M62. 82 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M62.
ICD-10-CM Code for Pain in unspecified hand M79. 643.
The patient's primary diagnostic code is the most important. Assuming the patient's primary diagnostic code is Z76. 89, look in the list below to see which MDC's "Assignment of Diagnosis Codes" is first. That is the MDC that the patient will be grouped into.
ICD-10 code R06. 02 for Shortness of breath is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
ICD-10-CM Code for Myalgia M79. 1.
606.
ICD-10 code: Z76. 9 Person encountering health services in unspecified circumstances.
Codes from category Z15 should not be used as principal or first-listed codes.
Z76. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
R06. 00 Dyspnea, unspecified - ICD-10-CM Diagnosis Codes.
ICD-10 code M62. 81 for Muscle weakness (generalized) is a medical classification as listed by WHO under the range - Soft tissue disorders .
09: Other forms of dyspnea.
ICD-10 code M79. 642 for Pain in left hand is a medical classification as listed by WHO under the range - Soft tissue disorders .
ICD-10 Code for Pain in unspecified knee- M25. 569- Codify by AAPC.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code. Type 1 Excludes.
The 2022 edition of ICD-10-CM T79.6 became effective on October 1, 2021.
A type 2 excludes note represents "not included here". A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code ( T79.6) and the excluded code together.
The 2022 edition of ICD-10-CM D68.69 became effective on October 1, 2021.
D50-D89 Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
When coding a poisoning or reaction to the improper use of a medication (e.g., overdose, wrong substance given or taken in error, wrong route of administration), first assign the appropriate code from categories T36-T50. The poisoning codes have an associated intent as their 5th or 6th character (accidental, intentional self-harm, assault and undetermined. If the intent of the poisoning is unknown or unspecified, code the intent as accidental intent. The undetermined intent is only for use if the documentation in the record specifies that the intent cannot be determined. Use additional code (s) for all manifestations of poisonings.
My rationale is that ICD-10 conventions themselves supersede even the Uniform Hospital Discharge Data Set (UHDDS) guidelines in the hierarchy of coding. The UHDDS definitions are the standards for interpreting the guidelines, but I do not believe they can directly contradict an instructional note in the ICD-10 system itself which includes those “code first” type of instructions.
If the doctor documented that the patient clearly would not have been admitted for the overdose and clearly was only being admitted for the Rhabdomyolysis/AKI, then you would have additional support for placing Rhabdomyolysis or AKI as the principal diagnosis. However, the way the physician listed the diagnoses in his or her discharge summary, I don’t think you are on solid grounds for making that suggestion.
A: In this case, the Official Guidelines for Coding and Reporting suggest that the poisoning from the heroin overdose should be sequenced as the principal diagnosis. The remaining sequela that came about after the overdose would be listed as secondary diagnoses. Make sure the AKI gets included in the final code set and doesn’t get skipped because it was omitted from the discharge summary.