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.

You have now come to the end of this learning activity.

Move on to your next learning activity.

Made with Slides.com