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Health Information Management · RHIA/RHIT

Health Information Management: ICD-10-CM Coding

ICD-10-CM diagnosis coding conventions, chapter structure, and coding guideline rules tested on the RHIA and RHIT exams.

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How many characters can an ICD-10-CM code have?
3 to 7 characters
What is the minimum number of characters required for a valid ICD-10-CM category code?
3 characters
In ICD-10-CM, what does the seventh character often represent in injury and external cause codes?
The episode of care (initial encounter, subsequent encounter, or sequela)
What placeholder character fills empty positions when a code needs a seventh character but doesn't yet have six characters?
The letter X
What does "NEC" mean in ICD-10-CM?
Not elsewhere classifiable
What does "NOS" mean in ICD-10-CM?
Not otherwise specified
In ICD-10-CM, what does an "Excludes1" note mean?
The excluded condition can never be coded together with the code above it
In ICD-10-CM, what does an "Excludes2" note mean?
The excluded condition is not part of the condition represented, but a patient may have both, so both codes may be used together
What does the ICD-10-CM convention "code first" instruct a coder to do?
Sequence the underlying condition before the code that carries this note
What does the ICD-10-CM convention "use additional code" instruct a coder to do?
Add a secondary code to fully describe the condition, sequenced after the primary code
In ICD-10-CM, what do square brackets [ ] enclose?
Synonyms, alternative wording, or explanatory phrases
In ICD-10-CM, what do parentheses ( ) enclose?
Supplementary words (nonessential modifiers) that do not affect code selection
In the ICD-10-CM Tabular List, what does a colon after a term mean?
The term is incomplete until modified by one of the terms listed after it
When an ICD-10-CM title links two conditions with "and," such as "acute and chronic," what does that mean for code use?
The title covers either condition alone or both together
Which ICD-10-CM chapter covers codes for external causes of injury (V, W, X, Y codes)?
Chapter 20, External Causes of Morbidity

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