Q: Does acute/chronic respiratory acidosis really code as acute/chronic respiratory failure? Can a code for respiratory acidosis be reported with the respiratory failure codes?
A: Yes, that is how it is indexed in ICD-10-CM. There is an Exclude2 note for code E87.29, Other acidosis that it may be reported in addition to the respiratory failure codes. Haugen Consulting Group recommends referring to Coding Clinic, 4th Quarter 2022. In the fourth quarter issue every year, more advice is published on the new codes, and we are optimistic that this common topic will be addressed further.
Q: How are the fractures due to CPR indexed? Will we find them under the term “complication” or “fracture?”
A: These codes are indexed under “Fracture, traumatic,” which may seem unintuitive since it’s a complication of care and the codes are classified to Chapter 13, Diseases of the Musculoskeletal System.
Q: For the new dementia codes, does the physician have to specify that the agitation, etc. are due to dementia in order to use the combination code? Are any of these codes are CCs (or even MCC)?
A: For manifestations of dementia (e.g., agitation, anxiety, mood disturbance), a causal relationship is assumed per guideline I.A.15., the “With” convention. These manifestations are indexed under the subterm “with” under the dementia main term in ICD-10-CM. Severity of vascular dementia and dementia in diseases classified elsewhere must be documented by the provider. All of the codes for dementia with manifestations are complications/comorbidities for hospital inpatient coding. None are MCCs.
Q: For code W23.2, Caught, crushed, jammed or pinched between a moving and stationary object, would this include getting your finger slammed in a car door? The car is stationary, but the door is moving.
A: Code W23.2 is the correct code for reporting getting slammed by a door.
Q: For the risk of suffocation code, what should documentation look like for the use of this code? Is documentation of co-sleeping enough or does the provider have to document that the newborn is at risk?
A: Haugen Consulting Group recommends coding this only when there is mention of concern for suffocation when cosleeping. This should not be coded when documentation of cosleeping exists without documentation of its significance. This advice is subject to change should Coding Clinic publish additional advice on the collection of this code.
9/22/22 Q: With the rib fractures and CPR is there any distinction if a LUCAS machine was used for CPR?
A: There is no distinction in the code set between rib fractures incurred during CPR when done either manually or using LUCAS machine.
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Kristi also performs DRG and APC audits and is known for her vast knowledge on coding vascular interventional radiology procedures. Kristi has an extensive background in coding education and consulting and is a national speakers on topics related to ICD-10 and CPT coding as well as code-based reimbursement.