Combined ICD10 codes
To code some diagnoses as part of ICD10 collection, several lines of entries in the Patient viewer tab ICD10 need to be grouped together.
To group diagnoses together, use the same Dx Priority for all of them.
Coding instructions
Introduction
- There are numerous situations in which multiple codes need to be listed in order to accurately reflect what's going on medically.
- For some situations the multiple codes need to be linked together (we use the term "combined").
- For other situations it's just a matter of ensuring that the multiple codes are all in the diagnosis list -- i.e. they don't need to be combined.
- There are some #Dxs that can only be expressed as combinations
Clinical Situation Plus its Cause
- Many ICD10 codes are for manifestations of disease, not a specific disorder per se.
- In their Wiki articles it will say something like "also code cause if known" e.g: Hematemesis
- If the cause is an infection, the Wiki article will instruct to "also code infection source", e.g: Shock, septic
- In general, when you have a manifestation and a cause, the two codes should be combined.
Primary Admit Diagnosis in Combined Codes
Dxs that can only be expressed as combinations
Some entities can only be coded with a combination of two codes.
Examples:
- retroperitoneal hemorrhage; code combined
- Hospital-acquired pneumonia (HAP) in ICD10
Some specific cases
Template:Combined dx metastasis primary Template:Trauma w mechanism Template:ICD10 infection Template:Combined dx AB resistance Template:ICD10 Symptoms not needed when cause known
Other co-codes
- In addition to the combined coding situations listed above, you can combine codes when it makes sense to you to do so. The general guideline should be that codes be combined (instead of just both listed in the diagnosis list) when they are strongly related to each other.
- Use your judgement. Either listing them separately, or combined ensures that they're all there.
Transition notes
Yes, this different from how we used to use dx priorities where they had to be unique.
Data
The records are combined by same L_ICD10.Dx Priority.