ICD 10 Coding Alert
Look for Related Conditions in Influenza Diagnosis
Question: How can we report the diagnosis of swine flu influenza in ICD-10-CM?
Ohio Subscriber
Answer: For Swine flu influenza, look to ICD-10-CM code category J09 (Influenza due to certain identified influenza viruses). Influenza due to identified novel influenza A virus is reported with code set (J09._) and requires 5 characters to further identify the manafestations present. This subcategory of codes includes Avian influenza, Bird influenza, Influenza of other animal origin, and Swine influenza.
ICD-10-CM options: There are 21 codes in several subcategories for influenza included in ICD-10-CM within the section for influenza pneumonia (J09-J18).
Check these three code sets for influenza:
Look for related conditions: ICD-10-CM introduces codes with increased specificity for many conditions including influenza. Influenza is defined by type along with manifestations. In addition, you should look for related conditions that are documented and should be reported.
Each of the code subsets mentioned are further defined by the associated manifestations including: with pneumonia, with other respiratory manifestations, with gastrointestinal manifestations and with other manifestations. Documentation should include the manifestations associated with the influenza.
For example, under J09, you will find the following more specific codes:
Also, related conditions should be reported in addition to the influenza such as otitis media or lung abscess.
Example: Code J09.X1 includes this note:
Code also, if applicable, associated:
The J10 code set (J10._) includes other identified viruses, such as H1N1 not identified as “Novel” along with influenza B and C types. There is an additional code set for unidentified influenza (J11._) which is used when the influenza type is unknown.
Follow the instructional notes: The ICD-10-CM Official Guidelines for Coding and Reporting for influenza instruct coders to code only confirmed cases of influenza due to certain identified influenza viruses (category J09), and due to other identified influenza virus (category J10).
In this context, “confirmation” does not require documentation of positive laboratory testing specific for avian or other novel influenza A or other identified influenza virus. However, coding should be based on the provider’s diagnostic statement of what strain of influenza the patient has. If the provider records “suspected” or “possible” or “probable” avian influenza, novel influenza, or other identified influenza, coders should report the appropriate influenza code from category J11 (Influenza due to unidentified influenza virus).
Related Articles
ICD 10 Coding Alert
- Breaking News:
So Now You're Using ICD-10 -- Time to Look Forward to 2016 ICD-10 Ob-Gyn Changes
Avoid Z3A codes when patient has postpartum complication. You’ve studied and now transitioned to the [...] - Guidelines:
Watch Your Step When Assigning Diagnosis Codes for Falls
Read the rules about including Z codes describing a risk or history of falling. ICD-10 [...] - News You Can Use:
This Payer Identifies Issue with ICD-10 Code Z86.010
Here’s why you don’t need to take any action. Just one month after the ICD-10 [...] - Training:
Follow These Five Steps To Make Your Way To Correct Neoplasm Coding
The pathology report will guide you to the right code in the neoplasm table.. Coding [...] - Learn More with These Neoplasm Coding Examples
Here are some examples that will help you gain a better understanding of neoplasm coding. [...] - Otolaryngology:
Keep Your Epistaxis Coding Simple With a Single ICD-10 Choice
Remember you still have multiple procedure codes associated with diagnosis. Epistaxis – commonly known as [...] - Orthopedics:
Here's How to Capture Carpal Tunnel Coding With Your New Diagnosis System
Don’t miss this Excludes1 note under the G56 category.
When your orthopedist treats carpal [...] - Anesthesia:
Choose Between 2 Codes for Hysterectomy Diagnosis
Relax: The descriptors are already familiar. With approximately 20 CPT® codes addressing hysterectomy, coding for [...] - Reader Question:
Establish Medical Necessity for Screening Breast MRI
Question: How can we report a screening MRI? Our physician wants to schedule a breast MRI [...] - Reader Question:
Look for Related Conditions in Influenza Diagnosis
Question: How can we report the diagnosis of swine flu influenza in ICD-10-CM? Ohio Subscriber Answer: For [...]
