10 Clinical Concepts Series
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ICD-10 Clinical Concepts Series
ICD-10 Clinical Concepts for Pediatrics is a feature of Road to 10, a CMS online tool built with physician input.
ICD-10
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ICD-10 Compliance Date: October 1, 2015
Clinical Concepts for Pediatrics
Common Codes
Clinical Documentation Tips
Clinical Scenarios
• Scenario 1: Diarrhea, Fever, and Vomiting
• Scenario 2: Physical for Preschool Entrance
• Scenario 3: Asthma and Atopic Dermatitis
• Scenario 4: Newborn Feeding
Clinical Scenarios
Table Of Contents Common Codes
Clinical Documentation Tips
• Abdominal Pain
• Acute Bronchitis
• Acute Pharyngitis
• Allergic Inflammation of the Nasal Airways
• Asthma
• Chest Pain
• Diabetes Mellitus (Select)
• Headache
• Otitis Media
• Pain in Limb
• Routine Child Health Examination
• Urinary Tract Infection, Cystitis
• Asthma
• Underdosing
• Diabetes Mellitus, Hypoglycemia and Hyperglycemia
• Injuries
• Well Child Exams and Screening
• Otitis Media
• Bronchitis and Bronchiolitis
• Feeding Problems of the Newborn
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Common Codes
ICD-10 Compliance Date: October 1, 2015
R10.0 Acute abdomen R10.10 Upper abdominal pain, unspecified R10.11 Right upper quadrant pain R10.12 Left upper quadrant pain R10.13 Epigastric pain R10.2 Pelvic and perineal pain R10.30 Lower abdominal pain R10.31 Right lower quadrant pain R10.32 Left lower quadrant pain R10.33 Periumbilical pain R10.84 Generalized abdominal pain R10.9* Unspecified abdominal pain
Abdominal Pain (ICD-9-CM 789.00 to 789.09 range)
*Codes with a greater degree of specificity should be considered first.
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J02.0 Streptococcal pharyngitis J02.8 Acute pharyngitis due to other specified organisms J02.9* Acute pharyngitis, unspecified
Acute Pharyngitis (ICD-9-CM 034.0, 462)
*Codes with a greater degree of specificity should be considered first.
J20.0 Acute bronchitis due to Mycoplasma pneumoniae J20.1 Acute bronchitis due to Hemophilus influenzae J20.2 Acute bronchitis due to streptococcus J20.3 Acute bronchitis due to coxsackievirus J20.4 Acute bronchitis due to parainfluenza virus J20.5 Acute bronchitis due to respiratory syncytial virus J20.6 Acute bronchitis due to rhinovirus J20.7 Acute bronchitis due to echovirus J20.8 Acute bronchitis due to other specified organisms J20.9* Acute bronchitis, unspecified
Acute Bronchitis (ICD-9-CM 466.0, 466.11, 466.19) [Note: Organisms should be specified where possible]
*Codes with a greater degree of specificity should be considered first.
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J30.0 Vasomotor rhinitis J30.1 Allergic rhinitis due to pollen J30.2 Other seasonal allergic rhinitis J30.5 Allergic rhinitis due to food J30.81 Allergic rhinitis due to animal (cat) (dog) hair and dander J30.89 Other allergic rhinitis J30.9* Allergic rhinitis, unspecified
J45.20 Mild intermittent asthma, uncomplicated
J45.21 Mild intermittent asthma with (acute) exacerbation
J45.22 Mild intermittent asthma with status asthmaticus
J45.30 Mild persistent asthma, uncomplicated
J45.31 Mild persistent asthma with (acute) exacerbation
J45.32 Mild persistent asthma with status asthmaticus
J45.40 Moderate persistent asthma, uncomplicated
J45.41 Moderate persistent asthma with (acute) exacerbation
J45.42 Moderate persistent asthma with status asthmaticus
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbation
J45.52 Severe persistent asthma with status asthmaticus
J45.901* Unspecified asthma with (acute) exacerbation
J45.902* Unspecified asthma with status asthmaticus
J45.909* Unspecified asthma, uncomplicated
J45.990 Exercise induced bronchospasm
J45.991 Cough variant asthma
J45.998 Other asthma
Allergic Inflammation of the Nasal Airways (ICD-9-CM 477.0 TO 477.9 range)
Asthma (ICD-9-CM 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)
*Codes with a greater degree of specificity should be considered first.
*Codes with a greater degree of specificity should be considered first.
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R07.1 Chest pain on breathing R07.2 Precordial pain R07.81 Pleurodynia R07.82 Intercostal pain R07.89 Other chest pain R07.9* Chest pain, unspecified
Chest Pain (ICD-9-CM 786.50 TO 786.59 range)
*Codes with a greater degree of specificity should be considered first.
E10.65 Type 1 diabetes mellitus with hyperglycemia E10.9 Type 1 diabetes mellitus without complications E11.65 Type 2 diabetes mellitus with hyperglycemia E11.9 Type 2 diabetes mellitus without complications
Diabetes Mellitus (Select) (ICD-9-CM 250.00 to 250.03 range)
*Codes with a greater degree of specificity should be considered first.
R51 Headache
Headache (ICD-9-CM 784.0)
*Codes with a greater degree of specificity should be considered first.
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H65.00* Acute serous otitis media, unspecified ear H65.01 Acute serous otitis media, right ear H65.02 Acute serous otitis media, left ear H65.03 Acute serous otitis media, bilateral H65.04 Acute serous otitis media, recurrent, right ear H65.05 Acute serous otitis media, recurrent, left ear H65.06 Acute serous otitis media, recurrent, bilateral H65.07* Acute serous otitis media, recurrent, unspecified ear
Acute Serous Otitis Media (ICD-9-CM 381.01)
*Codes with a greater degree of specificity should be considered first.
H65.111 Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), right ear
H65.112 Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), left ear
H65.113 Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), bilateral
H65.114 Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, right ear
H65.115 Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, left ear
H65.116 Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, bilateral
H65.117* Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, unspecified ear
H65.119* Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), unspecified ear
H65.191 Other acute nonsuppurative otitis media, right ear
H65.192 Other acute nonsuppurative otitis media, left ear
H65.193 Other acute nonsuppurative otitis media, bilateral
H65.194 Other acute nonsuppurative otitis media, recurrent, right ear
H65.195 Other acute nonsuppurative otitis media, recurrent, left ear
H65.196 Other acute nonsuppurative otitis media, recurrent, bilateral
H65.197* Other acute nonsuppurative otitis media recurrent, unspecified ear
H65.199* Other acute nonsuppurative otitis media, unspecified ear
Other Acute Nonsuppurative Otitis Media (ICD-9-CM 381.00, 381.02 to 381.06 range)
*Codes with a greater degree of specificity should be considered first.
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H65.20* Chronic serous otitis media, unspecified ear H65.21 Chronic serous otitis media, right ear H65.22 Chronic serous otitis media, left ear H65.23 Chronic serous otitis media, bilateral
H65.30* Chronic mucoid otitis media, unspecified ear H65.31 Chronic mucoid otitis media, right ear H65.32 Chronic mucoid otitis media, left ear H65.33 Chronic mucoid otitis media, bilateral
Chronic Serous Otitis Media (ICD-9-CM 381.10, 381.19)
Chronic Mucoid Otitis Media (ICD-9-CM 381.20, 381.29)
*Codes with a greater degree of specificity should be considered first.
*Codes with a greater degree of specificity should be considered first.
H65.411 Chronic allergic otitis media, right ear H65.412 Chronic allergic otitis media, left ear H65.413 Chronic allergic otitis media, bilateral H65.419* Chronic allergic otitis media, unspecified ear H65.491 Other chronic nonsuppurative otitis media, right ear H65.492 Other chronic nonsuppurative otitis media, left ear H65.493 Other chronic nonsuppurative otitis media, bilateral H65.499* Other chronic nonsuppurative otitis media, unspecified ear
Other Chronic Nonsuppurative Otitis Media (ICD-9-CM 381.3)
*Codes with a greater degree of specificity should be considered first.
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H65.90* Unspecified nonsuppurative otitis media, unspecified ear H65.91* Unspecified nonsuppurative otitis media, right ear H65.92* Unspecified nonsuppurative otitis media, left ear H65.93* Unspecified nonsuppurative otitis media, bilateral
H66.001 Acute suppurative otitis media without spontaneous rupture of ear drum, right ear
H66.002 Acute suppurative otitis media without spontaneous rupture of ear drum, left ear
H66.003 Acute suppurative otitis media without spontaneous rupture of ear drum, bilateral
H66.004 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, right ear
H66.005 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, left ear
H66.006 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, bilateral
