Assigning an ICD code : Complicated Examples
Sometimes assigning an ICD code to a disease can be confusing or complicated.
In certain situations, it is important to have complete details on manner of death. In order to identify if it was an accident/suicide/intended injury/unknown intent/iatrogenic injury and assign ICD code accordingly (scenarios 1 to 3) ;in other situations, it is important to know the timing of the disease diagnosis, so as to be aware of the definition of the disease condition (scenario 4).
These concepts are explained through a set of examples.
| Case | Case 1 | Case 2 |
|---|---|---|
| Question | A man dies after accidental exposure to pesticides. What is the code? | A man dies after intentional ingestion of chlorine containing pesticide. What is the code? |
Scenario 1
| Disease | Accidental poisoning by and exposure to organic solvents and halogenated hydrocarbons and their vapours |
Intentional self-poisoning by and exposure to pesticides |
|---|---|---|
| Chapter | Chapter XX: External causes of morbidity and mortality | Chapter XX: External causes of morbidity and mortality |
| Block | Accidental poisoning by and exposure to noxious substances | Intentional self-harm |
| Code | X46 | X68 |
| Case | Case 1 | Case 2 |
|---|---|---|
| Question | A man died in Kerala Kollam temple firework accident.What is the code? | A man with crush injury due to a building collapse died in Kerala Kollam temple incident. What is the code? |
Scenario 2
| Disease | Discharge of firework | Struck by thrown, projected or falling object |
|---|---|---|
| Chapter | Chapter XX: External causes of morbidity and mortality | Chapter XX: External causes of morbidity and mortality |
| Block | Exposure to inanimate mechanical forces | Exposure to inanimate mechanical forces |
| Code | W39 | W20 |
| Case | Case 1 | Case 2 |
|---|---|---|
| Question | One year old boy is bitten and mauled to death by a dog. What is the code? | A physician diagnoses a child to have died due to rabies. What is the code? |
Scenario 3
| Disease | Bitten or struck by dog | Rabies |
|---|---|---|
| Chapter | Chapter XX: External causes of morbidity and mortality | Chapter I: Certain infectious and parasitic diseases |
| Block | Exposure to animate mechanical forces | Viral infections of the central nervous system |
| Code | W54 | A82 |
| Case | Case 1 | Case 2 |
|---|---|---|
| Question | A pregnant woman is diagnosed with diabetes at 12 weeks. What is the code? | A pregnant woman is diagnosed with diabetes at 26 weeks. What is the code? |
Scenario 4
| Disease | Insulin-dependent diabetes mellitus | Diabetes mellitus in pregnancy |
|---|---|---|
| Chapter | Chapter IV: Endocrine, nutritional and metabolic diseases | Chapter XV: Pregnancy, childbirth and puerperium |
| Block | Diabetes mellitus | Other maternal disorders predominantly related to pregnancy |
| Code | E10 | O24 |
** If in a pregnant woman, diabetes is detected before 20 weeks it will be coded as E10. If the onset of diabetes is after 20 weeks and it is confirmed as gestational diabetes then it will be coded O24, as diseases arising due to pregnancy are listed under Chapter XV.
Remember
Specific cause over non-specific cause:
When coding always remember that it is important to code for a specific cause over a non-specific cause.
eg
It is appropriate to code the underlying cause of death to a specific cause like a stroke (I64) or an infection (G00/G04) rather than to a manifestation or a non-specific cause like hemiplegia (G81), although hemiplegia can be used in clinical practice and in morbidity coding.
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e-MCCD M2U2LA3
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e-MCCD M2U2LA3
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