Top 100 Icd 10 Codes for Family Practice

Diagnosis Coding for Value-Based Payment: A Quick Reference Tool

Utilise this crook sheet to identify diagnosis codes that are weighted for risk aligning.

Fam Pract Manag. 2018 Mar-Apr;25(2):26-30.

Writer disclosures: no relevant fiscal affiliations disclosed.

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Diagnosis codes are increasingly used by accountable care organizations and others using culling payment models to assess the health status of patient panels. By mapping ICD-10 codes to Hierarchical Condition Categories (HCCs), payers tin can cistron severity of illness into value-based payment calculations, including shared savings allocations. Skeptical physicians may await "HCC coding" to crave more than fourth dimension clicking boxes with additional risk for payment cuts. However, we have plant that by using a uncomplicated workflow intervention and tool, physicians can ensure that their diagnosis coding is informed by HCCs and optimized for payers' risk adjustment calculations. Here's how it works.

First, identify which of a patient's chronic conditions take diagnosis codes weighted for run a risk aligning. Qualifying diagnoses are typically specific, chronic, and predictive of significantly higher wellness costs. Electronic wellness record (EHR) systems can help with this procedure, simply medico familiarity with these codes is still essential. For this reason, we created a three-page reference tool list common diagnoses and the HCC weight for each one. Nosotros post it nigh our computers, where we can glance at it as we review our patient's trouble list before the encounter. Our EHR time-stamps when a given problem was last updated. This information and the tool aid us choose which chronic atmospheric condition to address during the visit and guide our coding for the run across. (Encounter "ICD-10 — HCC coding reference for family unit medicine.")

KEY POINTS

• Understanding Hierarchical Status Categories (HCCs) and annually reporting ICD-10 codes that correspond to them is vitally important nether new payment models that shift financial risk to physicians.

• Using a quick reference tool that lists ICD-10 codes that take HCC weights can help busy practices make sure their coding accurately reflects their patients' complexity.

For example, consider Mr. White, a 62-year-quondam male person who was seen in our dispensary for a new patient visit. He had been seen in our health system in the past, and then his medical history was well-documented in our EHR. A quick review of his trouble listing showed 19 chronic conditions. Comparing this list with our reference tool, only 1 — chronic hepatitis C status (ICD-ten code B18.2) — has an HCC weight. This was ane of several conditions we addressed during his date, and nosotros made certain to code for information technology and certificate the electric current status of the condition and plans for addressing it. Many common chronic conditions, such as Mr. White's hypothyroidism and essential hypertension, practice non correspond to HCCs. Mr. White'south problem list also includes "low with anxiety" (F41.8). We scheduled a follow-up appointment for Mr. White in ane month to discuss his mood concerns and requested records from his previous therapist. If nosotros decide that Diagnostic and Statistical Manual of Mental Disorders criteria are met, "major depressive disorder, recurrent" (F33.9) or "major depressive disorder, in fractional remission" (F32.4) might be a more advisable diagnosis. Both accept HCC weight.

Clinics in value-based payment settings must document and report as many qualifying diagnoses as possible for each patient annually. This should be a natural extension of taking a thorough medical history and addressing chronic conditions and wellness concerns in a consistent manner. We propose using your EHR's trouble list feature to track relevant diagnoses, comparing them to our coding tool, and paying hawk-like attention to when they were final addressed.

ICD-10 — HCC CODING REFERENCE FOR FAMILY MEDICINE

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If your patient has any of these problems, certificate the diagnosis, cess, and plan, and study the corresponding code annually.

Examples	ICD-10	HCCi	HCC weight2	Notes
Type 2 diabetes (T2D)
T2D without complications	E11.9	19	0.104	Always has HCC weight. Certificate as specifically as possible.
T2D with hyperglycemia	E11.65	18	0.318
T2D with hypoglycemia, no coma	E11.649	18	0.318
T2D with mild retinopathy	E11.329	18	0.318
T2D with diabetic chronic kidney disease (CKD)	E11.22	18	0.318
T2D with polyneuropathy	E11.42	xviii	0.3168
Long term (current) insulin use	Z79.4	nineteen	0.104
Hypertension (HTN)
HTN with congestive centre failure (CHF)	I11.0	85	0.323	Isolated essential HTN has no HCC weight. Relationship must be explicitly documented.
HTN + CKD stage v/end phase renal disease (ESRD)	I12.0	136	0.237
HTN + CHF + CKD stage one–4	I13.0	85	0.323
HTN + CHF + CKD phase 5/ESRD	I13.2	85	0.323
HTN + centre disease (no CHF) + CKD 5/ESRD	I13.11	136	0.237
Chronic kidney disease (CKD)
CKD stage iv, glomerular filtration charge per unit (GFR) xv–29	N18.4	137	0.237	No HCC weight unless stage 4 or worse, or associated with HIV.
CKD phase 5, GFR <15	N18.five	136	0.237
ESRD	N18.six	136	0.237
Major infections
HIV/AIDS	B20	1	0.312	Agile infections — serious, systemic, opportunistic, or os/joint/muscle.
Sepsis	A41.8	2	0.455
Cancer
Breast cancer	C50.nine	12	0.146	Active cancers — new, under treatment, or treatment declines — with documentation of any metastases.
Prostate cancer	C61	12	0.146
Lung, gastrointestinal, or pancreatic cancers	Varies	nine	0.970
Metastasis to lymph nodes	C77.X	8	2.625
Hematologic issues
Myelodysplastic syndrome	D46.ix	46	1.388
Aplastic anemia	D61.9	46	1.388
Acquired coagulopathy	D68.4	48	0.221
Senile purpura	D69.ii	48	0.221
Immune thrombocytopenic purpura	D69.3	48	0.221
Thrombocytopenia	D69.6	48	0.221
Morbid obesity
Morbid obesity	E66.01	22	0.273	No HCC weight unless BMI is 40 or greater or there are comorbidities.
Code BMI if known	Z68.41–45	22	0.273
Malnutrition
Poly peptide-calorie malnutrition	E46	21	0.545	Malnutrition requires documentation of objective data (e.g., albumin less than three.4) or subjective data (wasted appearance).
Cachexia	R64	21	0.545
Chronic lung affliction
Smoker'southward cough	J41.0	111	0.328	Document specifically if possible (smoking history, chest computed tomography results, pulmonary function tests, etc.). *Too lawmaking Z99.81, dependent on supplemental oxygen.
Emphysema	J43.Ten	111	0.328
Chronic obstructive pulmonary disease (COPD), other	J44.X	111	0.328
COPD, unspecified	J44.9	111	0.328
Pulmonary fibrosis	J84.10	112	0.209
Chronic respiratory failure	J96.10*	84	0.302
Inflammatory bowel disease
Crohn's disease	K50.90	35	0.294
Ulcerative colitis	K51.xc	35	0.294
Chronic hepatitis
Chronic hepatitis C	B18.2	29	0.165
Chronic hepatitis, unspecified	K73.9	29	0.165
Cirrhosis
Alcoholic cirrhosis	K70.30	28	0.390
Non-alcoholic cirrhosis	K74.60	28	0.390
Esophageal varices, no drain	I85.00	27	0.962
Portal hypertension	K76.6	27	0.962
Chronic pancreatitis
Chronic pancreatitis	K86.i	34	0.276
Rheumatologic bug
Lupus	M32.ix	twoscore	0.423
Sicca syndrome (Sjoren)	M35.00	forty	0.423
Rheumatoid arthritis	M06.9	40	0.423
Inflammatory polyarthropathy	M06.4	40	0.423
Polymalgia rheumatica	M35.three	40	0.423
Psychiatric problems
Schizophrenia	F20.9	57	0.608	"Run-of-the-manufactory" depression/anxiety has no HCC weight. Must certificate Diagnostic and Statistical Manual of Mental Disorders criteria.
Schizoaffective disorder	F25.9	57	0.608
Major depression, recurrent	F33.9	58	0.395
Bipolar disorder	F31.9	58	0.395
Alcoholism	F10.xx	55	0.383
Alcoholism, in remission	F10.21	55	0.383
Drug dependence	F1X.xx	55	0.383
Drug dependence, in remission	F1X.21	55	0.383
Neurologic problems
Parkinson'south disease	G20	78	0.585	Call back to list these chronic diseases annually, fifty-fifty if primary management is by a consultant.
Multiple sclerosis	G35	77	0.441
Paralysis	G83.9	104	0.395
Seizure disorder	G40.909	79	0.227
Ischemic stroke	Varies	100	0.265
Cardiac affliction
Angina	I20.9	88	0.140
Coronary avenue illness with angina	I25.119	88	0.140
Unstable angina	I20.0	87	0.218
Acute myocardial infarction	I21.3	86	0.233
Pulmonary hypertension	I27.2	85	0.323
Cor pulmonale	I27.81	85	0.323
Cardiomyopathy	I42.9	85	0.323
CHF	I50.9	85	0.323
Atrial fibrillation	I48.91	96	0.268
Aortic atherosclerosis	I70.0	108	0.298
Intestinal aortic aneurysm	I71.4	108	0.298
Deep venous thrombosis (DVT)
DVT, astute	I82.40	108	0.298
DVT, chronic	I82.50	108	0.298
Vascular disease
Peripheral vascular disease	I73.ix	108	0.298
Diabetic peripheral vascular disease	E11.51	18	0.318
Venous stasis ulcers with varicose veins	I83.0	107	0.400
Chronic venous stasis ulcer	I87.31	107	0.400
Ophthalmology
Wet macular degeneration	H35.32	124	0.499
Proliferative diabetic retinopathy	E11.359	18	0.318
Trauma
Concussion w/o loss of consciousness, sequelae	S06.0X0S	167	0.191	Any lawmaking reflecting major or severe head trauma has HCC weight.
Caput injury with subdural hemorrhage	S06.6X6A	166	0.584
Hip fracture	S72.009A	170	0.418
Bogus openings
Tracheostomy condition	Z93.0	82	1.055
Gastrostomy status	Z93.i	188	0.571
Colostomy status	Z93.3	188	0.571
Cystostomy status	Z93.5	188	0.571
Amputation status
Specify site	Z89.4-half dozen	189	0.588	Lower limb only.
Major organ transplant
Center transplant status	Z94.one	186	1.000	Can be any duration from surgery.
Lung transplant status	Z94.two	186	1.000
Liver transplant status	Z94.iv	186	1.000
Excluded chronic conditions
Essential hypertension, hyperthyroidism or hypothyroidism, iron deficiency anemia, gastroesophageal reflux, osteoarthritis, and tobacco employ.

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ABOUT THE AUTHORS

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Dr. Belatti is a resident physician at St. Mary's Hospital in Yard Junction, Colo....

Dr. Lykke is a faculty physician at St. Mary's Hospital.

Writer disclosures: no relevant financial affiliations disclosed.

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