Question

"Referencing ICD-10-CM guideline I.B.11, what is the appropriate action when a physician documents an impending condi- tion that had not occurred by the time of discharge?

A. Check the ICD-10-CM Alphabetic Index to see if there are listings under threatened or impending; and if not, code the existing underlying condition(s) rather than the condition described as impending.
B. Code the condition that is impending.
C. Use a Z code to describe the patient encounter.
D. Use the appropriate 7th character to indicate the condition is impending or threatened."

Answer 1

ICD-10-CM guideline I.B.11 indicates that an impending condition that has not occurred by discharge should not be coded as if the condition occurred. Instead, symptoms or conditions leading to the concern should be coded. This is vital for accurate clinical documentation and insurance processing.

Step-by-step explanation:

According to ICD-10-CM guideline I.B.11, when a physician documents an impending condition that has not occurred by the time of discharge, the appropriate action is not to use a diagnosis code for the actual condition, since it did not occur. Instead, the coder should find a suitable code representing the current condition or symptoms that led to the concern for the impending event.

For instance, if a patient has chest pain and there's a concern for an impending myocardial infarction, the myocardial infarction should not be coded since it hasn't happened. The chest pain, or any other present symptoms, should be coded instead. ICD codes are essential for clinical fields in processes such as ordering laboratory tests, prescribing treatments, recording procedures, processing claims for reimbursement, and classifying diseases for morbidity and mortality statistics.