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Icd 10ebook
Icd 10ebook
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ICD-10 y s
Doc u m e n t a t io n in 1 0 D a
Specia lty Clinica l Scen a rios
Oct Docu mentation Ga p A n a lysis
01 Glossa ry of Most Co m mon ICD-10 Codes
About this Workbook
Dear Provider,
ICD-10 is a watershed moment in US Healthcare. There is no consensus, at the moment, about the exact
magnitude of impact this transition will have on your practice. Thus, the writing on the wall is to prepare for
the worst. We agree, its easier said than done. But its possible. Simply use your time, whatever remains of it,
wisely.
If CureMD ICD-10 eBook was a good start to understand the transition process, this ICD-10 Documentation
Worksheet will help you in the last leg of the race and beyond.
We are condent that this publication will be your best friend for the next few months.
Best of Luck,
Team CureMD
01
We just made your Life Easier!
Providers will have to make the most adjustments post ICD-10 and have the least time
to prepare for it. Read on for a comprehensive ICD-10 Documentation coverage.
Clinical Scenario
This section has sample, outpatient focused, scenarios that illustrate the proper level of detail
required for a specic diagnosis; for creating an acceptable claim for the service rendered.
02
ICD-10 Introduction
03
How is this Code Set Different?
The ICD-10 code set is structurally and conceptually different from its ICD-9 counterpart. This eBook has been created with the purpose to
notify, educate, and train your team so that you can effectively manage clinical documentation for your specialty prior to October 1, 2015.
More complex codes 1st digit: alpha/numeric, digits 2-5: numeric 1st digit: alpha, digits 2-3: numeric, digits 4-7:
alpha/numeric
Allow addition Limited space for new codes Flexibility for code addition
Have laterality Lacks laterality Codes differ for different sides of the body
X X X X X X X
Category Etiology Anatomic Severity Extension
04
Gap analysis of Physician Documentation
1. Step 1 is to see how your practice is currently documenting records. View several patient encounters and check
how well your documentation would fare with respect to the ICD-10 requirements. This will help identify
inadequacies in your existing documentation.
2. Begin implementing the ICD-10 documentation requirements right now; this way youll be able to avert much
of the pressure the October 1 conversion will bring. This would mean that youd have to document more
information for every encounter, even before October 1, however; you'd end up getting more practice.
Post-October Review
3. After the conversion date, you must periodically review your documentation to identify areas where your staff
is falling behind. Your EHR Report & Analytics feature should help you with this.
05
Where do you stand?
For any process, preparation is the key. ICD-10 is no different; the more time you spend, the better off youll be. Get
acquainted with the documentation requirements, the new codes, and a reformed practice workow for the conversion.
This e-book has been designed to assist your specialty in understanding the documentation requirements for ICD-10,
introduce you to the new codes that your practice will need to learn, and prepare you for a smoother ICD-10 transition. If
you require additional guidance , you can contact our ICD-10 implementation experts.
For example, a mere pain in limb associated with ICD-9 code 729.5 will not be enough to get you paid. For your coder to
send out the correct code, you will have to provide a more detailed account specifying which limb has been affected (arm,
leg, etc).
Additionally, if the pain is in the left upper arm, its code will differ from that of the patients left arm, the code for the right
upper arm wont be the same as pain in ngers, thighs, and so on. In short, if youre not specic in your documentation, your
billers wont have much of a chance of getting you reimbursed for services provided.
More is better . Dont leave out the small details, as they could be crucial for coding
06
Must Know Secrets for Easier
EHR Documentation
01 02 03 04 05
Family Medicine OB/GYN Dermatology Pediatrics Cardiology
08
Family Medicine
10
Documentation Analysis
11
Clinical Scenario
Chief Complaint
Stomach ache, feeling gassy and queasy.
History
40 year old Caucasian male with mid abdominal epigastric pain, coupled with
severe vomiting and nausea; not able to keep down any liquid or food. Pain is
severe & constant.
Weight loss over past 40 days estimated at around 17 pounds.
Patient believes consuming around 6 pieces of meat at home four days ago for
lunch at home triggered his symptoms.
Patient validated alcohol dependence history. Consuming 4-5 beers per day at the
moment, previously 9-11 each day around six months ago. Reports being nauseous,
sweaty & shaky when he does not consume beer.
Exam
Vitals: temperature 99.8; otherwise normal.
Mild-jaundice noted.
Oral mucosa dry, chapped lips, decreased skin turgor.
Abdomen distended & tender across upper abdomen. Guarding is present. Bowel sounds diminished
in all (4) quadrants.
12
Clinical Scenario
ICD-10 CM Impacts
Clinical Documentation
Pain needs to be described comprehensively (specically), and including location details to the maximum extent.
Alcohol-related disorders must be distinguished according to: use, abuse, & dependence. ICD-10-CM terminology and requirements for coding substance
abuse disorders is new. In this case, based on suspected acute pancreatitis, and his alcohol consumption status, the relevant alcoholism code is given.
Abdominal tenderness should be included in coding. While more specicity is preferred (including laterality) to generate a more specic code, R10.819 for
Abdominal tenderness, unspecied site is used here as we do not have more information to make a more thorough judgment.
789.60 Abdominal tenderness, unspecied site R10.819 Abdominal tenderness, unspecied site
Other Impacts
None
13
Common Codes
List of the most common ICD-10 codes for the Family Practice specialty.
*Always utilize more specic codes rst.
ABDOMINAL PAIN ICD-9-CM Codes: 789.00 - 789.09 ACUTE RESPIRATORY ICD-9-CM Codes: 462, 465.9, 466.0
INFECTIONS
ICD-10-CM Codes Diagnosis ICD-10-CM Codes Diagnosis (Specify organisms where possible)
R10.0 Acute abdomen J02.8 Acute pharyngitis due to other specied organisms
R10.10 Upper abdominal pain, unspecied J02.9* Acute pharyngitis, unspecied
R10.11 Right upper quadrant pain J06.9* Acute upper respiratory infection, unspecied
R10.12 Left upper quadrant pain J20.0 Acute bronchitis due to Mycoplasma pneumonia
R10.13 Epigastric pain J20.1 Acute bronchitis due to Hemophilus inuenza
R10.2 Pelvic and perineal pain J20.2 Acute bronchitis due to streptococcus
R10.30 Lower abdominal pain J20.3 Acute bronchitis due to coxsackievirus
R10.31 Right lower quadrant pain J20.4 Acute bronchitis due to parainuenza virus
R10.32 Left lower quadrant pain J20.5 Acute bronchitis due to respiratory syncytial virus
R10.33 Periumbilical pain J20.6 Acute bronchitis due to rhinovirus
R10.84 Generalized abdominal pain J20.7 Acute bronchitis due to echovirus
R10.9* Unspecied abdominal pain J20.8 Acute bronchitis due to other specied organisms
J20.9* Acute bronchitis, unspecied
14
Common Codes
BACK AND NECK PAIN ICD-9-CM Codes: 723.1, 724.1, 724.2, 724.5 CHEST PAIN ICD-9-CM Codes: 786.50 - 786.59
(SELECTED)
ICD-10-CM Codes Diagnosis ICD-10-CM Codes Diagnosis
DIABETES MELLITUS W/O ICD-9-CM Code: 250.00 GENERAL MEDICAL EXAMINATION ICD-9-CM Code: V70.0
COMPLICATIONS TYPE 2
ICD-10-CM Codes Diagnosis ICD-10-CM Codes Diagnosis
Encounter for general adult medical exam
E11.9 Type 2 diabetes mellitus Z00.00 without abnormal ndings
15
OB/GYN
Laterality Nutritional
Bilateral Specify deciencies
Right Malnutrition: complications & severity
Left Overweight vs. obesity vs. morbid obesity
Multiple locations
Female Reproductive
Infections
Linkage between disease process & infective organism Infertility source
Prolapsed extent & location: Midline/ lateral, incomplete/
Disease Status complete
Acute
Sub-acute Neoplasms
Intermittent Malignant vs. benign, in situ, primary, secondary
Transient Locations details, laterality
Chronic Overlapping vs. distinct locations
Recurrent
Obstetrics Diabetes
C-section reason (as principal diagnosis) Type I, Type II, or due to other cause (disease/ drug)
Trimester (when complication arose) Due to other disease/ drug: specify other disease, or drug/
Abortion: completion, success, & related complications chemical if any
High-risk pregnancy: Hx of infertility, molar, or Linkage with complications
ectopic pregnancy Gestational vs. pre-pregnancy
Condition: gestational vs. preexisting (if gestational
diabetes is controlled)
Others
Multiples: Fetuses, fetus identication Metabolic Disease: Hyper- & Hypo- dont document ^ or v
(one with complication) Skin: Disease linkage with cause or infectious agent
17
Clinical Scenario
Chief Complaint
Vaginal discharge accompanied by odor since one week.
History
32 year old female, mother, complains of a watery, whitish-gray vaginal discharge, accompanied by a
bitter-shy smell and an itchy vulva. Symptoms were observed about 8 days back. She afrms that symptoms
have never appeared before, and that she tried self-treatment using an OTC (over the counter) yeast mix
ture about 5 days ago. Method was ineffective.
LMP: two-weeks ago: normal. Mammograms: none, previously. Previous PAP examination 7 months ago:
normal.
Social history: Physically and sexually active. Patient is in a sexually active relationship with protection with
new male partner since 6 weeks (one partner). Denies history or presence of STIs. Informs of regular bubble
baths & douching.
She does not take alcohol, tobacco, or other drugs.
Patient is not immunized for Human papillomavirus (HPV).
Exam
Vitals: T 98.7, BP 126/62, Weight: 115 lbs.
Well groomed, A&O x3.
Pelvic: External exam-vulvar redness, negative for vulvar edema, and negative for adherent
white clumps.
Bimanual exam: patient has no pelvic tenderness, the uterus (smooth) & adnexa are both sized
normal, and ovaries arent palpable.
Speculum exam: pink vaginal-walls, cervix is intact, os is closed, thin gray-white & sharp, foul
smelling discharge observed in vaginal canal. Swab specimen has been obtained for her
microscopy exam.
In-ofce lab tests: Urine hCG - Negative; Yeast - negative; Wet Prep - Positive whiff test,
leukocytes and clue cells present; Vaginal-pH - elevated.
Summary of ICD-10-CM-Impacts
Clinical Documentation
1. In ICD-10-CM, there are 4 choices in contrast to ICD-9s single code for Vaginitis and vulvovaginitis, unspecied, 616.10. The alternatives are N76.0 for
acute vaginitis, N76.1 subacute & chronic vaginitis; N76.2 acute vulvitis; & N76.3 subacute & chronic vulvitis. As the patient shows no trends or history of
ongoing care or previous episodes, we have selected Acute vaginitis.
2. Moreover, as bacterial vaginosis is not frequently connected to itching, irritation or soreness, it will be assigned a separate code.
3. Although bacterial vaginosis is not an STI. The physician has recommended refraining from intercourse.
4. In ICD-9, there are several vaccination codes while ICD-10 contains only one general code for immunization.
5. The note intentionally does not include a discussion of STI or reproductive planning as it is expected to be commonly denoted in the evaluation & counselling
of females of this age.
V04.89 Need for prophylactic vaccination and inoculation Z23 Encounter for Immunization
against other viral diseases
19
Common Codes
List of the most common ICD-10 codes for an Obstetrics & Gynecology practice.
*Always utilize more specic codes rst.
ABNORMAL FEMALE GENITAL CYTOLOGY ICD-9-CM Codes: 622.10, 622.11, 622.12,792.9, 795.01 - 795.19, 795.4
(excluding neoplasia and malignancy codes)
ICD-10-CM Codes Diagnosis
R87.610 Atypical squamous cells of undetermined signicance on cytologic smear of cervix (ASC-US)
R87.611 Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of cervix (ASC-H)
R87.612 Low grade squamous intraepithelial lesion on cytologic smear of cervix (LGSIL)
R87.613 High grade squamous intraepithelial lesion on cytologic smear of cervix (HGSIL)
R87.620 Atypical squamous cells of undetermined signicance on cytologic smear of vagina (ASC-US)
R87.621 Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H)
R87.622 Low grade squamous intraepithelial lesion on cytologic smear of vagina (LGSIL)
R87.623 High grade squamous intraepithelial lesion on cytologic smear of vagina (HGSIL)
R87.69 Abnormal cytological ndings in specimens from other female genital organs
R87.810 Cervical high risk human papillomavirus (HPV) DNA test positive
R87.811 Vaginal high risk human papillomavirus (HPV) DNA test positive
R87.820 Cervical low risk human papillomavirus (HPV) DNA test positive
R87.821 Vaginal low risk human papillomavirus (HPV) DNA test positive
20
Common Codes
EXCESSIVE, FREQUENT, GENERAL MEDICAL AND ICD-9-CM Codes: V70.0, V72.31, V72.32
AND IRREGULAR MENSTRUATION ICD-9-CM Codes: 626.2 - 626.6, 627.0 GYNECOLOGICAL EXAMINATIONS (excluding contraceptive and procreative encounter codes)
N92.0 Excessive & frequent menstruation with regular cycle Z00.00 Encounter for general adult medical exam without a ab
N92.1 Excessive & frequent menstruation with irregular cycle Z00.01 Encounter for general adult medical exam with ab
N92.2 Excessive menstruation at puberty Z01.411 Encounter for gynecological examination (general) (routine) w ab
N92.3 Ovulation bleeding Z01.419 Encounter for gynecological examination (general) (routine) w/o ab
N92.4 Excessive bleeding in the premenopausal period Z01.42 Encounter for cervical smear to conrm ndings of recent normal
smear following initial abnormal smear
N92.5 Other specied irregular menstruation
N92.6* Irregular menstruation, unspecied *abnormal ndings=ab
21
Dermatology
Specialty: Dermatology
The clinical staff at a Dermatology practice must adequately document these elds in order to fulll the ICD-10 coding requirements:
Laterality Diabetes
Bilateral Type I, Type II, or due to other cause (disease/ drug)
Right Linkage with complications
Left
Skin
Multiple locations
Disease linkage with cause or infectious agent
Infections Pressure ulcer: laterality, stage (I to IV), & site
Linkage between disease process & infective organism Non pressure ulcer (chronic): laterality, site, skin breakdown,
muscle necrosis, bone necrosis, fat-layer exposed
Disease Status
Primary General Injuries
Secondary Location: head, proximal, shaft, etc
Acute Care episode: initial / subsequent/ sequela
Intermittent Document reason for contact dermatitis
Transient
Injury Cause
Chronic
Reason: e.g. fell from stairs
Recurrent
Location: e.g. stadium
Musculoskeletal Activity: e.g. collecting tickets
Previous trauma, infection, other disease courses External cause: civil, military, leisure, work related
Disease linkage with cause or infectious agent Neoplasms
Primary, secondary, or post-traumatic disease Malignant vs. benign, in situ, primary, secondary
Cause: pathological fracture due to osteoporosis, Location details
neoplastic disease, or other Overlapping vs. distinct locations
Arthritis: osteoarthritis vs. rheumatoid
23
Clinical Scenario
Subjective
A 78-year-old returning female patient came in today on Dr. Andrews request. Patient recovering from a fall (from stairs) while walking in her home. Patient
complaining of pain in lower back; just above her hips.
Following up last week on an ulcer, the nurse requested Dr. Andrew to inspect the patients nose which contains a multicolored lesion with unusual borders.
It is usually covered using makeup. Patient said a beauty mark was always present there, but that it grew recently (over several months), and
changed color.
We conducted a biopsy last week, which is being returned to the patient along with its results. The complete lesion wasnt taken last week; because of its size.
All other systems came out as negative.
Objective
Vitals: BP 120/80, temperature 98.9, and BMI 20.1.
Exam
GEN: Patient is alert but appears somewhat uncomfortable.
CV: No murmur reported.
RESP: No crackles, wheezing, or rales.
ABD: Abdomen not tender to palpitation. Though, pressure on ulcer center on sacrum was present
(specify). Fat layer was exposed (specify detailed stage) because patients skin was vulnerable to
breakdown and very thin. There was not any exposure, nor was there necrosis of muscle or bone.
EXT: No bruising or edema.
FACE: Lesion observed on her nose on the right side of the nasal bridge. It was above the supratip
break on the other side of the nose to the tear trough of the patients right side (location in detail).
About 2.6 cm across, and having a reddish appearance lacking clear borders.
24
Common Codes
List of the most common ICD-10 codes for Dermatology.
*Always utilize more specic codes rst.
25
Pediatrics
Laterality Neoplasms
Bilateral Type: in situ, malignant vs. benign, primary, & secondary
Right Locations: overlapping & distinct
Left Leukemia: in relapse or in remission
Multiple Locations
Nervous System
Infections Primary vs. secondary: cause & disease
Linkage: disease process & infective organism Epilepsy type: seizure is a single event (or yet to be diagnosed),
seizure disorder is epilepsy
Disease Status Drug-induced disorders: drug name / type
Acute Migraine type & aura presence
Recurrent Hydrocephalus type
Intermittent Intractable disease presence
Chronic Paralysis: type & level
Transient
Digestive System
Newborns Linkage of complications with disease: bleeding, stula,
Newborn-conditions codes differ from 28 day (and perforation, obstruction, abscess, and gangrene
older) babies Hernia: unilateral vs. bilateral
Specify maternal conditions: affected & suspected Constipation: slow transit / outlet dysfunction
27
Documentation Analysis
Circulatory System
Rheumatic vs. nonrheumatic disease
Musculoskeletal
Previous trauma, infection, other disease courses
Disease linkage with cause or infectious agent
Primary, secondary, or post-traumatic disease
Arthritis: osteoarthritis vs. rheumatoid
Diabetes
Type I, Type II, or due to other cause (disease/ drug)
Linkage with complications
Skin
Disease linkage with cause or infectious agent
General Injuries
Location: head, proximal, shaft, etc
Care episode: initial / subsequent/ sequela
Genitourinary
Disease: primary vs. secondary
Disease linkage with cause or infectious agent
28
Clinical Scenario
Chief Complaint
Watery (thin) diarrhea accompanied by vomiting and fever since 1 day.
History
31 month-old female came in with dehydration after 2 days of vomiting, watery diarrhea, & fever. She did not show nauseous symp-
toms, but she kept crying without any tears. According to her father, she is unimmunized for all vaccines. Her parents also reported
that she was urinating lesser than before. The father is of the view that symptoms began after a swimming pool outing with her siblings
where she could have swallowed water from the swimming pool.
Exam
She is in evident acute distress, appears dehydrated, and is continuously holding her stomach.
Vitals: T 100.0, BP 90/55, P 135, R 36. BS hyperactive times all 4 quadrants. Abdomen appears swollen and diffusely tender to
palpation. Rebound tenderness, organomegaly or masses not present.
Both mouth and tongue are dry, and her membranes are mildly pale. Her capillary rell is less than 3 seconds. Skin is dry and skin
turgor poor.
29
Clinical Scenario
ICD-10-CM Impacts
Clinical Documentation
1. The symptoms of dehydration, diarrhea, dry mouth, vomiting, and fever must be coded. After the determination of nausea (if the patient feels nauseous), the
appropriate codes will be entered. Nausea & vomiting differ in codes, as does vomiting unaccompanied by nausea.
2. Establishing why the patient remains unimmunized is necessary for documentation. It is important to determine why the patient was unimmunized & to
document it here as this is a signicant public health issue. ICD-10-CM has multiple codes to explain why a child has not been immunized.
Other Impacts
None.
30
Common Codes
List of the most common ICD-10 codes for a Pediatrics practice.
*Always utilize more specic codes rst.
ABDOMINAL PAIN ICD-9-CM Codes: 789.00 - 789.09 ACUTE BRONCHITIS ICD-9-CM Codes: 466.0, 466.11, 466.19
CHEST PAIN ICD-9-CM Codes: 786.50 - 786.59 CHEST PAIN ICD-9-CM Codes: 786.50 - 786.59
31
Common Codes
ASTHMA ICD-9-CM Codes: 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.81, 493.82 , 493.90, 493.91, 493.92
R51 Headache
without complications
32
Common Codes
CHRONIC TUBOTYMPANIC CHRONIC ATTICOANTRAL SUPPURATIVE
SUPPURATIVE OTITIS MEDIA ICD-9-CM Code: 382.01 OTITIS MEDIA ICD-9-CM Code: 382.2
H66.10* Chronic tubotympanic suppurative otitis media, unspecied H66.20* Chronic atticoantral suppurative otitis media, unspecied ear
H66.11 Chronic tubotympanic suppurative otitis media, right ear H66.21 Chronic atticoantral suppurative otitis media, right ear
H66.12 Chronic tubotympanic suppurative otitis media, left ear H66.22 Chronic atticoantral suppurative otitis media, left ear
H66.13 Chronic tubotympanic suppurative otitis media, bilateral H66.23 Chronic atticoantral suppurative otitis media, bilateral
33
Cardiovascular
Specialty: Cardiovascular
The clinical staff at a cardiovascular practice must adequately document these elds in order to fulll the ICD-10 coding requirements:
35
Clinical Scenario
Chief Complaint
Dr. Andrews said that you need to check my hypertension before my surgery.
History
77-year-old male patient scheduled for a Transurethral resection of the prostate (TURP) in 6 days. Dr. Andrews asked
for the patient to be evaluated for hypertension & cardiac clearance assessment before surgery.
Inferior wall MI, about one year and two months ago, received thrombolytic therapy which resolved his symptoms
completely. The most recent EF, last month, was 50%.
Patient partakes in swimming, golng, and walking regularly; denies shortness of breath (SOB) with exertion.
Patient has no prior history of cerebrovascular disease, and is also negative for CHF,DM, agina, or renal failure.
Patient does have a history of essential hypertension for which he had been prescribed one daily dose of metoprolol
succinate by his primary care physician; however, he has not been taking it citing expense related issues.
Exam
Patient is in no acute distress.
Vitals: BP at 157/92 is elevated. Weight & height are ne for age.
EKG: non-specic t-wave changes.
PE is normal, chest clear, and no pedal edema.
Labs: creatinine is at 1.5, slightly increased from his baseline, and could be a possible indicator of early renal
insufciency.
36
Summary of ICD-10-CM Impacts
Clinical Documentation
1. Documenting the need of the clinical encounter is essential, because the coders assign different codes for initial vs. routine vs. surgery clearance visits.
2. According to the lab results, there is a slight enhancement in the patients baseline, and could be an indicator of early renal insufciency. This allows the
physician to report additional diagnoses that add validity to the abnormal test result.
3. If recognized, it is essential to document the patients compliance with their prescribed medications. ICD-10-CM introduces a relatively new concept of
underdosing, which can be captured in alongside diagnoses; in this case that is of metoprolol succinate. Also with underdosing, the physician must document if
the undedosing is recurrent or new.
4. ICD-10 also allows coders to Use Additional Code notes beneath the Hypertensive diseases (I10-I15). If recognized, you can document if patients have:
exposure to environmental tobacco smoke, occupational exposure to environmental tobacco smoke, history of tobacco use, tobacco use, and/or dependence.
794.31 Nonspecic abnormal Electrocardiogram (ECG)(EKG) R94.31 Abnormal electrocardiogram [ECG] [EKG]
794.4 Nonspecic abnormal results of function study of kidney R94.4 Abnormal results of kidney function studies
Other Impacts
In Medicare Advantage Risk Adjustment plans, specically hierarchical condition categories (HCC), some diagnosis codes are considered to determine severity
of risk, illness, and resource utilization. These HCC effects are unnoticed by many in the ICD-9 to ICD-10 conversion. For this, physicians need to examine
patients each year and subsequently document the latters chronic and acute condition statuses accordingly. These HCC codes are considered payment
multipliers.
37
Common Codes
List of the most common ICD-10 codes for the Cardiovascular specialty.
*Always utilize more specic codes rst.
38
Common Codes
CARDIAC ARRHYTHMIAS ICD-9-CM Codes: 427.41, 427.42, 427.60, CHEST PAIN ICD-9-CM Codes: 411.1, 413.1, 413.9, 786.50 - 786.59
(OTHER) 427.61, 427.69, 427.81, 427.89, 427.9
39
Need Help?
Request Demo to see how CureMD can help your practice through the
ICD-10 transition plus increase your practices revenue, accelerate cash
ow and cut costs.
Get in touch with our ICD-10 experts at (212) 852 0279 Ext 379.
References
Getting Specific: ICD-10 for Dermatology, Nextech, 2015 Retrieved from: http://www.nextech.com/blog/getting-specific-icd-10-for-dermatology
ICD-10: Interactive Training Guide, Pulse, 2014. Retrieved from: http://www.pulseinc.com/wp-content/uploads/2014/10/eBook_ICD-10_10232014.pdf
Road to 10: The Small Physician Practice's Route to ICD-10. Retrieved from: http://www.roadto10.org/
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