- D—Even though the patient’s chief complaint is for a follow-up of chronic idiopathic gout without tophi, the patient is presenting with an acute flare of idiopathic gout of the left knee. Acute gout and chronic gout have specific coding guidelines, because they each have an Excludes 1 note. This indicates they are mutually excluded from each other and should not be coded together on the same encounter.
- B—When looking for a code, it is important to start in the alpha section and follow the steps as guided in the manual to get you to the correct category/family of the code. Once the category/family of the code is located, it will give you directions to find the code in the tabular section. It is imperative for physicians and staff to never code directly from the alpha section, as there are usually further instructions in the tabular section for the final code set (examples of guidance in the tabular section include instruction on which codes have an Excludes 1 or Excludes 2 note as well as when an additional code is needed). For the first year of ICD-10, the ACR continues to strongly recommend that rheumatology practices have at least one ICD-10 manual to help staff understand the full rules and guidelines of the new code set.
- False—M25.50—pain in unspecified joint is not a substitution for pain in multiple joints. There is currently no single code for pain in multiple joints in ICD-10. The rheumatologist will have to code out each individual joint for that encounter.
- C—When coding from the E66.0_ category, the coding guidelines included in this code set instruct the user to, “Use additional code to identify body mass index (BMI), if known (Z68._).”
- C—M79.642 is the correct code for pain in the left hand.
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