Cardiology - PowerPoint Presentation

Slide1

Cardiology

ICD-10 CM TrainingSlide2

ICD-10-CM will be valid for dates of service on or after

October 1, 2015Outpatient dates of service of October 1, 2015 and beyond. Inpatient hospital service claims,

is effective for dates of discharge after September 30, 2015

ICD-10-CM Compliance DatesSlide3

Covered EntitiesEveryone covered by the

Health Insurance Portability Accountability Act (HIPPA)Non-Covered EntitiesWorker’s CompensationAuto InsuranceNon covered HIPAA entities are exempt but are encouraged to adapt the new code set

Covered and Non-Covered EntitiesSlide4

21 Chapters

Alpha-numeric codes; not case-sensitiveCodes begin with Alpha letter, A-Z, excluding UCommon errorsI verses 1O verses 0

“X” Placeholder3 to 7 characters Decimal following 3rd character

ICD-10 Code StructureSlide5

Placeholder “X”Used for future expansion of a code

Fills in empty characters when a 6th and/or 7th character applyThe placeholder may be used in different scenarios but should never serve as the final character

.Example: W19.XXXA Unspecified fall, Initial Encounter

ICD-10 Code StructureSlide6

7

th CharacterProvides specified information regarding the clinical visitIs required for certain categories and must be reported in the seventh positionMay be alpha or numeric

Has different meanings depending on the coding category

ICD-10 Code StructureSlide7

Laterality

Some ICD-10-CM codes indicate laterality, specifying whether the condition occurs on the left, right or is bilateral.

If no bilateral code is provided and the condition is bilateral, assign separate codes for both the left and right side. If the side is not identified in the medical record, assign the code for the unspecified side

. OGCR section 1.B.13

ICD-10 Code StructureSlide8

“Other” CodesCodes titled “other” or “other specified” are for use when the information in the medical record provides detail for which a specific code does not exist.

“Unspecified” CodesCodes titled “unspecified” are for use when the information in the medical record is insufficient to assign a more specific code.

OGCR section 1.A.9.a.b

ICD-10 Code StructureSlide9

Excludes Notes

Excludes1A type 1 Excludes note is a pure excludes noteIt means “NOT CODED HERE”The code excluded should never be used at the same timeWhen two conditions cannot occur togethe

rExcludes2Represents “Not included here”The condition excluded is not part of the condition represented by the codeIt is acceptable to use both the code and the excluded code together, when appropriate

OGCR section 1.A.12.a.b

ICD-10 StructureSlide10

“Code First” and “Use Additional Code”ICD-10 has a coding convention that requires the underlying condition be sequenced first followed by the manifestation.

These instructional notes indicate the proper sequencing order of the codes.OGCR section 1.A.13The “-” indicates there are additional reporting options

ICD-10 Code StructureSlide11

Most Common Diagnosis Codes Slide12

Chest pain

ICD-9 Code

ICD-10 Code

Description

Excludes1

Excludes2

786.50

R07.9

Chest pain, unspecified

epidemic myalgia (B33.0)

jaw pain R68.84

pain in breast (N64.4)

There are more

specific code choice selections:

786.51

R07.2

Precordial pain

786.52

R07.1

Chest pain on breathing

786.52

R07.81

Pleurodynia

786.59

R07.82

Intercostal pain

786.59

R07.89

Other chest painSlide13

TypeChest pain due to myocardial ischemia

Chest pain on breathingIntercostal painPleurodyniaPrecordial chest pain

Use of a symptom code with a definitive diagnosis codeCodes for signs and symptoms may be reported in addition to a related definitive diagnosis when the sign or symptom is not routinely associated with that diagnosis, such as the various signs and symptoms associated with complex syndromes. The definitive diagnosis code should be sequenced before the symptom code.

Signs or symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.OGCR Section I.C.18.b

Documentation TipsSlide14

Atherosclerotic heart disease of native coronary artery without angina pectoris

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2414.00

I25.10

Atherosclerotic heart disease of native coronary artery without angina pectoris

Applicable To:

Atherosclerotic heart disease NOS

N/A

atheroembolism

(I75.-)

atherosclerosis of coronary artery bypass graft(s) and transplanted heart (I25.7-)

414.01

I25.10

No

ICD-10 code exists for unspecified vessel; native or bypass graft must be indicated

Use additional code, if applicable, to identify:

coronary atherosclerosis due to calcified coronary lesion (I25.84)

coronary atherosclerosis due to lipid rich plaque (I25.83)

chronic total occlusion of coronary artery (I25.82)

exposure to environmental tobacco smoke (Z77.22)

history of tobacco use (Z87.891)

occupational exposure to environmental tobacco smoke (Z57.31)

tobacco dependence (F17.-)

tobacco use (Z72.0)Slide15

Associated Artery/Lesion TypeNative artery

Bypass graftBypass graft, autologous arteryBypass graft, autologous veinBypass graft, nonautologous biological

Bypass graft, otherDue to calcified coronary lesionDue to lipid rich plaqueNative vs Transplanted Heart

Associated anginaWithout anginaWith unstable anginaWith angina and spasm

Artherosclerotic

Heart Disease

Coronary Artery Documentation TipsSlide16

Atrial fibrillation

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2427.31

I48.91

Unspecified atrial fibrillation

N/A

N/A

There are more specific code choice selections available below:

I48.0

Paroxysmal atrial fibrillation

I48.1

Persistent atrial fibrillation

I48.2

Chronic atrial fibrillation

Permanent atrial fibrillationSlide17

TypeChronic (I48.2)

Paroxysmal (I48.0)Persistent (I48.1)

Atrial

Fibrillation

Documentation

TipsSlide18

Cardiac Arrhythmias

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2427.89

I49.8

Other specified cardiac arrhythmias

Applicable To:

Coronary sinus rhythm disorder

Ectopic rhythm disorder

Nodal rhythm disorder

bradycardia NOS (R00.1)

neonatal dysrhythmia (P29.1-)

sinoatrial bradycardia (R00.1)

sinus bradycardia (R00.1)

vagal bradycardia (R00.1)

N/A

427.89

R00.1

Bradycardia, unspecified

Applicable To:

Sinoatrial bradycardia

Sinus bradycardia

Slow heart beat

Vagal bradycardia

abnormalities originating in the perinatal period (P29.1-)

specified arrhythmias (I47-I49)

neonatal bradycardia (P29.12)

N/A

There are

more

code

choice selections below:

427.9

I49.9

Cardiac arrhythmia, unspecifiedSlide19

TypeAtrial fibrillation

Atrial flutterPremature depolarizationRe-entry ventricular arrhythmiaSick sinus syndromeSupraventricular tachycardiaVentricular fibrillation

Ventricular flutterVentricular tachycardiaParoxysmal tachycardiaCardiac arrhythmia

Cardiac Arrhythmias Documentation

TipsSlide20

Fibrillation TypeChronic

ParoxysmalPersistentFlutter TypeTypicalAtypical

Premature Depolarization TypeAtrialJunctionalVentricular

Cardiac Arrhythmias Documentation

TipsSlide21

R00.1 - Use Additional code

for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)I49 - Code first cardiac arrhythmia complicating:Abortion or ectopic or molar pregnancy (O00-O07, O08.8)Obstetric surgery and procedures (O75.4)

Cardiac Arrhythmias Documentation

TipsSlide22

Abnormal electrocardiogram [ECG] [EKG]

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2794.31

R94.31

Abnormal electrocardiogram [ECG] [EKG]

long QT syndrome (I45.81)

abnormal findings on antenatal screening of mother (O28. -)

abnormal findings on antenatal screening of mother (O28.-)

certain conditions originating in the perinatal period (P04-P96)

signs and symptoms classified in the body system chapters

signs and symptoms of breast (N63, N64.5)Slide23

Symptom Codes Codes that describe symptoms and signs are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider.

Use of a symptom code with a definitive diagnosis codeCodes for signs and symptoms may be reported in addition to a related definitive diagnosis when the sign or symptom is not routinely associated with that diagnosis code.Signs or symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.

Documentation TipsSlide24

Aortic Valve Disorders

Nonrheumatic

ICD-9 Code

ICD-10 CodeDescription

Excludes1

Excludes2

424.1

I35.0

Nonrheumatic

aortic (valve) stenosis

Aortic

valve disorder of unspecified cause but with diseases of mitral and/or tricuspid valve(s) (I08.-)

Aortic valve disorder specified as congential (Q23.0, Q23.1)

Aortic valve disorder specified as rheumatic (I06.-)

Hypertrophic subaortic stenosis (I42.1)

N/A

There are more specific code choice selections below:

424.1

I35.1

Nonrheumatic

aortic (valve) insufficiency

424.1

I35.2

Nonrheumatic

aortic (valve) stenosis with insufficiency

424.1

I35.8

Other

nonrheumatic

aortic valve disorders

424.1

I35.9

Nonrheumatic

aortic valve disorder, unspecifiedSlide25

TypeStenosis

InsufficiencyStenosis with insufficiencyList other

Documentation TipsSlide26

Shortness of breath

ICD-9 Code

ICD-10 Code

Description

Excludes1

Excludes2

786.05

R06.02

Shortness of breath

abnormalities originating in the perinatal period (P29.1-)

specified arrhythmias (I47-I49)

acute respiratory distress syndrome (J80)

respiratory arrest (R09.2)

respiratory arrest of newborn (P28.81)

respiratory distress syndrome of newborn (P22.-)

respiratory failure (J96.-)

respiratory failure of newborn (P28.5)

tachypnea NOS (R06.82)

transient tachypnea of newborn (P22.1)

N/A

There are more specific code choice selections below:

786.09

R06.00

Dyspnea,

unspecified

786.02

R06.01

Orthopnea

786.09

R06.09

Other forms

of dyspneaSlide27

Dyspnea TypeShortness of breath

OrthopneaOther forms

Documentation TipsSlide28

Ventricular premature depolarization

ICD-9 Code

ICD-10 Code

Description

Excludes1

Excludes2

427.69

I49.3

Ventricular premature depolarization

bradycardia NOS (R00.1)

neonatal

dyrhythmia (P29.1-)

sinoatrial bradycaria (R00.1)

sinus

bradycaria (R00.1)

vagal bradycaria (R00.1)

N/A

There are more specific code choice selections below:

427.69

I49.49

Other premature depolarization

Code first cardiac arrhythmia complicating:

Abortion or ectopic or molar pregnancy

(O00.-O07, O08.8)

Obstetric surgery and procedures (O75.4)Slide29

TypeAtrial premature depolarization (I49.1)

Junctional premature depolarization (I49.2)Ventricular premature depolarization (I49.3)Other specified cardiac arrhythmias (I49.8)

Documentation TipsSlide30

Ventricular tachycardia

ICD-9 Code

ICD-10 Code

Description

Excludes1

Excludes2

427.1

I47.2

Ventricular tachycardia

tachycardia NOS (R00.0)

Sinoatrial tachycaria (R00.0)

sinus tachycardia (R00.0)

Code first cardiac arrhythmia complicating:

Abortion or ectopic or molar pregnancy (O00.-O07, O08.8)

Obstetric surgery and procedures (O75.4)Slide31

Other cardiomyopathies

ICD-9 Code

ICD-10 Code

Description

Excludes1

Excludes2

425.4

I42.8

Primary cardiomyopathies, NEC

Ischemic cardiomyopathy

(I25.5)

Peripartum cardiomyopathy (O90.3)

Ventricular hypertrophy (I51.7)

There are more specific code choice selections below:

425.4

I42.2

Other hypertrophic cardiomyopathy

425.4

I42.5

Other restrictive cardiomyopathy

425.4

I42.9

Cardiomyopathy,

unspecified (familial)(idiopathic)

Code first

pre-existing cardiomyopathy complicating pregnancy and

puerperium

(O99.4)Slide32

Syncope and collapse

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2780.2

R55

Syncope and collapse

Applicable To:

Blackout

Fainting

Vasovagal attack

cardiogenic shock (R57.0)

carotid sinus syncope (G90.01)

heat syncope (T67.1)

neurocirculatory asthenia (F45.8)

neurogenic orthostatic hypotension (G90.3)

orthostatic hypotension (I95.1)

postprocedural shock (T81.1-)

psychogenic syncope (F48.8)

shock NOS (R57.9)

shock complicating or following abortion or ectopic or molar pregnancy (O00-O07, O08.3)

shock complicating or following labor and delivery (O75.1)

Stokes-Adams attack (I45.9)

unconsciousness NOS (R40.2-)

abnormal findings on antenatal screening of mother (O28.-)

certain conditions originating in the perinatal period (P04-P96)

signs and symptoms classified in the body system chapters

signs and symptoms of breast (N63, N64.5)Slide33

TypeCarotid sinus syncope (G90.01)

Heat syncopeInitial encounter (T67.1XXA)Subsequent encounter (T67.1XXD)Sequela (T67.1XXS)

Psychogenic syncope (F48.8)Stokes-Adams syncope (I45.9)Vasovagal syncope (R55)

Documentation TipsSlide34

Cardiomegaly

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2429.3I51.7

Cardiomegaly

Applicable To:

Cardiac dilatation

Cardiac hypertrophy

Ventricular dilatation

N/A

certain conditions originating in the perinatal period (P04-P96)

certain infectious and parasitic diseases (A00-B99)

complications of pregnancy, childbirth and the puerperium (O00-O9A)

congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)

endocrine, nutritional and metabolic diseases (E00-E88)

injury, poisoning and certain other consequences of external causes (S00-T88)

neoplasms (C00-D49)

symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

systemic connective tissue disorders (M30-M36)

transient cerebral ischemic attacks and related syndromes (G45.-)Slide35

Hypertension

ICD-9 Code

ICD-10 Code

Description

Excludes1Excludes2

401.1

401.9

401.0

I10

Essential (Primary)

Hypertension

Includes: high blood pressure, Hypertension (arterial) (benign) (essential) (malignant) (systemic)

Hypertensive disease complicating pregnancy, childbirth and the puerperium

(O10-O11, O13-O16)

Neonatal hypertension (P29.2)

Primary pulmonary hypertension (I127.0)

Essential (primary) hypertension involving vessels

of brain (I60-I69)

Essential (primary) hypertension involving vessels of eye (H35.0-)

Hypertensive

Diseases

Categories (I10-I15)

The use additional codes and Excludes1 codes apply for all categories.

(I10-I15)

Use additional code to identify:

Exposure to environmental tobacco smoke (Z77.22)

History

of tobacco use (Z87.891)

Occupational exposure to environmental tobacco smoke (Z57.31)

Tobacco dependence (F17.-)

Tobacco use (Z72.0)

Hypertensive

disease complicating pregnancy, childbirth and the puerperium (O10-O11. O13-O16)

Neonatal hypertension (P29.2)

Primary Pulmonary hypertension (I27.0)Slide36

Hypertension cont.

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2402.01

402.11

402.91

I11.0

Hypertensive Heart Disease with heart

failure

Use additional code to identify type of heart failure (I50.-)

N/A

N/A

402.00

402.10

402.90

I11.9

Hypertensive

Heart Disease without heart failure

N/A

N/A

403.01

403.11

403.91

I12.0

Hypertensive Chronic Kidney Disease with stage 5 Chronic Kidney

Disease or end stage renal disease.

Use additional code to identify the stage of chronic kidney disease (N185.5, N18.6)

Hypertension

due to Kidney Disease (I15.0, I15.1)

Renovascular Hypertension (I15.0)

Secondary Hypertension (I115.-)

Acute Kidney Failure (N17.-)

403.00

403.10

403.90

I12.9

Hypertensive Chronic

Kidney Disease with stage 1-4 Chronic Kidney Disease, or unspecified Chronic Kidney Disease.

Use additional code to identify the stage of chronic kidney disease (N18.1-N18.9)

Hypertension

due to Kidney Disease (I15.0, I15.1)

Renovascular Hypertension (I15.0)

Secondary Hypertension (I115.-)

Acute Kidney Failure (N17.-)Slide37

Hypertension cont.

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2404.01

404.11

404.91

I13.0

Hypertensive heart and chronic kidney disease with heart failure and stage 1-4 chronic

kidney disease, or unspecified chronic kidney disease

Use additional code to identify type of heart failure (I50.-)

Use additional code to identify stage of chronic kidney disease (N18.1-NN18.4, N18.9)

N/A

N/A

404.00

404.10

404.90

I13.10

Hypertensive Heart and Chronic Kidney Disease without heart failure, with stage 1-4 chronic kidney disease, or unspecified chronic kidney disease.

Use additional code to identify the stage of chronic kidney disease

(N18.1-N18.4, N18.9)

N/A

N/A

404.02

404.12

404.92

I13.11

Hypertensive heart and chronic kidney disease without

heart failure, with stage 5 chronic kidney disease or end stage renal disease.

Use additional code to identify the stage of chronic kidney disease (N18.5, N18.6)

N/A

N/A

404.03

404.13

404.93

I13.2

Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease.

Use additional code to identify type of heart failure (I50.-)

Use

additional code to identify the stage of chronic kidney disease (N18.5. N18.6)

N/A

N/ASlide38

Hypertension

cont.

ICD-9 Code

ICD-10 CodeDescriptionExcludes1

Excludes2405.01405.11

405.91

I15.0

Renovascular

Hypertension

Code also underlying condition

Postprocedural hypertension (I97.3)

Secondary

hypertension involving vessels of brain (I60-I69)

Secondary hypertension involving vessels of eye (H35.0-)

405.91

I15.1

Hypertension secondary to other renal disorders

Code also underlying condition

Postprocedural hypertension (I97.3)

Secondary

hypertension involving vessels of brain (I60-I69)

Secondary hypertension involving vessels of eye (H35.0-)

405.99

I15.2

Hypertension secondary to endocrine

disorders

Code also underlying condition

Postprocedural hypertension (I97.3)

Secondary

hypertension involving vessels of brain (I60-I69)

Secondary hypertension involving vessels of eye (H35.0-)

405.09

405.19

405.99

I15.8

Other

secondary hypertension

Code also underlying condition

Postprocedural hypertension (I97.3)

Secondary

hypertension involving vessels of brain (I60-I69)

Secondary hypertension involving vessels of eye (H35.0-)

405.99

I15.9

Secondary

hypertension, unspecified

Code also underlying conditionPostprocedural hypertension (I97.3)Secondary hypertension involving vessels of brain (I60-I69)

Secondary hypertension involving vessels of eye (H35.0-)Slide39

Hypertension is no longer classified as benign, malignant or unspecified.

ICD-10 Codes have been grouped according to disease progression:I10 Essential HypertensionI11.- Hypertensive Heart DiseaseI12.- Hypertensive CKDFurther subdivided by stage of kidney disease

I13.- Hypertensive Heart and CKDFurther subdivided by stage of kidney diseaseI15.- Secondary HypertensionTransient HypertensionA code for hypertension is NOT assigned unless the patient has a documented, established diagnosis of hypertension.

R03.0 Elevated blood pressure reading without diagnosis of hypertensionDocument requirementsTypeCurrent StatusAssociated relationships

Hypertension Documentation TipsSlide40

Hyperlipidemia

ICD-9 Code

ICD-10 Code

DescriptionExcludes1

Excludes2272.4

E78.4

Other Hyperlipidemia

Familial

combined hyperlipidemia

Sphingolipidosis (E75.0-E75.3)

N/A

272.4

E78.5

Hyperlipidemia,

unspecified

There are more specific code choice selections available below:

272.0

E78.0

Pure Hypercholesterolemia

272.1

E78.1

Pure Hypercholesterolemia

272.2

E78.2

Mixed Hyperlipidemia

272.3

E78.3

Hyperchylomicronemia

272.5

E78.6

Lipoprotein deficiencySlide41

TypeMixed

OtherUnspecified

Hyperlipidemia Documentation TipsSlide42

Heart failure, unspecified

ICD-9 Code

ICD-10 Code

Description

Excludes1

Excludes2

428.0

I50.9

Heart failure, unspecified

Applicable To:

Biventricular (heart) failure NOS

Cardiac, heart or myocardial failure NOS

Congestive heart disease

Congestive heart failure NOS

Right ventricular failure (secondary to left heart failure)

Cardia arrest (I46.-)

Neonatal

cardiac failure (P29.0)

fluid overload (E87.70)

N/A

Code first:

Heart failure

complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8)

Heart failure following surgery (I97.13-)

Heart failure due to hypertension (I11.0)

Heart failure due to hypertension with chronic kidney disease (I13.-)

Obstetrics surgery and procedures (O75.4)

Rheumatic heart failure (I09.81)Slide43

TypeSystolic

DiastolicCombinedChronicityAcute

ChronicAcute on chronic

Heart failure,

unspecified Documentation TipsSlide44

1) Hypertension with Heart Disease

Heart conditions classified to I50.- or I51.4-I51.9, are assigned to a code from category I11, Hypertensive heart disease, when a causal relationship is stated (due to hypertension) or implied (hypertensive). Use an additional code from category I50, Heart failure, to identify the type of heart failure in those patients with heart failure.

Heart failure,

unspecified Documentation TipsSlide45

2) Hypertensive

Chronic Kidney Disease Assign codes from category I12, Hypertensive chronic kidney disease, when both hypertension and a condition classifiable to category N18, Chronic kidney disease (CKD), are present. Unlike hypertension with heart disease, ICD-10-CM presumes a cause-and-effect relationship and classifies chronic kidney disease with hypertension as hypertensive chronic kidney disease. The appropriate code from category N18 should be used as a secondary code with a code from category I12 to identify the stage of chronic kidney disease.

See Section I.C.14. Chronic kidney disease. If a patient has hypertensive chronic kidney disease and acute renal failure, an additional code for the acute renal failure is required.

Heart failure,

unspecified Documentation TipsSlide46

On October 01, 2015 we will monitor claims for date of service rules

Outpatient claims cannot have crossover dates Outpatient claims will be coded according to date of serviceInpatient facility claims will be coded per date of discharge

We will monitor claims to resolve any unanticipated problems with the submission process

Monitor ClaimsSlide47

We will monitor for claim denialsWe will monitor editing trends for ICD-10 Coding guidelines

We will provide feedback to the physicians regarding supporting documentation requirements We will monitor WC or Liability carriers for published rules on use of ICD-9 or ICD-10 code sets

Claim Denial and ManagementSlide48

Client will need to update Templates

Order SetsSuperbillsFavoritesFuture OrdersRemove ICD-9 code add ICD-10 code

Client ResponsibilitiesSlide49

All Conditions treated or assessed must be documented in the medical record. In addition to the documentation tips reviewed, below are more areas to document that will ensure proper ICD-10-CM code selection.

Site specificityDocument notation of qualifiers

ExacerbationManifestationsRelapseStatusStagesIndicate acute or chronic

Indicate underlying or external cause factorsMedicationSmokeAccidentsMechanical failure

LateralityBilateralRight Left

Documentation – Start NowSlide50

Episode of Care for injuries, poisoning, external causes and other conditions

Initial EncounterUse while the patient is receiving active treatment of the conditionActive treatment includes surgical treatment, an emergency encounter, and evaluation and treatment by a new physician

Subsequent EncounterUsed on encounter after the patient has received active treatment of the condition and is receiving routine care for the condition during the healing or recovery phase.Medication adjustments, aftercare, device adjustments, cast change

SequelaUsed for complications or conditions that arise as a direct result of a condition, late effect

Documentation – Start NowSlide51

Combination codes that captureEtiology and manifestation

Related conditionsDisease, injury or other medical condition and complicationsDisease or other medical conditions and common signs or symptomsAdd ICD-10 Codes to patient Problem List

Documentation – Start NowSlide52

codingresource@g1hs.com

Centers for Disease Control and Prevention (ICD-10-CM)http://www.cdc.gov/nchs/icd/icd10cm.htm

Questions