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Medical Coding News Archives

September Coding Corner

September 20, 2017:

In the Optum360 Coding Corner, we highlight areas in which medical coding professionals are struggling for uniformity and correct coding amongst their peers. In this article, we discuss coding variances for ICD-10-CM, ICD-10-PCS and/or CPT® found on a monthly basis and explore the codes, coding concepts and conventions for those variances. This month’s article highlights updates to the 2017 ICD-10 CM guidelines effective October 1, 2017.

Diabetes mellitus and the use of insulin

A new guideline has been added to the above section to address the coding of long term use of insulin. When the documentation states a patient is being treated with both oral medication and insulin, then diagnosis code Z79.4 (Long term (current) use of insulin) should be assigned. This guideline has also been added to the subsection Secondary diabetes mellitus and the use of insulin.


This new subsection has been added to the guideline section of Chapter 7: Disease of Eye and Adnexa. This guideline applies if the documentation states “blindness” or “visual loss.” If the documentation states blindness without identifying if one or both eyes are affected, then diagnosis code H54.7 (Unspecified visual loss) should be assigned. When the documentation does not identify the visual impairment category, then diagnosis code H54.3 (Unqualified visual loss, both eyes) or H54.6- (Unqualified visual loss, one eye) should be assigned based on if one or both eyes are affected.

Other types of myocardial infarction

New wording has been added in 2017 to identify that previous coding guidelines now applies to a type 1 myocardial infarction. Therefore, a new section has been added to the AMI section to address other types of myocardial infarction. This section identifies that type 1 AMIs should be assigned diagnosis codes from the following categories: I21.0- (ST elevation (STEMI) myocardial infarction of anterior wall), I21.1- (ST elevation (STEMI) myocardial infarction of inferior wall), I21.2- (ST elevation (STEMI) myocardial infarction of other sites), I21.3- (ST elevation (STEMI) myocardial infarction of unspecified site) and I21.4- (Non-ST elevation (NSTEMI) myocardial infarction). When the documentation states AMI type 2, then newly created diagnosis code I21.A1 (Myocardial Infarction type 2) should be assigned. To identify other types of infarctions, such as type 3 or 4a, then new diagnosis code I21.A9 (Other myocardial infarction type) should be assigned.

Functional quadriplegia

This guideline has been deleted effective October 1, 2017.

CPT is a registered trademark of the American Medical Association.


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