Download - Understanding ICD-9-CM Coding Mary Jo Bowie MS, RHIA, RHIT Regina Schaffer AAS, RHIA, CPC
Understanding ICD-9-CM Coding
Mary Jo Bowie MS, RHIA, RHIT
Regina Schaffer AAS, RHIA, CPC
CHAPTER
14Diseases of the
Digestive System
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Digestive System• Chapter Nine of the ICD-9-CM:
– 520-529: Oral Cavity, Salivary Glands, Jaws– 530-538: Esophagus, Stomach, Duodenum– 540-543: Appendicitis– 550-553: Hernia of abdominal cavity– 555-558: Noninfectious enteritis and colitis– 560-569: Other diseases of intestine and peritoneum– 570-579: Other diseases of digestive system
• Gastrointestinal tract (GI)• Alimentary canal• Starts with the mouth• Through intestines to anus
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Accessory Organs• Gastrointestinal tract (GI)
• Alimentary canal (aliment=nourishment)
• Starts with the mouth
• Through intestines to anus
• Secondary organs include– Gallbladder– Liver– Pancreas
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© 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated,or posted to a publicly accessible website, in whole or in part.
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Diseases of Oral Cavity, Salivary Glands, and Jaws
• Disorders of oral cavity (520-529)– Tooth development anomalies– Diseases of enamel– Pulp (Pulpitis code 522.0)– Geographic tongue– Gingivitis– Diseases of the jaw and salivary glands
• Reference to diagram of oral anatomy
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Diseases of the Esophagus
• Category Codes 530-538
• Connects throat to stomach
• Esophagitis (inflammation reflux of acid and pepsin from the stomach into the esophagus)
• Gastroesophageal Reflux (GERD)
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Stomach and Intestines• Stomach connects esophagus
to duodenum
• Duodenum—Start of small intestine including jejunum and ileum
• Cecum—Start of large intestine including ascending, transverse, and descending colon
• Coders should know where structures are located.
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Remaining Structures
• Sigmoid colon, rectum, and anus
• Code assignment requires knowledgeof where structures stop and start
• Structures connecting toother structures
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Ulcers of theGastrointestinal Tract
• Code to site of the ulcer– Gastric ulcer- stomach (531)– Duodenal ulcer – upper part of small
intestines (532)– Peptic ulcer –unspecified part of digestive
tract (533)– Gastrojejunal ulcer (534)
• Fifth digit code assignment is necessary
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Appendicitis• Category Codes 540-543
• Inflammation of appendix
• Other complications—present or absent– Generalized peritonitis “0”– Peritoneal abscess “1”– W/O mention of peritonitis “9”
• Note the use of acute, chronic, or subacute
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Hernia of Abdominal Cavity• Category Codes 550-553
• Protrusion or bulge of tissue – Inguinal – intestines– Hiatal – stomach to chest– Direct or indirect
• Fifth digit code assignment is necessary in many types of hernias
• Recurrent
• Unilateral or bilateral – 4th and 5th digits
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Enteritis and Colitis
• Infectious
• Noninfectious
• Enteritis—inflammation of intestines– Crohn’s Disease
• Colitis—inflammation of colon– Ulcerative colitis
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Other Diseases of Intestines
• Diverticulosis
• Diverticulitis
• Peritonitis
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Accessory Organs
• Liver (hepatic)—secretes bile
• Pancreas—part of the endocrine system and digestive system
• Gallbladder—stores bile neededfor digestion
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Cholecystitis and Cholelithiasis
• Cholecystitis—sudden and severe inflammation of the gallbladder
• Cholelithiasis—gallstones
• Documentation in coding these conditions is critical
• Fourth and fifth digit code assignments are necessary (obstruction/acute/other