Taking a Closer Look at the December ICD-10 Coding Challenge

Jan. 14, 2015 / By Sue Belley, RHIA

CHALLENGE QUESTION:

 A 72 –year old male was admitted to the hospital with a chief complaint of a  fever with a temperature of 101° F and feeling ill with worsening chills, cough, nasal congestion and body aches that began two days prior to admission. A chest x-ray revealed bilateral infiltrates in both lower lobes of the lungs. A viral culture was positive for AH3N2 influenza.  The patient received antiviral medication and supportive care.  The patient recovered enough to be discharged three days later with a diagnosis of pneumonia due to AH3N2 influenza.

Assign ICD-10 diagnosis codes for the inpatient hospitalization.

ANSWERS:

1. J10.01 Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia

BLOG RESPONSE:

The CDC is currently reporting that illnesses, hospitalizations and deaths due to influenza are high across the country. The A(H3N2) strain of influenza is currently the most prevalent strain causing illness. This strain causes more severe disease in children under the age of 5 and adults 65 years and older. The CDC reports that the severity of influenza due to A(H3N2) is comparable to previous years when this particular strain of flu virus was circulating.  To learn more about influenza and the current strain, please visit the CDC’s website.

The patient in this scenario was admitted with flu-like symptoms and tested positive for A(H3N2) influenza as well as pneumonia due to the same virus. Combination code J10.01, Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia, is assigned for this diagnosis. The following index path will help you arrive at this code: Index the main term Influenza, due to, identified influenza virus NEC with pneumonia, with same identified influenza virus, J10.01.

Code J09.X1, Influenza due to identified novel influenza virus A virus with pneumonia, was a frequently submitted code for this scenario.  This code is not correct because the strain of virus in this scenario, A(H3N2) is not identified as a novel influenza A virus. Take a look at the fourth quarter 2011 issue of Coding Clinic pp. 110-114 for further information on the novel influenza A virus.  Note that novel influenza A viruses are viruses that are subtyped as nonhuman in origin, or those that are unsubtypable in the laboratory.

Thank you for participating in this month’s coding challenge.  Stay well!

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Sue Belley is a project manager with the consulting services business of 3M Health Information Systems.