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When no intent of poisoning is indicated, code to accidental.
Undetermined intent is only for use when there is specific documentation in the record that the intent of the poisoning cannot
be determined.
ICD-10-CM includes a table of drugs and chemicals; however, the columns have been restructured to group all poisoning
columns together, followed by adverse effect and underdosing.
Coding professionals must refer back to the tabular list rather
than code directly from the table of drugs and chemicals.
Coding professionals may assign as many codes as necessary
to describe all drugs and medicinal or biological substances. If
two or more drugs and medicinal or biological substances are
reported, code each individually unless the combination code
is listed in the table of drugs and chemicals.
Underdosing is a new concept in ICD-10-CM. It refers to taking less of a medication than is prescribed by a provider or a
manufacturer’s instruction. For underdosing, assign the code
from categories T36–T50 (fifth or sixth character “ 6”). Codes
for underdosing should never be assigned as principal or first-listed codes.
If a patient has a relapse or exacerbation of the medical condition for which the drug is prescribed because of the reduction
in dose, then the medical condition should be coded. Codes
for noncompliance (Z91.12-, Z91.13-) or complication of care
(Y63.61, Y63.8–Y63.9) should be used with an underdosing code
to indicate intent, if known.
Coding Burns and Corrosions
ICD-10-CM distinguishes between burns and corrosions. Burn
codes apply to thermal burns (except sunburns) that come from
a heat source, such as fire or hot appliance. They include electricity and radiation burns. Corrosions are burns due to chemicals. The guidelines are the same for burns and corrosions.
Current burns (T20–T25) are classified by depth, extent, and
agent (X code). Burns are classified by depth as first degree
(erythema), second degree (blistering), and third degree (
full-thickness involvement). Burns of the eye and internal organs
(T26–T28) are classified by site, not by degree.
For any documented infected burn site, coders should use an
additional code for the infection. When coding burns, separate
codes for each burn site should be assigned. Category T30, Burn
and corrosion, body region unspecified, is extremely vague and
should be used rarely. ¢
References
National Center for Health Statistics. “ICD-10-CM Official
Guidelines for Coding and Reporting.” 2010. Available online
at www.cdc.gov/nchs/icd/icd10cm.htm.
National Center for Health Statistics. “ICD-10-CM Index and
Tabular.” 2010. Available online at www.cdc.gov/nchs/icd/
icd10cm.htm.
Ann Zeisset ( ann.zeisset@ahima.org) is a professional practice manager at
AHIMA.
