![]() ![]() ![]() When an "Excludes2" notation appears under a code, it is acceptable to use both the code and the excluded code together. An "Excludes1" notation is used when two conditions cannot occur together, such as the congenital form of a condition versus an acquired form of the same condition.įor example, code H93.25 for central auditory processing disorder (CAPD) has an "Excludes1" note that prevents clinicians from coding it with F80.2 for mixed receptive-expressive language disorder.Įxcludes2 indicates codes that may be listed together because the conditions may occur together, even if they are unrelated. What do the "Excludes1" and "Excludes2" notations mean on the ICD-10-CM code lists?Įxcludes1 indicates that the codes excluded should never be used at the same time as the code above the "Excludes1" notation. Conversely, the I69 series is accompanied by a "use additional" note instructing the SLP to identify the type of dysphagia in the R13.1 series, if known. For example, if an SLP assigns a diagnosis of dysphagia from the R13.1 series, the accompanying "code first" note directs the SLP to first list a separate code in the I69 series (in this case, dysphagia following cerebrovascular disease), when appropriate. These variations in sequencing will be identified very clearly at both the etiology ICD-10-CM code and the ICD-10-CM code that identifies the manifestation. Some codes may require different sequencing based on additional notes in the ICD-10-CM code list. This is a coding convention, but if your payer or facility requests that you list the medical diagnosis as the first-listed diagnosis, and the speech, language, swallowing, vestibular, and/or hearing diagnosis as the second-listed diagnosis, then you should follow that payer’s or facility’s guidance. You need a secondary diagnosis for medically or neurologically based speech, language, swallowing, vestibular, and/or hearing disorders when you have medical evidence of a problem. ![]() Twelve slots are available on the CMS-1500 claim form to accommodate the need for multiple diagnosis codes. The second-listed diagnosis-sometimes referred to as the secondary or medical diagnosis-is the medical diagnosis that is causing or contributing to the speech, language, swallowing, vestibular, and/or hearing disorder. Generally, audiologists and SLPs should use the ICD-10-CM diagnosis code for the speech, language, swallowing, vestibular, and/or hearing disorder that they are evaluating or treating (i.e., primary or treating diagnosis) as their first-listed diagnosis. How do I know which ICD-10-CM code to list first on my claim form? See also: Coding Normal Results Frequently Asked Questions An evaluation to "rule out" a condition is not recognized as a coding convention and should not be used. List any additional codes that describe coexisting conditions. Instead, the signs and symptoms, chief complaint, or reason for the encounter should be reported as the primary diagnosis. There are no ICD-10-CM codes to reflect a normal result. What does it mean to "code to the highest level of specificity possible"?.What is the difference between codes listed as "other" and codes listed as "unspecified"?.What do the "Excludes1" and "Excludes2" notations mean on the ICD-10-CM code lists?.How do I know which ICD-10-CM code to list first on my claim form?.See also: ICD-10-CM Diagnosis Codes for Audiology and Speech-Language Pathology ICD-10-CM Coding Principles ICD-10-CM Coding for Speech-Language Pathologists.Audiologists and speech-language pathologists (SLPs) are responsible for verifying coding and billing policies with their specific payers. ![]() The following answers regarding ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) are based on general coding principles and best practices as well as guidance from the Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS). ![]()
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