Alicia: ICD-10-CM Under Dosing Medical Coding – This is really interesting. There are certain things about ICD 10-CM that you need to be aware of so that you can assist your physician as the transition happens to say, “Hey! This wasn’t on your radar before, but ICD-10 has this now; and so, therefore, we need to change the documentation,” if you’re aware of it.
One of those things is drug under-dosing. This isn’t in ICD-9, but it is in ICD-10. So what is drug under-dosing? “Under-dosing is a new code in ICD-10-CM. It identifies situations in which a patient has taken less of a medication than prescribed by the physician.” Now, in ICD-9, you have a code for if a patient intentionally took too much of his medication, or if a patient wasn’t paying attention, wasn’t coherent and took a pill when they got up in the morning and then forgotten two hours later, took another one, and then the afternoon, took… There are codes to describe all of that.
But this is one that says the patient is not taking the prescribed dose, he’s taking less. It really works just like your poison codes, so if you’re familiar with how that works, you can follow those steps. And mind you, the Blitz has a fantastic description of how to handle that.
The medical condition is sequenced first – so, what happened? And I gave an example here, the gentleman who had a seizure. The under-dosing code is listed as a secondary diagnosis. The additional code explains why the patient is not taking the medication. This has never been available to us before. Not only could you not say, “Well, he’s just not taken his medicine.” How do you document that? “Well, why is he not taking his medicine?” “Well, he forgets.” That would deal with geriatric and give reasons why, maybe they need home health or interventions, or financial reasons.
ICD-10-CM Under Dosing Medical Coding – Video
Laureen: Yeah, that’s a big one.
Alicia: Yeah, really big. So, as we look down, here I wrote these codes down. We’ve got R56.9, T42.0X6A, Z91.120. When I have done this before, obviously I made a mistake because I did a strikethrough the letter O. This is a perfect example of when you’re doing this new and first getting used to it, you want your letter O to have a definition between that and the zero.