This page addresses follow-up questions and additional information pertinent to our webinar
Quarterly ICD-10 Coding Update.

** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.

Q: Can conditions documented on the pathology report be coded in the outpatient setting?
A: Yes, conditions documented solely on the pathology report can be coded in the outpatient setting since the pathology findings are often the most definitive diagnosis on the record and the pathology is a physician who documents an interpretation. This advice is consistent with Coding Clinic, 1st Quarter 2017, page 4.

Q: What is the difference between a cricothyroidotomy and a tracheostomy?
A: A cricothyroidotomy is an emergent procedure performed to establish a temporary airway. It involves making an opening to the trachea through the cricothyroid membrane, which is located between the cricoid and thyroid cartilages. It can be done without anesthesia. A tracheostomy is a more technically challenging procedure, in which the surgeon makes an opening in the trachea below the cricoid cartilage. Tracheostomies are done when the establishment of an airway will be needed for a longer period of time. Tracheostomies are performed under sedation or anesthesia.

Q: Is stage 3a chronic renal impairment the same as stage 3a chronic kidney disease (CKD)?
A: The provider should be queried when staged chronic renal impairment is documented to determine if the patient has CKD. The coder should not assume the patient has CKD without provider documentation. If the provider states the patient did not have CKD or a query cannot be sent or remains unanswered, assign code N28.89, other specified disorders of kidney and ureter. This is consistent with ICD-10-CM indexing for Impairment; renal.