Download ICD-9/10 Codes: Loss of Consciousness & Brain Injuries and more Lecture notes Biology in PDF only on Docsity!
Top Codes by Cost Tip Sheet: ICD-10 Chapter Overview
Chapter 19 - Injury, Poisoning, and Certain Other Consequences of External Causes
(S00-T88)
Key Updates
Injuries are grouped by body part rather than category of injury as they were in ICD-9-CM.
Laterality is specified in this chapter.
ICD-10-CM introduces a 7th character requirement that describes the type of encounter.
Most categories in this chapter use the 7th character requirement. Most categories in this
chapter (see below for fractures) have three 7th character values of:
A - Initial encounter
D - Subsequent encounter
S - Sequela
For traumatic fractures, there are additional 7th^ character requirements depending
upon the type of fracture, and complication. Some of these character descriptions
are based on the Gustilo open fracture classification.
Codes for underdosing are new in ICD-10-CM. Underdosing refers to taking less of a
medication than is prescribed by a provider or less than the manufacturer’s instructions.
Codes for underdosing should not be assigned as principal or first-listed codes.
Chapter 21 - Factors Influencing Health Status and Contact with Health Services (Z00-
Z99)
Key Updates
These codes are used in any healthcare setting. Z codes may be used as either a first-
listed or principal diagnosis code in the inpatient setting, or secondary code, depending on
the circumstances of the encounter. Certain Z codes may only be used as first- listed or
principal diagnosis in certain situations. Refer to Official Coding Guidelines for details.
Z codes are not procedure codes. A corresponding procedure code must accompany a Z
code to describe any procedure performed.
(Source: 2015 Draft ICD-10-CM Official Guidelines for Coding and Reporting)
The top 25 codes by cost in ICD-9 to ICD-10 mappings are found in the chart below.
Top 25
ICD- 9
Code ICD-9 Description
ICD- 10
Code ICD-10 Description 1 851. Cerebellar or brain stem contusion w/open intracranial wound w/prolonged (more than 24 hours) loss of consciousness and return to pre-existing conscious level S01.90XA Unspecified open wound of unspecified part of head, initial encounter S06.375A Contusion, laceration, and hemorrhage of cerebellum w/loss of consciousness greater than 24 hours w/return to pre-existing conscious level, initial encounter S06.385A Contusion, laceration, and hemorrhage of brainstem w/loss of consciousness greater than 24 hours w/return to pre-existing conscious level, initial encounter 2 854.14 (^) Intracranial injury of other and unspecified nature w/open intracranial wound, w/prolonged (more than 24 hours) loss of consciousness and return to pre-existing conscious level S01.90XA Unspecified open wound of unspecified part of head, initial encounter S06.895A Other specified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter 3 V36. Other multiple birth (three or more), mates liveborn and stillborn, born in hospital, delivered without mention of cesarean delivery Z38.61 Triplet liveborn infant, delivered vaginally Z38. Quadruplet liveborn infant, delivered vaginally Z38. Quintuplet liveborn infant, delivered vaginally Z38. Other multiple liveborn infant, delivered vaginally Z38. Other multiple liveborn infant, unspecified as to place of birth 4 801. Closed fracture of base of skull with other and unspecified intracranial hemorrhage, with moderate [1-24 hours] loss of consciousness S02.10XA Unspecified fracture of base of skull, initial encounter for closed fracture S06.363A Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter
Top 25
ICD- 9
Code ICD-9 Description
ICD- 10
Code ICD-10 Description S06.337A Contusion and laceration of cerebrum, unspecified, w/loss of consciousness of any duration w/death due to brain injury prior to regaining consciousness, initial encounter S06.338A Contusion and laceration of cerebrum,unspecified, w/loss of consciousness of any duration w/death due to other cause prior to regaining consciousness, initial encounter 8 806. Open fracture of C5-C7 level w/complete lesion of cord S12.400B Unspecified displaced fracture of fifth cervical vertebra, initial encounter for open fracture S12.401B Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture S12.500B Unspecified displaced fracture of sixth cervical vertebra, initial encounter for open fracture S12.501B Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture S12.600B Unspecified displaced fracture of seventh cervical vertebra, initial encounter for open fracture S12.601B Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture S14.115A Complete lesion at C5 level of cervical spinal cord, initial encounter S14.116A Complete lesion at C6 level of cervical spinal cord, initial encounter S14.117A Complete lesion at C7 level of cervical spinal cord, initial encounter 9 800. Closed fracture of vault of skull w/cerebral laceration and contusion, w/prolonged (more than 24 hours) loss of consciousness w/o return to pre-existing conscious level S02.0XXA Fracture of vault of skull, initial encounter for closed fracture S06.336A Contusion and laceration of cerebrum, unspecified, w/loss of consciousness greater than 24 hours w/o return to pre-existing conscious level w/patient surviving, initial encounter S06.337A Contusion and laceration of cerebrum, unspecified, w/loss of consciousness of any duration w/death due to brain injury prior to regaining consciousness, initial encounter S06.338A Contusion and laceration of cerebrum, unspecified, w/loss of consciousness of any duration w/death due to other cause prior to regaining consciousness, initial encounter 10 803. Other closed skull fracture w/cerebral laceration and contusion, w/loss of consciousness of unspecified duration S02.91XA Unspecified fracture of skull, initial encounter for closed fracture
Top 25
ICD- 9
Code ICD-9 Description
ICD- 10
Code ICD-10 Description S06.339A Contusion and laceration of cerebrum, unspecified,w/loss of consciousness of unspecified duration, initial encounter 11 863. Injury to ascending (right) colon, w/ open wound into cavity S316.09A Unspecified open would of abdominal wall, unspecified quadrant w/ penetration into peritoneal cavity, initial encounter S36.500A Unspecified injury of ascending (right) colon, initial encounter 12 851. Cerebellar or brain stem laceration w/o mention of open intracranial wound,w/prolonged (more than 24 hours) loss of consciousness w/o return to pre-existing conscious level S06.376A Contusion, laceration and hemorrhage of cerebellum w/loss of consciousness greater than 24 hours w/o return to pre-existing conscious level w/patient surviving, initial encounter S06.377A Contusion, laceration and hemorrhage of cerebellum w/loss of consciousness of any duration w/death due to brain injury prior to regaining consciousness, initial encounter S06.378A Contusion, laceration and hemorrhage of cerebellum w/loss of consciousness of any duration w/death due to other cause prior to regaining consciousness, initial encounter S06.386A Contusion, laceration and hemorrhage of brainstem w/loss of consciousness greater than 24 hours w/o return to pre-existing conscious level w/patient surviving, initial encounter S06.387A Contusion, laceration and hemorrhage of brainstem w/loss of consciousness of any duration w/death due to brain injury prior to regaining consciousness, initial encounter S06.388A Contusion, laceration and hemorrhage of brainstem w/loss of consciousness of any duration w/death due to other cause prior to regaining consciousness, initial encounter 13 967.2 Poisoning by paraldehyde T42.6X1A Poisoning by other antiepileptic & sedative- hypnotic drugs,accidental(unintentional), initial encounter T42.6X2A Poisoning by other antiepileptic & sedative- hypnotic drugs,intentional self-harm, initial encounter T42.6X3A Poisoning by other antiepileptic & sedative- hypnotic drugs,assault, initial encounter T42.6X4A Poisoning by other antiepileptic & sedative- hypnotic drugs,undetermined, initial encounter 14 803. Other open skull fracture w/intracranial injury of other & unspecified nature, w/ loss of consciousness of unspecified duration S02.91XB Unspecified fracture of skull,initial encounter for open fracture S06.899A Other specified intracranial injury w/loss of consciousness of unspecified duration,initial encounter
Code Code 17 V37. Other multiple birth (three or more),unspecified whether mates liveborn or stillborn, born in hospital, delivered by cesarean delivery Z38. Triplet liveborn infant, delivered by cesarean section Z38. Quadruplet liveborn infant, delivered by cesarean Z38. Quintuplet liveborn infant, delivered by cesarean Z38. Other multiple liveborn infant, delivered by cesarean Z38. Other multiple liveborn infant, unspecified as to place of birth 18 800. Open fracture of vault of skull w/subarachnoid, subdural, & extradural hemorrhage, w/ no loss of consciousness S02.0XXB Fracture of vault of skull, initial encounter for open fracture S06.4X0A Epidural hemorrhage w/o loss of consciousness, initial encounter S06.5X0A Traumatic subdural hemorrhage w/o loss of consciousness, initial encounter S06.6X0A Traumatic subarachnoid hemorrhage w/o loss of consciousness, initial encounter 19 V36. Other multiple birth(three or more),mates liveborn and stillborn,born in hospital delivered by cesarean delivery Z38. Triplet liveborn infant, delivered by cesarean section Z38. Quadruplet liveborn infant, delivered by cesarean Z38. Quintuplet liveborn infant, delivered by cesarean Z38. Other multiple liveborn infant, delivered by cesarean Z38. Other multiple liveborn infant, unspecified as to place of birth 20 801. Closed fracture of base of skull w/cerebral laceration & contusion,w/ concussion, unspecified S02.10XA Unspecified fracture of base of skull, initial encounter for closed fracture S06.330A Contusion & laceration of cerebrum,unspecified,w/o loss of consciousness, initial encounter 21 863. Injury to multiple sites in colon & rectum, w/o mention of open wound into cavity S36.508A Unspecified injury of other part of colon, initial encounter S36.518A Primary blast injury of other part of colon, initial encounter S36.528A Contusion of other part of colon, initial encounter S36.538A Laceration of other part of colon, initial encounter S36.598A Other injury of other part of colon, initial encounter 22 803. Other open skull fracture w/subarachnoid, subdural, extradural hemorrhage w /loss of consciousness of unspecified duration S02.91XB Unspecified fracture of skull, initial encounter for open fracture
Top 25
ICD- 9
Code ICD-9 Description
ICD- 10
Code ICD-10 Description S06.4X9A Epidural hemorrhage w/loss of consciousness of unspecified duration, initial encounter S06.5X9A Traumatic subdural hemorrhage w/loss of consciousness of unspecified duration, initial encounter S06.6X9A Traumatic subarachnoid hemorrhage w/loss of consciousness of unspecified duration, initial encounter 23 286.1 Congenital factor IX disorder D67 Hereditary factor IX deficiency 24 V31. Twin birth, mate liveborn, born before admission to hospital Z38.4 Twin liveborn infant, born outside hospital 25 803. Other open skull fracture w/cerebral laceration & contusion,w/no loss of consciousness S02.91XB Unspecified fracture of skull, initial encounter for open fracture S06.330A Contusion & laceration of cerebrum,unspecified, w/o loss of consciousness, initial encounter The codes highlighted in orange indicate the individual ICD-9 code that is being mapped to one or many ICD-10 codes
(Source of ICD-9-CM to ICD-10-CM mappings: CMS.org General Equivalence Mappings (GEMs), 2015)
The information in this document is not intended to impart legal advice. This overview is intended as an educational tool only and should not be relied upon as legal or compliance advice. If you have any legal questions about the information contained herein, you should consult your attorney or other professional legal services provider.
