims in the U.S.) useful for classifying morbidity data. ICD-10-CM has a set of rules/ guidelines developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The guidelines are organized into sections.

  • Section I includes the structure and conventions of the classification and general guidelines that apply to the entire classification, and chapter-specific guidelines that correspond to the chapters as they are arranged in the classification.
  • Section II includes guidelines for selection of principal diagnosis for non-outpatient settings.
  • Section III includes guidelines for reporting additional diagnoses in non-outpatient settings.
  • Section IV is for outpatient coding and reporting. It is necessary to review all sections of the guidelines to fully understand all of the rules and instructions needed to code properly

Understanding diagnostic coding is vital in avoiding errors, denials, rejections, audits, etc. All providers and coding staff should understand coding structure, terminology, and documentation requirements. Documentation is what determines codes, Incomplete or Incorrect Documentation will result in coding errors. ICD-10-PCS was adopted under HIPAA for hospital inpatient healthcare settings, and not used in outpatient settings.

I. Code Sets

ICD-10-CM Codes

Find-A-Code's ICD-10-CM Code List

II. Find-A-Code's Tools & Resources

ICD-10-CM Validator

Find-A-Code's ICD-10-CM Validator Tool

Click-A-Dex

Find-A-Code's Index Search Tool

AHA Coding Clinic

Find-A-Code's AHA Coding Clinic Lookup Tool

III. Additional Links and Resources

Guidelines

Guidelines for Coding and Reporting ICD-10-CM

Quick Reference Guide

ICD-10-CM Quick Reference Guide

ICD-10-CM Medicare Fact Sheets

ICD-10-CM Fact Sheet PDFs from Medicare

Diagnostic Coding Articles

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What is Medical Necessity and How Does Documentation Support It?

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We recently fielded the question, “What is medical necessity and how do I know if it's been met?" The AMA defines medical necessity as: It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ...

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Diagnosis Coding for Cardiology

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Diseases of the Circulatory system are found in Chapter 9 and reported with I00 through I99 according to the following sections: Acute rheumatic fever (I00-I02)Chronic rheumatic heart diseases (I05-I09)Hypertensive diseases (I10-I16)Ischemic heart diseases (I20-I25)Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)Other forms of heart disease (I30-I52)Cerebrovascular diseases (I60-I69)Diseases of arteries, ...

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Coding Clinic Officially Defines Spondylolisthesis and Disc Disorder

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The Coding Clinic for ICD-10-CM and ICD-10-PCS is a quarterly newsletter published by the American Hospital Association's Central Office (AHA). The information they publish is a joint effort of several organizations including the Centers for Disease Control and Prevention (CDC), the National Center for Health Statistics (NCHS), the Centers for Medicare and ...

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2019 Code Changes are Just Around the Corner - Are You Ready?

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The leaves are beginning to change and it’s time once again for the annual code changes for 2019. ICD-10-CM codes are out and will be effective October 1, 2018. CPT code changes also just came out and will be effective January 1, 2019. The ChiroCode DeskBook and ICD-10-CM Coding for Chiropractic books have been ...

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Coding for Strains in ICD 10

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According to the National Institutes of Health, a review was carried out on 20 patients who had a pectoralis major muscle repair between 2003 and 2011, and the results were as follows....

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Traumatic Subluxation Coding Controversy

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There has been some controversy over the use of the ICD-10-CM subluxation codes commonly referred to as traumatic (S13.1-, S23.1-, and S33.1-). Are they appropriate for chiropractors to use? The answer to that question is complicated. The problem basically lies in the lack of official guidance and differing opinions on ...

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NEW on Find-A-Code...National Coverage Determinations (NCDs)

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Medicare limits its coverage of services to those considered to be reasonable and necessary for the diagnosis and treatment of an injury or illness based on coverage guidelines. National Coverage Determinations (NCDs) are created based on research, evidence-based processes, public participation, and other resources, and made available to the public. ...

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Billing Electrotherapy with AcuKnee

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This code is commonly used to bill for AcuKnee products.  Per AcuKnee, “NMES and electrotherapy may be covered by most insurance providers, provided the following criteria are met;” Documentation of chronic pain or muscle atrophy 3 months or longer Must document improvement Must have physician document medical necessity/Prescription Appropriate authorization from your insurance provider Suggested codes when billing  64550 initial electrotherapy education and placement E0720 Electrotherapy unit itself E0731 Garment ...

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Diagnosis Coding with Diagnostic Testing

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Adequate documentation is an essential part of selecting a correct code in any setting. When providers order a test, the information that they document regarding the test results determines the primary and secondary diagnosis codes a coder assigns. If a physician confirms a diagnosis based on the results of a diagnostic ...

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Diagnostic Coding Tips


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Diagnostic Coding Webinars

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Anatomy and Diagnosis of the Heart

Join Brandon Leavitt in this webinar all about the heart. He'll review the anatomy of the heart (including functionality) and the guidelines specific to ICD-10-CM code selection for specific diseases, injuries, or other conditions.

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Anatomy and Diagnostic Coding for Wound Care

In this webinar, Brandon Leavitt will review the anatomy of wounds from injury, disease, and other conditions and the proper ICD-10-CM coding for them. A review of pressure and non-pressure, and venous stasis ulcers, burns, corrosions, neoplasms, and other diseases affecting the integument will be presented.

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Radiology Coding Auditing Dexa Scans for Osteoporosis & Mammograms for the Breast

Learn important coding tips when billing Dexa scans (for osteoporosis) and mammograms (for breast diseases). Coders and clinicians specializing in Radiology, Family Practice, Orthopedics, and OB-GYN will all find useful information for their practice. This is a follow-up from the webinar "Diagnosis of osteoporosis and diseases of the breast".

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Diagnosis of Osteoporosis and Diseases of the Breast

Osteoporosis diagnosis and breast diseases will be covered in this webinar, benefiting coders and clinicians specializing in Radiology, Family Practice, Orthopedics, and OB-GYN. This will prepare participators for the following Find-A-Code webinar on radiology coding, which will explain coding/billing for Dexa scans to detect osteoporosis, and mammogram screening for breast evaluation.

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ICD-10-CM Updates for the Auditor, a NAMAS webinar

ICD-10-CM Updates for the Auditor, a NAMAS webinar

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ICD-10-CM Training - Session 08

ICD-10-CM Training - Session 08

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ICD-10-CM Training - Session 07

ICD-10-CM Training - Session 07

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ICD-10-CM Training - Session 06

ICD-10-CM Training - Session 06

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ICD-10-CM Training - Session 05

ICD-10-CM Training - Session 05

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ICD-10-CM Training - Session 36

ICD-10-CM Training - Session 36

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ICD-10-CM Training - Session 35

ICD-10-CM Training - Session 35

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ICD-10-CM Training - Session 34

ICD-10-CM Training - Session 34

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ICD-10-CM Training - Session 33

ICD-10-CM Training - Session 33

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ICD-10-CM Training - Session 04

ICD-10-CM Training - Session 04

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ICD-10-CM Training - Session 32

ICD-10-CM Training - Session 32

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ICD-10-CM Training - Session 31

ICD-10-CM Training - Session 31

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ICD-10-CM Training - Session 03

ICD-10-CM Training - Session 03

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ICD-10-CM Training - Session 02

ICD-10-CM Training - Session 02

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ICD-10-CM Training - Session 30

ICD-10-CM Training - Session 30

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ICD-10-CM Training - Session 29

ICD-10-CM Training - Session 29

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ICD-10-CM Training - Session 28

ICD-10-CM Training - Session 28

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ICD-10-CM Training - Session 27

ICD-10-CM Training - Session 27

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ICD-10-CM Training - Session 01

ICD-10-CM Training - Session 01

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ICD-10-CM Training - Session 26

ICD-10-CM Training - Session 26

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ICD-10-CM Training - Session 25

ICD-10-CM Training - Session 25

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ICD-10-CM Training - Session 24

ICD-10-CM Training - Session 24

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ICD-10-CM Training - Session 23

ICD-10-CM Training - Session 23

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ICD-10-CM Training - Session 22

ICD-10-CM Training - Session 22

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ICD-10-CM Training - Session 21

ICD-10-CM Training - Session 21

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ICD-10-CM Training - Session 20

ICD-10-CM Training - Session 20

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ICD-10-CM Training - Session 19

ICD-10-CM Training - Session 19

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ICD-10-CM Training - Session 18

ICD-10-CM Training - Session 18

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ICD-10-CM Training - Session 17

ICD-10-CM Training - Session 17

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ICD-10-CM Training - Session 16

ICD-10-CM Training - Session 16

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ICD-10-CM Training - Session 15

ICD-10-CM Training - Session 15

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ICD-10-CM Training - Session 14

ICD-10-CM Training - Session 14

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ICD-10-CM Training - Session 13

ICD-10-CM Training - Session 13

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ICD-10-CM Training - Session 12

ICD-10-CM Training - Session 12

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ICD-10-CM Training - Session 11

ICD-10-CM Training - Session 11

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ICD-10-CM Training - Session 10

ICD-10-CM Training - Session 10

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ICD-10-CM Training - Session 09

ICD-10-CM Training - Session 09

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2020 ICD-10-CM Comprehensive Book

ICD-10-CM Comprehensive Code Book

  • Large Font
  • 2 Book Format
  • Shortened Descriptions
  • Indicators (Age, Sex, HCC, MCC, etc.)
  • Alphabetic Index
  • ICD-10-CM Official Guidelines
  • External Cause Index
  • Drug & Neoplasm Tables
  • Complete Tabular List

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