Pain Management Coding Alert

Question: If I find that a common ICD-9 code that I use doesn’t have a direct crosswalk to ICD-10, will I be able to use “other” or “other specified” codes in ICD-10?

Alabama Subscriber

Answer: You will see that not all codes in ICD-9 have a direct crosswalk to ICD-10 codes.

However, that doesn’t mean that you’ll automatically select an “other” or “other specified” code for the condition. It may be that ICD-10 provides multiple codes that provide more granularity for reporting the condition you have previously reported with a single code in ICD-9.

For instance, ICD-10 introduces laterality for specimen site, so a single ICD-9 code may translate to three comparable codes for “right,” “left,” and “unspecified” sites.

You may need to ask your provider for more detailed documentation, perhaps in the form of an addendum, in order to find the most appropriate code. This conversion time is the best time to illustrate a better line of communication with your provider around the documentation needs.

You should reserve codes that state “other” or “other specified” for when the information in the medical record provides detail (provides a diagnosis) for which a specific ICD-10 diagnostic code does not exist. You should use “unspecified” codes when the information in the medical record is insufficient to assign a more specific ICD-10 code.