Wiki Diagnosing + References

[cmk112@gmail.com]

Hi Fellow Members!
Can anyone suggest a book to understanding diagnosing codes more in-depth outside the ICD 10 manual?

To clarify, I am not looking to diagnose charts myself as that's beyond my role as a coder.

I want to gain more knowledge from a coding standpoint. For example, a provider states, Lumbar Disc Herniation, Lumbar Radiculopathy, and Lumbar Disc Degeneration. I would code as M51.16 + M51.36. The feedback from our auditor stated M51.36 would not be coded as it is inclusive to M51.16. Logically, I understand the degeneration, leads to herniation, which ultimately progressed to radiculopathy.

Is there a book targeted specifically for coders in understanding the disease process and it relates to codes and uses an example like above? Any suggestions would be much appreciated!! I hear the CRC credential is great for this realm of knowledge.
Thanks again for any suggestions!

Best Regards,
Chad

 

[thomas7331]

I don't have a specific book to recommend to you for this, but I think there are many great resources available on the internet these days that can give you a lot of good background on disease processes. For example, Johns Hopkins and the Mayo Clinic both have great web sites that give a lot of information in terms that are easy to understand. Also, WebMD and MedicineNet are good comprehensive and reliable resource.s But if you're working in a provider office, there's no better substitute for just talking with your physicians. I've found that physicians enjoy teaching and even though they're quite busy, they'll often enjoy taking the time to answer your questions and explain what they're doing.

As far as this ties into coding though, it's not really going to help you avoid an error like the one you describe above, as what the auditor has cited here comes directly from the coding guidelines, not from an understanding of the disease. Radiculopathy is linked to both of the other conditions by a 'with' term in the alphabetic index, and the coding for both the herniation and/or the degeneration of the disc both would direct you to the combination code M51.16 if radiculopathy is documented as present in the record. So although the auditor isn't speaking accurately by describing M51.36 as 'inclusive' to M51.16 (there are no excludes notes on these codes here), they are correct that you should not arrive at M51.36 if you follow the correct sequence through the alphabetic index.