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Which ICD 10 coding convention or coding guideline do you find to be the most challenging,...

Which ICD 10 coding convention or coding guideline do you find to be the most challenging, and why? Please provide a ICD 10 coding scenario/example, along with the ICD-10 codes, applicable to the coding convention or guideline that you chose.

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International Statistical Classification of Diseases and Related Health Problems. This is briefly referred to as ICD-10, denoting that it is the tenth revision of the International Classification of Diseases.

ICD has been coordinated by WHO. The ICD-10 came into effect on 1.1.1993.

The basic code is a three character code, comprising a letter of the alphabet (excluding U) followed by two digits from 0-9.
Letter U is reserved for provisional classification of new diseases of uncertain etiology.
The total ICD-10 is divided into 21 Chapters, each chapter having a few blocks of disease categories.

1 Certain infectious and parasitic diseases  
2 Neoplasms  
3 Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism  
4 Endocrine, nutritional and metabolic diseases  
5 Mental and behavioral disorders  
6 Diseases of the nervous system  
7 Diseases of the eye and adnexa  
8 Diseases of the ear and mastoid process  
9 Diseases of the circulatory system  
10 Diseases of the respiratory system  
11 Diseases of the digestive system
12 Diseases of the skin and subcutaneous tissue  
13 Diseases of the musculoskeletal system and connective tissue  
14 Diseases of the genitourinary system  
15 Pregnancy, childbirth and the puerperium  
16 Certain conditions originating in the perinatal period  
17 Congenital malformations, deformations, and chromosomal abnormalities  
18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified  
19 Injury, poisoning and certain other consequences of external causes  
20 External causes of morbidity and mortality  
21 Factors influencing health status and contact with health services  

For example, chapter 1 is titled “Certain infectious and parasitic diseases”. It covers entries from A00 to B99 spread over 21 blocks.

  • A00-A14 Intestinal infectious diseases
  • A15-A19 Tuberculosis
  • A20-A28 Certain zoonotic bacterial diseases
  • A30-A49 Other bacterial diseases
  • A50-A64 Infections with a predominantly sexual mode of transmission
  • A65-A69 Other spirochaetal diseases
  • A70-A74 Other diseases caused by chlamydiae
  • A75-A79 Rickettsioses
  • A80-A89 Viral infections of the central nervous system
  • A92-A99 Arthropod-borne viral fevers and viral haemorrhagic fevers
  • B00-B09 Viral infections characterized by skin and mucous membrane lesions
  • B15-B19 Viral hepatitis
  • B20-B24 Human immunodeficiency virus [HIV] disease
  • B25-B34 Other viral diseases
  • B35-B49 Mycoses
  • B50-B64 Protozoal diseases
  • B65-B83 Helminthiases
  • B85-B89 Pediculosis, acariasis and other infestations
  • B90-B94 Sequelae of infectious and parasitic diseases
  • B95-B98 Bacterial, viral and other infectious agents
  • B99-B99 Other infectious diseases

Eg: The block for viral hepatitis (B+15 to B19) has the following categories:

B 15 Acute hepatitis A
B 16 Acute hepatitis B
B 17 Other acute viral hepatitis
B 18 Chronic viral hepatitis
B 19 Unspecified viral hepatitis.

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