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Questions and Answers
What does Chapter 1 of ICD-10-CM focus on?
What does Chapter 1 of ICD-10-CM focus on?
When selecting codes from Chapter 1, how many codes may be required?
When selecting codes from Chapter 1, how many codes may be required?
Two codes
What is the correct coding for an AIDS patient diagnosed with meningitis caused by histoplasmosis?
What is the correct coding for an AIDS patient diagnosed with meningitis caused by histoplasmosis?
B20, B39.9, G02
In the ICD-10-CM Alphabetic Index, brackets indicate that the code within is sequenced before the code preceding the brackets.
In the ICD-10-CM Alphabetic Index, brackets indicate that the code within is sequenced before the code preceding the brackets.
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Which condition must be confirmed in the inpatient setting to select the code?
Which condition must be confirmed in the inpatient setting to select the code?
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B20 is sequenced first when a patient is admitted for an HIV-related condition.
B20 is sequenced first when a patient is admitted for an HIV-related condition.
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Name one condition that is always considered HIV-related.
Name one condition that is always considered HIV-related.
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What code is applied when a patient is HIV positive and asymptomatic?
What code is applied when a patient is HIV positive and asymptomatic?
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What codes should be reported when billing for a patient with an unrelated condition who has HIV?
What codes should be reported when billing for a patient with an unrelated condition who has HIV?
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What does code Z20.6 indicate?
What does code Z20.6 indicate?
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During pregnancy, how should HIV infection status be reported?
During pregnancy, how should HIV infection status be reported?
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The code for severe sepsis requires documentation of ______.
The code for severe sepsis requires documentation of ______.
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What is the proper sequence of codes when treating an HIV-related illness during pregnancy?
What is the proper sequence of codes when treating an HIV-related illness during pregnancy?
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Study Notes
Certain Infectious and Parasitic Diseases (Codes A00-B99)
- Chapter 1 covers infectious and parasitic diseases, requiring careful coding practices.
- Coding may involve multiple codes: one for the organism, one for the condition, a combination code, or a single code.
Coding for Specific Diagnoses
- For AIDS patients with meningitis caused by histoplasmosis, use codes B20 (HIV disease), B39.9 (unspecified histoplasmosis), and G02 (meningitis).
- Always consult the ICD-10-CM Alphabetic Index and follow notes and directives in the Tabular List for accurate coding.
Coding and Sequencing Practices
- In inpatient settings, HIV must be confirmed for coding; other conditions marked as probable or suspected are coded as existing.
- When admitting a patient for an HIV-related condition, code B20 should be sequenced first, followed by additional HIV-related conditions.
Opportunistic Infections
- Common HIV-related conditions include Kaposi's sarcoma, lymphoma, PCP, cryptococcal meningitis, and cytomegaloviral disease.
- A complete list of opportunistic infections defining AIDS can be found on the CDC's website.
Asymptomatic HIV
- Use code Z21 for asymptomatic HIV infection status when a patient is HIV positive but lacks documented symptoms.
- R75 indicates inconclusive laboratory evidence of HIV with no definitive diagnosis.
Pregnancy-Related HIV Coding
- During pregnancy, use codes from O98.7- for HIV complicating pregnancy and Z21 if the patient is asymptomatic.
- When treating an HIV-related illness in pregnant women, sequence properly with O98.7 first, followed by B20 and relevant codes.
HIV Testing and Counseling
- Use code Z11.4 for encounters that focus on HIV screening.
- If there are signs or symptoms related to HIV, code the signs/symptoms or the confirmed diagnosis instead of just positive test results.
Documenting Complications and Secondary Conditions
- For a symptomatic HIV patient presenting with unrelated conditions, such as an ankle sprain, the injury should be coded first, followed by B20.
- Code B20 must be reported alongside any HIV-related conditions during visits for unrelated issues.
Additional Coding Examples
- Toxic shock syndrome due to Staphylococcus aureus requires codes A48.3 for the syndrome and B95.61 for the causative organism.
- For pneumonia resistant to penicillin, use code J18.9 for unspecified pneumonia and Z16.11 for resistance to penicillin.
Severe Sepsis Coding
- R65.2 for severe sepsis should only be used when severe sepsis with acute organ dysfunction is documented.
- Severe sepsis requires two codes: one for the systemic infection (e.g., A41.9) and one from R65.2, along with additional codes for each identified organ dysfunction.
Clinical Example of Sepsis
- For a patient with sepsis, acute kidney failure, and bladder cancer, the proper coding sequence depends on the documented cause of the acute kidney failure, potentially including A41.9, R65.20, N17.9, and C67.9 in the sequence based on clinical findings.
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Description
Test your knowledge on ICD-10-CM codes from Chapters 1 to 11, focusing on infectious and parasitic diseases. This set of flashcards will help you understand code selection, combination codes, and reporting requirements. Perfect for healthcare professionals and students preparing for certification.
