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Portfolio Project [Blank line]
Shannon Hutson
Bryant & Stratton College
MCCG 212: Advanced ICD Diagnostic Coding
Dr. Meyer
12/19/2023
Training Plan for Advanced ICD Diagnostic Coding Skills Educational Program
The primary goal of the ICD Diagnostic coding skills training program is to introduce complex coding scenarios that will challenge the learner to deeply examine coding guidelines and how they apply. Each scenario is tailored to acquaint the learner with specific coding examples that require an in-
depth review of individual coding guidelines. The learner will be able to abstract and apply advanced coding classification requirements that fulfill official coding guidelines.
The training program will be administered through three separate courses that will build upon each other while integrating new concepts each time. The first two courses will involve coding scenarios and the application of coding guidelines, and the final course will analyze guidelines that are often confused. The following coding scenarios will be presented in the first two courses and will be used to guide a larger conversation on coding guidelines and how to best apply them.
Coding Scenarios for Week One and Two
Outpatient Scenario 1:
The ICD-10-CM code for Mary’s visit would be G56.03- Carpal tunnel syndrome, bilateral upper limbs. To find this code, first look up Syndrome, Carpal Tunnel G56.0- in the Alphabetic Index of your manual. The instructional notation of – indicates that additional characters are needed to complete the code. The next step is to find G56.0 in the Tabular List. The diagnosis states that Mary has bilateral carpal tunnel syndrome, which should que you into the code G56.03 being the highest degree of specificity. Outpatient Scenario 2:
The ICD-10-CM codes for Tina’s visit would be sequenced as T65.891A- Toxic effect of other specified substances, accidental (unintentional), initial encounter and J69.1- Pneumonitis due to
inhalation of oils and essences. To find these codes, first look up Pneumonitis, oils, essences J69.1 in the Alphabetic index of your manual. Next find J69.1 in the Tabular list to find the instructional notation Code first (T51-T65) to identify substance. This notation should que you into the need for an additional code to describe the type of substance causing pneumonitis. The code T65.891 best describes the substance and that it was unintentionally inhaled. This code has an instructional notation that requires a
seventh character to be added. The appropriate seventh character for this encounter would be A- initial encounter. It is important to remember to sequence the code for the substance first as directed by the instructional notation for J69.1.
Inpatient Scenario 1:
The ICD-10-CM coding for this scenario would be sequenced as I20.0 - Angina pectoris and I47.1-
Paroxysmal ventricular tachycardia, unspecified. The admitting diagnosis for this scenario would be I20.0
because it best describes the unstable angina as the condition that required admission. The principal diagnosis for this scenario would be I47.9 based on Section II. Selection of the Principal Diagnosis of the coding guidelines. It states that the principal diagnosis is defined as “that condition established after study to be chiefly responsible for occasion the admission of the patient to the hospital for care.” In this case, the patient was found to have paroxysmal tachycardia after having an EKG. This is the reason I47.9 would be the principal diagnosis. According to the Present on Admission Reporting Guidelines, the POA indicator for I20.0 would be assigned as a Y for conditions diagnosed during admission but clearly present before admission.
Inpatient Scenario 2:
The ICD-10-CM coding for this scenario would be sequenced as Z51.11- Encounter for antineoplastic chemotherapy, C91.00- Acute lymphoblastic leukemia NOS, and R11.2- Nausea with vomiting, unspecified. The patient was admitted for her third round of chemotherapy for acute
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