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MEDICAL CODING CLASS – 4

Updated: May 22, 2020

Medical Coding, ICD-10-CM



ICD-10

The international classification of diseases and related health problems, 10th Revision (ICD-10)

  • Published by World Health Organisation(WHO)

  • It is the foundation of ICD-10-CM.

  • It is used for coding in United States.


ICD-10-CM

International Classification of Diseases and, 10th revision, Clinical Modification

  • Is published by the United States Government in recognition of its responsibility to promulgate this classification throughout the United States for morbidity coding.

  • The ICD-10-CM is comparable with the ICD-10.

  • It is United States’ clinical modification of the WHO’s ICD-10.

  • The term “clinical” is used to emphasize the modification’s intent: to serve as a useful tool in the area of classification of morbidity data for indexing of health records, medical care review, and ambulatory & other healthcare services.

ICD-10-CM Code Structure:

  • Format of ICD is Indented format.

  • Indentation means spacing.

  • Consists of 3-7 digits.

  • Minimum of 3 digits.

  • Maximum of 7 digits.

  • Have alphanumeric codes (alphabets + numbers)

  • First digit is alphabet only.

  • There can be 7th digit character in a code with or without 4th digit or 5th digit or 6th digit.

  • 7th digit character should be only in 7th place, if 4, 5, 6 characters are not present.

  • But if only 7th character is present, without 4, 5, 6 characters, assign a dummy place holder “X” to fill the gap.


Example of a dummy place holder:


Let’s see a code ----> E46.2X27

Here there is no 5th digit, so “X” is given as 5th digit.

ICD-10-CM book has two volumes.

1) Volume-I

2) Volume-II



Main Term:


A main term is present in a different colour or bold font, and present extremely to the left side with first letter as capital.

A main term may be

  • A disease

E.g. gastritis, hepatitis, colitis, etc

  • A condition like

E.g. pain, fever, fracture, etc

  • A word like

Disease, disorder or syndrome

  • A eponym (a word which is given for disease with place or persons name)

E.g. Alzheimer’s disease

Let’s have a simple Quiz on finding “Main Term”.

Below are some conditions given, find what is the “Main Term” in those conditions, and also try to find under which category type of main term (as above) it falls under.


1) Acute Gastritis

2) Chronic Enteritis

3) Allergic Rhinitis

4) Abdominal pain

5) Humerus fracture

6) Addiction to alcohol

7) Yellow fever

8) Mathematics Disorder

9) Irritable Bowel Syndrome

10) Chronic Obstructive Pulmonary Disease

11) Parkinson’s Disease


I hope you guys are able to find “main term” in these given condition.

Let’s see the answers for the above conditions. (Underlined and pink colored is the answer)


1) Acute Gastritis (a disease)

2) Chronic Enteritis (a disease)

3) Allergic Rhinitis (a disease)

4) Abdominal pain (a condition like)

5) Humerus fracture (a condition like)

6) Addiction to alcohol (a condition like)

7) Yellow fever (a condition like)

8) Mathematics Disorder (a word like)

9) Irritable Bowel Syndrome (a word like)

10) Chronic Obstructive Pulmonary Disease (a word like)

11) Parkinson’s Disease (a eponym)


Let’s see some more examples:

Acute Gastritis

Here ===> gastritis is main term

Acute is sub term


Abdominal pain

Here ===> Abdomen + al = Abdominal ---> which is not a complete word, so it cannot be a main term.

Therefore, Abdominal is sub term

Pain is main term


Addiction to alcohol

Here ===> “to” is a connecting word, so the previous word will be main term.

Therefore, Addiction is main term

Alcohol is sub term

Dementia in Parkinson’s disease

Here ===> “in” is a connecting word.

Therefore, Dementia is main term

Parkinson’s is sub term.

In ICD-10-CM, there are some guidelines.

GCG – General Coding Guidelines

CSG – Chapter Specific Guidelines

PRG/CRG – Project /Client Related Guidelines

  • GCG is general for all.

  • For any exceptions CSG are used.

  • For any work – project or specific client, PRG/CRG are used.

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