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icd 9 code for weight loss
another thing about icd-10 is that you kindof need to understand the disease process when coding an icd-10. you do that with icd-9but it’s so much more in icd-10, so i thought i’d pull out something, like one of thebody systems and then go in and let’s talk about that and understand the disease process.so, i picked gastrointestinal ulcers just because i had information on it, but it wouldbe something that some of you might be able
icd 9 code for weight loss, to learn from.the first thing with gastrointestinal ulcers you would need to know the type of gastrointestinalulcers. we have gastric, duodenal, peptic, gastrojejunal. these are the four types ofgastrointestinal ulcers. now, the next thing when understanding the disease process, you’regoing to need to know the contributing factors,
because when you’re coding, unless you’vegiven a definitive diagnosis in physician-based coding, you would code the signs and the symptoms– so we’re going to talk about those -- and to back up the treatments or that the personhas a current condition, you’re going to need to know the contributing factors thatwill show up in the case. contributing factors: reflux, hyperacidityin the stomach, extended use of anti-inflammatory drugs (aspirin or ibuprofen, there’s a lotof arthritis medication that will be an influence), steroids, alcohol, smoking, and presence of helicobacter pylori bacteria.they actually will go in and do an egd and take a sample and make sure that you don’thave this because if you have these bacteria, it will cause ulcers.the signs and symptoms to look for: burning
pain in the stomach or epigastric region (whichwould be up in the esophagus in the back of the throat), weight loss, nausea, vomiting,anemia – from blood loss, because when you get an ulcer it can actually be a bleedingulcer. what type of testing do they do to determinethat you have an ulcer? they do upper gi’s and barium studies (endoscopy) where theyactually have you drink a chalky substance and they take an x-ray. they go in endoscopicallyand do an upper gi where they literally take a camera in there and they go in, they takepictures to see if there’s anything going on. then they can actually visualize the liningof the epigastric area and the gastric (the stomach) to see if there’s an ulcer.then, there are several blood tests that they
can do that would indicate whether a personwas suffering from an ulcer; they can do a hemoglobin test, the hematocrit and serumgastrin and amylase levels. the hemoglobin and the hematocrit are decreased ina patient with bleeding from the ulcers, and that’s because this is blood levels. serumgastric and serum amylase levels are actually increased. then, they can do stool samples,which can be positive for occult blood. that’s where they literally take feces and put iton this little card and it turns to a specific color if it’s got blood in it.treatment – what are they going to do to treat it if you are diagnosed with a gastrointestinalulcer? really the main treatment is treating the signs and the symptoms, but they’regoing to try to eliminate the contributing
factors. they’re going to give an antacidsand dietary restrictions to neutralize the gastric acids, so they’re going to tellyou things like, “don’t eat tomatoes, don’t eat things that are acidic or irritantsto the lining, like chocolate and coffee.†if they do find that this bacteria present,then you’re given antibiotics. they want you to start on nutritious and regular meals;a lot of times when a person has some type of a gastric ulcer, they stop eating or they’renot eating proper foods because it hurts to eat, it’s so uncomfortable. so it’s encouragedthat they start back on regular meals. then, they give you medication to reduce the acidin your stomach. this is called anticholinergic drugs or you could call it like antacid-typedrug and you see those advertised on tv all
the time, there are several good ones outthere. but you don’t want to have to take them for long periods of time.last, if nothing else works, they’ll go in and do surgical intervention especiallywith hemorrhages, because you can actually get a perforation or an obstruction or thepain will be so bad that they need to go in and literally do something to alleviate thediscomfort. so, when you’re doing icd-10 it’s reallyimportant that if you’re doing a specific body system to familiarize yourself with theinformation about the types, the contributing factors to the disease process, the signsand symptoms. you want to know what type of clinical testing, there’s usually lab testingdone, and what are they going to do to treat
it? that is going to help you with your codingand substantiate that it is an active disease process going on.boyd: awesome! i think somebody was asking about the answer to, when we we’re askingabout all those codes with letter at the beginning, what was the answer to that one, after thati think. alicia: the letters in the beginning?boyd: yeah, remember that case study? alicia: yeah, it’s just the division onhow they divide up the chapters. so, instead of the first number in icd-9 telling you,kind of helping you decide what chapter you’re in, the letter is going to do it now for you.so, nothing’s really changed except it’s kind of like you have a prefix, and then theyalso added suffixes to the end of the codes.
hopefully that will explain it for you.so, each chapter will have a letter and then you’ll know by that letter what body systemor what diseases you’re working in. and not to say that ob-gyn is a disease, pregnancyand stuff, but it’s going to be in the “o†section and neoplasms are in the “c†section.so, if you see a code that starts with a “c†it probably will have something to do withneoplasms whether benign or malignant, but it will be a neoplasm.boyd: got it.
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