ICD-10-CM and the Gift of “With” Confirmed!

ICD-10-CM and the Gift of “With” Confirmed!

by Angela Lehoux, BS, CDIP, CCS, CIC, CPC-I

In the fourth quarter 2016 Coding Clinic I was excited to see the question about osteomyelitis and diabetes being posed.

First, a little history. There was advice provided in the fourth quarter 2013 Coding Clinic that osteomyelitis should not be coded to a diabetic complication unless the provider clearly documented a linkage between the two conditions. The question posed in fourth quarter 2016 Coding Clinic was whether or not that advice is still applicable. Coding Clinic explains that the advice from 2013 is now obsolete and the index was updated in 2016 to reflect osteomyelitis as a term to be associated with diabetes unless the provider states otherwise.

The ICD-10-CM Official Guidelines for Coding and Reporting FY 2017 states that the subterm “with” when found in the Index should be interpreted to mean “associated with” or “dueto.” The guideline goes on to state that a causal relationship is presumed and should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation states the conditions are unrelated.

The gift of “with” indeed! So, be sure to familiarize yourself with those “with” terms in your index. You may be surprised as you go through it how many gifts you find. Diabetes is not the only one; have a look at hypertension.

Happy coding!

About the Author

Angela Lehoux, BS, CDIP, CCS, CIC, CPC-I
Angela Lehoux applies a hands-on approach to her role as the Director of Education for Libman Education. Whether overseeing the work of subject matter experts including nationally recognized coding authorities; challenging instructional designers to deliver content in a way that is both engaging and memorable; or tapping her 25 years’ experience in inpatient, outpatient, and emergency room coding to write coder-friendly courses herself, Angela is responsible for ensuring that our training is accurate, easily accessible, and challenging.

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