May 24, 2011 | | Comments 0
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I.O.U. and alphanumeric soup

Just when I thought that ICD-10 would resolve those annoying coding guideline and definition inconsistencies, I have discovered that some will still exist in ICD-10, too. Oh no—say it ain’t so!

The ICD-10-CM diagnosis code structure will be alphanumeric consisting of three to seven characters. The ICD-10-PCS codes for reporting hospital inpatient procedures will also be alphanumeric with seven characters. What I didn’t realize is that certain alpha characters will be “off limits” in the design of the diagnosis or procedure codes.

According to the ICD-10-PCS coding guidelines:

  • One of 34 possible values can be assigned to each axis of classification in the seven-character code, which includes numbers 0 through 9 and the alphabet (except the letters “I” and “O” because they are easily confused with the numbers “1” and “0”).
  • “U” is a potential third character describing a root operation called supplement (i.e., putting in/on biological or synthetic material that physically enforces and/or augments the function of a portion of a body part).

According to the ICD-10-CM code descriptions:

  • “I” is used to assign diagnosis codes in Chapter 9, Diseases of the Circulatory System (I00–I99)
  • “O” is used to assign diagnosis codes in Chapter 15, Pregnancy, Childbirth and the Puerperium (O00–O9a)
  • “U” is not being used at this time and is reserved for future diagnosis code expansion

So in summary, use I, O, and U (in the future) to describe diagnosis codes, but never use I and O with procedure codes—use 1, 2, and U instead. Sounds like a jingle just waiting to be written, “I.O.U. and 1.2.U…”

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Debbie Mackaman About the Author: Debbie Mackaman, RHIA, CHCO, is an instructor for HCPro’s Medicare Boot Camp®—Hospital Version and Critical Access Hospital Version. She has over 18 years of experience in the healthcare industry, including both inpatient and outpatient Prospective Payment Systems (IPPS, OPPS) and Critical Access Hospital (CAH) coding and reimbursement issues. She most recently held the position of the Compliance Officer and Director of Health Information Services for a healthcare system.

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