Through our work conducting DRG audits, Provident has identified a number of new shifts due to the change from the ICD-9 to ICD-10 codeset. Many of these DRG shifts were due to changes in the Official Coding Guidelines, Indexing, and procedure coding. Below is an example of one of the ICD-10 driven shifts identified.

Case Study: Patient admitted with a COPD exacerbation and asthma exacerbation

• COPD with asthma exacerbation only required a single code in ICD-9

• COPD with asthma exacerbation is coded using two separate codes in ICD-10
• This results in a CC when coded in ICD-10
• The ICD-10-CM Index instructional notes under J44 Other chronic obstructive pulmonary disease states, “Code also type of asthma, if applicable (J45.-)”

Reference

1. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): Tabular Section – Category: J44 – Other chronic pulmonary disease – Code also type of asthma, if applicable (J45.-)