Home health care agencies and other providers can make judgment calls in when to use certain ICD-10 codes that in most circumstances are not meant to appear together, according to interim guidance issued Monday by the National Center for Health Statistics (NCHS).
Jennifer Gibson, RN, HCS-D, COS-C and Lead Trainer at Axxess, explained the issue with the “Excludes1” note, which indicates when two conditions cannot be coded together—in the example given in the new guidance, the code range I60-I69 for cerebrovascular diseases has an Excludes1 note for intracranial hemorrhage (S06.-). This indicates that when a patient presents with a stroke, for example, that individual cannot also be coded for a hemorrhage caused by a traumatic injury.
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