Thanks Katy! Thanks a very helpful Coding Clinic. I am not sure if I've ever read that one or not. I am copying/pasting it here for others.
Thanks Again!
Malnutrition and malabsorption
ICD-10-CM/PCS Coding Clinic, Fourth Quarter ICD-10 2017 Pages: 108-109 Effective with discharges: October 1, 2017
Related Information
Question:
A 45-year-old patient, who was diagnosed with scleroderma, severe gastroparesis, weight loss, severe malnutrition, and severe malabsorption, was admitted for total parenteral nutrition and placement of a peripherally inserted central catheter. Code E43, Unspecified severe protein-calorie malnutrition, is assigned for severe malnutrition and code K90.9, Intestinal malabsorption, unspecified, is assigned for malabsorption. There is an Excludes2 note at the beginning of Chapter 11 (K00-K95), and an Excludes1 note at the beginning category E40-E46. Based on the conflicting Excludes notes, please clarify whether the coding professional may assign code E43 and code K90.9 together?
Answer:
Assign both code K90.9, Intestinal malabsorption, unspecified, and code E43, Unspecified severe protein-calorie malnutrition. Although there is an Excludes1 note, these are separate conditions, which can exist independently. In order to convey the complete clinical picture and in the interest of reliable data, both codes should be used. The CDC/NCHS has agreed to consider revising the Excludes1 note through the ICD-10 Coordination and Maintenance Committee process.
Comments
I am not sure of the specifics of your case, but you may find Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2017: Page 108 helpful.
Katy
Thanks Katy! Thanks a very helpful Coding Clinic. I am not sure if I've ever read that one or not. I am copying/pasting it here for others.
Thanks Again!
ICD-10-CM/PCS Coding Clinic, Fourth Quarter ICD-10 2017 Pages: 108-109 Effective with discharges: October 1, 2017
Related Information
Question:
A 45-year-old patient, who was diagnosed with scleroderma, severe gastroparesis, weight loss, severe malnutrition, and severe malabsorption, was admitted for total parenteral nutrition and placement of a peripherally inserted central catheter. Code E43, Unspecified severe protein-calorie malnutrition, is assigned for severe malnutrition and code K90.9, Intestinal malabsorption, unspecified, is assigned for malabsorption. There is an Excludes2 note at the beginning of Chapter 11 (K00-K95), and an Excludes1 note at the beginning category E40-E46. Based on the conflicting Excludes notes, please clarify whether the coding professional may assign code E43 and code K90.9 together?
Answer:
Assign both code K90.9, Intestinal malabsorption, unspecified, and code E43, Unspecified severe protein-calorie malnutrition. Although there is an Excludes1 note, these are separate conditions, which can exist independently. In order to convey the complete clinical picture and in the interest of reliable data, both codes should be used. The CDC/NCHS has agreed to consider revising the Excludes1 note through the ICD-10 Coordination and Maintenance Committee process.