ICD 10 CM Guideline Mastery Week 5: Circulatory System 📱

Añadido: 2026-05-05

[00:00:03][music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] >> Hello everybody.

[00:03:48]Hello, hello. Happy Monday everyone. As always, let me know if you can hear me in the chat and I will go ahead and get started.

[00:04:03]Let me know if you can hear me.

[00:04:11]Thank you so much. Thank you so much for your response. Thank you everybody. All right. So, like I said, hello, hello and welcome to another wonderful week of our ICD-10-CM guideline mastery sessions. I am Miss Haley. I'm going to be your lead instructor for this class and I am so excited to welcome some new coders, some returning coders to our Monday night class right here every Monday at 7:00 p.m. Eastern Standard Time. As always, I am accompanied by my wonderful, awesome Monday night team, Miss Olga and Miss Vina. So, big shout-out to them. They will be in the chat and they will be encouraging you guys and answering any questions you may have.

[00:04:57]So, we are going to be beginning our week five this week. So, today we're going to be going over and reviewing some circulatory guidelines. So, we're going to be diving into topics like hypertension, arteriosclerotic coronary artery disease, angina, infarctions, TIA, and strokes. And as always, I'm going to be using our ICD-10-CM guidelines and also referencing our MCG manual in this session as well. So, make sure to have those both handy if you can and we will be keeping the same flow as the previous week. So, we're going to do our Jeopardy game to warm up with our true or false questions followed by some in-depth scenarios.

[00:05:42]And as always, please make sure to fill out our survey. We will post the link in the chat. Let us know how we're doing or if you have any follow-up questions about any of the material that we go over today in class. So, yes, hello, hello. All right, and let's go ahead and get started with our copyright. I'm going to fly through this super quick.

[00:06:05]All right. So, ICD-10-CM copyright 2026 American Medical Association all rights reserved. Fee schedules, relative value units, conversion factors, and or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained. ICD-10-CM is a registered trademark of AAPC. AAPC content found within this presentation is copyright of AAPC. Keyword concept, FTR, Chart, AMCI Fab 7, AMCI ICD-10, Flip Top, and MCG are trademarks of AMCI. The credentials CBC, CRC, COC, CPMA, CPB, CPPM, CBCO are owned by the AAPC. AMCI does not own the rights to these credentials. The credentials CCA, CCS, CCSP RHIA, RHIT are owned by AHIMA.

[00:07:00]AHIMA does not own the rights to these credentials. And thank you so much for Miss Olga for posting that survey link.

[00:07:07]We'll post it throughout the class, but that is in the chat. If you need to leave early or something, just make sure to fill that out.

[00:07:15]All right. So, without further ado, we are going to start our our Jeopardy game. If you are new, um this is going to be I'm going to stop showing my screen while I'm explaining and get to the game. So, if you are new, um we do a warm-up Jeopardy game just with different topics relating to what we're learning this week. So, all of them are going to be true or false and just put your answers in the chat and let us know what you think the answer is and all of them are going to be true or false.

[00:07:50]So, the today categories, I split them up. They're going to be divided into hypertension. They're going to be divided into arteriosclerotic coronary artery disease, ACD, and angina. That's going to be one topic.

[00:08:06]And then we have acute myocardial infarction or AMI. So, without further started.

[00:08:15]We're going to start off easy. Let's do a hypertension for 100 and put those answers in the chat.

[00:08:24]All right. So, starting off, true or false? An assumed relationship exists between hypertension and heart disease.

[00:08:33]What do you guys think? Is this going to be true or false? Let's have a great start to this warm-up game. Get those answers in the chat. I'll give you guys a few seconds.

[00:09:06]All right, and I'm getting an overwhelming true from this one and indeed it is true. That was a great warm-up to our circulatory section.

[00:09:17]Amazing job. And um I didn't mention it before, but all of these um true or false questions are taken directly out of the MCG manual, which are directly correlated with the ICD-10-CM manual. Um and I will post the um guideline references after this. So, if you have any follow-up questions, I will definitely explain it afterwards. All right, let's move on to the ACD angina.

[00:09:44]Let's do a 200.

[00:09:48]All right, this is a longer one. Okay.

[00:09:50]So, true or false? Category I69, which is sequela of cerebrovascular disease, is used to code the residual or late effects of cerebrovascular conditions such as strokes that result in lasting neurologic deficits. I know that one was a little bit of a long one, so I'll give you guys a few seconds to break that down. You got it.

[00:10:50]All right, amazing job. Amazing job.

[00:10:53]This one is going to indeed be true, which I'm pretty sure everyone put. Um, definitely category I69 is um, going to directly reference the sequela's of the cerebrovascular disease for sure. And I think actually we're going to use a guideline from using that category in one of our scenarios later. So, so glad that everyone got that one right.

[00:11:16]All right.

[00:11:17]Let's move on. Let's do a 400 for the AMI.

[00:11:23]All right. Coronary microvascular dysfunction or CMD is a condition that impacts the microvasculature by restricting microvascular flow and increasing microvascular resistance. So, this is kind of a little definition one.

[00:11:40]It's still going to be in your MCG manual, but what do we think, guys? Is this one true or false? CMD.

[00:12:27]All right, so I know this one was a [laughter] definition one. This one is going to be true. I don't know why I keep picking all the true ones. Oh my goodness, but um, yes, I know this is kind of a different one cuz it's kind of definition wise. Also, going on a tangent, if you haven't checked out Miss Mills's IM Tapper Interactive Medical Terminology and Anatomy and Physiology live class, definitely check that out. I know that I could always use a brush up in any kind of wording or definitions or medical terminology, that is for sure. That's on Wednesdays if anyone ever is interested in that.

[00:13:05]All right, let's move back to hypertension.

[00:13:07]>> [snorts] >> Let's do a 300 this time.

[00:13:12]All right.

[00:13:14]A relationship cannot be assumed between hypertension and heart involvement and hypertension and kidney involvement and a combination code would not be appropriate.

[00:13:26]Hmm. I know [clears throat] last time we did a relationship one, this is another one. What do we think? True or false?

[00:13:35]Let me know in the chat.

[00:14:13]All right, I seem to be getting an overwhelming amount of falses and that would be the correct answer to put in the chat. So, yes. So, this would be false. It says in the guideline section that there is an assumed relationship between hypertension and heart involvement and hypertension and kidney involvement and a combination code must be used. So, it is actually the complete opposite. I thought it would be a little bit tricky cuz normally you never want to assume anything when you're coding, but in this case, this definitely would be false. I think everyone got that one correct in the chat, so shout out to you guys.

[00:14:57]All right. Let's do a 400 in the middle section right here.

[00:15:04]All right, going back to I69. So, again, true or false? Codes from category I69, again, the sequela of cerebrovascular disease should only be assigned when the patient has documented neurologic deficits.

[00:15:22]Is this going to be true or false?

[00:15:24]>> [snorts] >> All right, I am loving this participation that is in the chat right now. You guys are doing awesome. So, yes, this one would be true.

[00:16:15]We are just going to learn all about category I69. That's a big part of um, that specific section of guidelines. So, yes, it should only be assigned when the patient has documented neurologic deficits for sure. So, yes, I agree, great participation. Keep up the great work.

[00:16:34]All right.

[00:16:35]Let's move right along. Let's go back to AMI and let's do Let's do a 100.

[00:16:43]Okay. True or false? If a type one STEMI changes to a NSTEMI due to treatment, code it as an NSTEMI.

[00:16:57]I know I just said STEMI so many times.

[00:16:59]So, I'll give you guys I'll give you guys a few seconds to solve this one. You got it.

[00:17:04]Let me know in the chat.

[00:17:50]All right, so I'm getting a little bit of mixed results for this one. So, this one is going to be false. And again, I will reference the specific guideline where it says this, but in the manual and in the ICD-10 book, it says, "If a type one STEMI changes to an NSTEMI due to treatment, you are still going to code it as a STEMI."

[00:18:16]So, that's what would make this one false.

[00:18:20]Hopefully we had some aha moments because again, we're going to be using a scenario later on that kind of has something to do with this one. So, hopefully this kind of makes sense. And if not, we will go over it in very deep detail later on, so no worries at all.

[00:18:39]All right.

[00:18:41]Let's move right back to hypertension and let's go to 400.

[00:18:48]All right.

[00:18:49]So, true or false? Elevated blood pressure can result from temporary conditions or circumstances and is always indicative of hypertension. True or false? Is this always indicative of hypertension? What do we think, guys?

[00:19:07]Let me know in the chat.

[00:19:09]>> [snorts and sighs] >> All right. I'm getting a lot of responses in the chat. Someone said part of it is true, but also false. Yes, I was trying to be a little tricky. So, this would be correct. This is indeed false. Think everyone got this one right. So, yes, you would be right.

[00:20:13]Elevated blood pressure can result from temporary conditions or circumstances, but it is not always indicative of hypertension. So, that would make this false. It is not always indicative. So, definitely it's not always. So, that's what would make this one false. So, amazing. Great catch everyone. Great job.

[00:20:36]All of the stars, I agree.

[00:20:39]All right. Did I just do a Am I going crazy? Okay.

[00:20:44]We're going to go to a 100.

[00:20:49]Okay.

[00:20:50]I'm [laughter] not trying to be sneaky, I promise. Okay. [gasps] If a patient has angina and arthrosclerotic heart disease, code them separately. Do not use a combination code.

[00:21:04]All right. So, this is kind of a sequencing. If someone has angina and the heart disease, are we coding them separately? What do you guys think? Let me know.

[00:21:58]All right. I am getting an overwhelming false, and that would be 100% true. Yes, this is false. That was really confusing for no reason. Okay, so >> [laughter] >> it states in the guidelines, if a patient has angina and arthrosclerotic heart disease, you do use a combination code, and you do not code them separately. So, that would make this completely false, and I think everyone got that one. Everyone caught that one.

[00:22:27]So, great job, as always.

[00:22:30]Perfect, indeed. Okay, let's move back to AMI. Let's do a 300.

[00:22:38]Okay.

[00:22:40]So, code I22 is only used for subsequent myocardial infarctions or AMI that are type one or unspecified if they occur within 10 weeks of initial AMI.

[00:22:58]Is this true or false?

[00:23:01]I know that was a lot of words, so I'll give you guys a few seconds. You got it.

[00:23:21]I'll still give you guys a few more seconds. I see some people putting false.

[00:23:26]If you want to go the extra mile, let me know what what specifically makes this one false.

[00:23:33]Let me know.

[00:24:01]Oh my goodness. I am blown away by people going the extra mile. Yes, so this one is going to be false. Great job to everyone that got that one right, and especially these people that went the extra mile and put in the chat what made it false, because you would be right.

[00:24:20]So, it says in the guidelines, code I22 is only used for subsequent myocardial infarction AMI that are type one or unspecified if they occur within four weeks of the initial AMI. So, four weeks, not 10 weeks. That is what makes this one false. So, amazing, amazing.

[00:24:40]Yes, great work. You guys are just blow me away every time.

[00:24:45]All right, let's move back and get rid of our last hypertension question.

[00:24:51]All right. So, as always, true or false, resistant hypertension refers to blood pressure in a patient with hypertension that remains above goal despite the use of antihypertensive medicines. So, again, this one's kind of a definition-ish one, but I'll still give you guys a few minutes to solve or a few seconds to solve, and good luck.

[00:25:50]Okay, I am getting an overwhelming true in the chat with all of this amazing participation, and you guys would be absolutely right. This 100% is going to be the definition of what resistant hypertension is. So, for all of you that put your answers in the chat, great work. Keep it up. We just have a couple left, and then we're going to move on to our in-depth scenarios. So, yes, you guys are absolutely on fire tonight. All right, and let's go back to our angina artery disease for 300.

[00:26:25]Okay. True or false? Again, codes from category I69 that specify hemiplegia, hemiparesis Oh my gosh, hemiparesis or monoplegia do not always need to verify whether the affected side is dominant or non-dominant.

[00:26:45]Is this going to be true or false? You guys got this one. I have full confidence in you. Let me know in the chat.

[00:27:33]Okay. So, this one is going to be false.

[00:27:39]This one is going to be false because it states in the guidelines that codes from category I69 that specify hemiplegia, hemiparesis, or monoplegia must identify whether the affected side is dominant or non-dominant.

[00:27:59]And then, um there also is a list, if you go on the guidelines, that will um tell you if they don't state whether it's dominant or non-dominant, you know, if the right side's affected or the left side's affected, all that jazz, but you definitely need to identify whether the side affected is dominant or non-dominant. And that's what would make this false. So, great job, everyone. All right, and now we are on our last question for our warm-up. Let's end on a great note. You guys have been killing this whole game, so I know you got it.

[00:28:32]Okay. Well, this is a long one.

[00:28:34]Okay, so true or false, if an acute myocardial infarction or AMI is documented as non-transmural or subendocardial and the site is specified, it should still be coded as subendocardial AMI.

[00:28:54]I know that is again a lot of words, so I'll let you guys focus, and let me know in the chat.

[00:29:37]All right. Way to go, everyone. Way to go. Yes, this one is going to be true, and I think everyone put that in the chat. So, that was an amazing way to end that warm-up. Shout-out to you guys. All right, I am going to stop sharing my screen just for a second, and I'm going to switch back over to our PowerPoint so that I can quickly click through the guideline references. I'm not going to go into explanation cuz I kind of went into explanation while we were already while we were already, you know, doing the game. So, I'll just click through them. And as always, this is a recorded video. So, if you need to go back um after it's been recorded, and you need to pause it so you can better look at these guidelines, go for it. So, this is going to be our first category, hypertension. This is going to be the question that we asked, the answer, and the specific guideline that I used. And again, I just took the words directly from the manual. So, um that is what I did. All right, and then the second one is going to be our arteriosclerotic coronary artery disease ACD and angina.

[00:30:52]The question, the answer, the guideline, and then last but not least, our AMI, our acute myocardial infarction.

[00:31:01]Question, answer, and guideline.

[00:31:06]All righty. So, but you guys did amazing. And if you just need to use this as a study tool, I highly encourage.

[00:31:13]Okay, so I'm going to stop sharing my screen again and switch over. How are we feeling? I hope you guys are feeling awesome cuz you are doing absolutely amazing. That warm-up was very very impressive. I'm going to go ahead and grab our I'm going to go ahead and grab our um Quizlet. I'm going to stop sharing. I'm going to grab our Quizlet. And um again, if you have not been here, um we're going to do a more in-depth scenario.

[00:31:44]So, I'm going to show you a scenario, and then we're going to break it down.

[00:31:47]Um first, we're going to break it down by keywords. Then, we're going to break it down by the guideline we're going to be using. And then, last but not least, we are going to finish it off by having our official ICD-10-CM codes. And we will go over everything all together at the end.

[00:32:04]So, this is going to be our first scenario for the night. And we are going to put our keywords we're taking out of here in the chat. So, Mrs. Waffles was given thrombolytic therapy for an acute myocardial infarction, STEMI, of the or the anterior Oh my goodness, of the anterolateral wall, which converted to an NSTEMI. What keywords are we taking out of this scenario? Let me know in the chat. I'll give you guys a few seconds for this one.

[00:33:30]Okay, I know a lot of people are still typing. Definitely put your answer in the chat if you are still typing. I know it's a lot to type. But, the keywords that I'm taking out of here are going to be the acute myocardial infarction, the STEMI, the anterolateral wall, and then converted to NSTEMI, which a lot of people, pretty much everyone, put in the chat. So, great job.

[00:33:57]All right, let's move on. We're going to use those keywords, and we're going to use all of our We're going to use the same scenario. And now, we are going to pick what specific guideline is going to be reported for this one.

[00:34:13]Let me know. I kind of gave you guys a clue when we were going through our warm-up scenario of kind of what guideline we're thinking for this one. But, yeah, you can um put the specific number, or you can just put the title.

[00:34:30]Let me know in the chat. I'll give you guys a few seconds for this one.

[00:35:06]All right, indeed. Everyone is on fire for this one. And yes, this one is going to be the I C 9 E 1. So, acute myocardial infarction AMI Whoa, AMI type 1 elevation, myocardial infarction STEMI, and non-ST elevation myocardial infarction NSTEMI. And a lot of people got that one right. That was like That was a very overwhelming response. That was awesome. So, great job. All right, and now for the final finale, we're using those keywords, we are using that guideline, and now we are breaking it down to specific ICD-10-CM code or codes.

[00:35:51]How are we coding this scenario? Let me know in the chat. I'll give you guys a few seconds, and then I'll switch over to our PowerPoint, and we will go over everything together.

[00:37:11]All right, if you are still working on this scenario, I'm not going to give away the answer just yet.

[00:37:18]So, I'm just going to switch over to the PowerPoint so we can see how everything looks all put together.

[00:37:27]All right.

[00:37:29]So, oop.

[00:37:34]Okay.

[00:37:36]All righty. So, again, this is our scenario.

[00:37:41]Mrs. Waffles was given thrombolytic therapy for an acute myocardial infarction STEMI of an anterolateral wall, which converted to an NSTEMI. What ICD-10-CM code or codes is our reported?

[00:37:52]So, our keywords that we took out of there going to be our acute myocardial infarction, specifically STEMI, and then our anterola- Oh my I cannot say that word today. Anterolateral wall, and then obviously converted to the NSTEMI. And everyone was outstanding finding the guideline. And this is what it's going to look like specifically in the MCG manual.

[00:38:16]So, if you look on here, right away, it tells you kind of what category you're going to um you're going to pick from.

[00:38:26]So, it's pretty much just going to be one code. And then, um if you focus on here, this is It was a really long code, so I kind of did or it's a really long guideline, so I kind of just shortened it. But, like we were going over in our warm-up, it says if a type 1 NSTEMI becomes a STEMI, code it as a STEMI. If a type 1 STEMI changes to an NSTEMI due to treatment, still code it as STEMI.

[00:38:53]>> [snorts] >> So, with all of that being said, our final code, we are going to be coding the STEMI cuz it went from STEMI to NSTEMI, but we're still coding it as STEMI.

[00:39:03]That was a lot of saying STEMI. And it's going to be specifically code I21.09, which is going to be the ST elevation myocardial infarction involving other coronary artery of anterior wall.

[00:39:21]And I think that a lot of people got that one in the chat. So, amazing job if you got that one right. Hopefully, this makes sense um to anyone that was confused. But, that was an amazing participation. You guys absolutely nailed that one. So, shout-out to you guys.

[00:39:41]All right, and now I'm going to move back over to our Quizlet so we can go over our next scenario.

[00:39:51]All righty.

[00:39:53]Perfect.

[00:39:55]Okay, so yes, that is going to be the code, I29.09.

[00:39:59]And next scenario.

[00:40:01]Okay, we're going to go back to selecting our keywords. So, a 63-year-old patient is seen for his hypertension with stage five chronic kidney disease and myocardial disease.

[00:40:14]The conditions are stable and he is told to continue with his medications. The myocardial disease is unrelated to the hypertension.

[00:40:24]So, let me know what our keywords are going to be in this scenario. Put them in the chat.

[00:41:25]Okay, everyone is so fast at typing, I swear. If you're still typing, please put your answer in the chat. I myself was a little slow typer, so no worries. There are a good amount of things to take out of this scenario. So, yes, obviously we're going to take out the hypertension. We're going to take out the stage five CKD or the chronic kidney disease. We're taking out the myocardial disease and then also the myocardial disease being unrelated to the hypertension. That is definitely a big one.

[00:41:58]And everyone always kills these keywords. I knew you guys were going to get them all, but yes, if you put those in the chat, great job. And now we are going to move on to what guideline we are going to be using for this scenario. Actually, there I'm just going to say it, there are two guidelines we're going to be using for this scenario. So, you can put one, you can put both. Let me know what you guys think. As always, you can put the specific guideline number or you can put the title. Just let me know in the chat and then we will move on to some codes.

[00:43:21]>> [snorts] >> All right, you guys are on fire with determining these guidelines tonight. My goodness. So, yes, we are going to be using the I10A2 hypertension, hypertensive chronic kidney disease and then we are going to be using a chart specifically that you can find in I10A1.

[00:44:05]And I think we're using another one, but yes, definitely I10A2 and I see a lot of people putting I10A3 and I10A one as well. So, yes, I think you can find them both in there. So, great job.

[00:44:19]All right, and then now and again, I'm just going to tell you there's going to be more than one code definitely used for this one. So, what ICD-10-CM codes are we using? Using those guidelines, using those keywords.

[00:44:35]You guys are doing absolutely awesome with these scenarios, so give you guys a few seconds to work on those and then I'll switch over to the PowerPoint.

[00:45:04]>> [snorts] [snorts] >> All right, I know that this involved multiple codes. As always, I'm not going to give away the answer, I'm just going to switch over to our PowerPoint really quick, so bear with me.

[00:46:49]Okay.

[00:47:02]Okay, so this is our last one.

[00:47:06]Come on.

[00:47:07]Okay, so [gasps] again, this this scenario, a 63-year-old patient seen for hypertension with stage five chronic kidney disease, myocardial disease. The conditions are stable and he is told to continue with his medications. The myocardial disease is unrelated to hypertension.

[00:47:25]What we're taking out of there, we're taking the hypertension, we're taking stage five chronic kidney disease, we're taking out myocardial disease and myocardial disease is unrelated to hypertension.

[00:47:38]So, this is going to be our main guideline that we're going to be focusing on, or hypertensive chronic kidney disease. And if you look right here, so it says assume link between hypertension and chronic kidney disease. So, we're going to assume that they are um there's going to they're going to be linked because there was nothing saying that they were unrelated, it's only saying that the myocardial disease is unrelated to the hypertension. So, with following these guidelines in the sequencing, first we are going to take a code from category I12.

[00:48:18]So, we're also going to be focusing after that on a category from N18. And then right here on the far left, it says C section I10A1 chronic kidney disease.

[00:48:33]So, that's why I was saying the other guideline we were going to be using. If you look at I10A1, I think you can find it in the circulatory system guidelines as well, but it gives you kind of a nice organized list of the codes for stage one, stage two, stage three, stage four and the ESRD as far as chronic kidney disease goes. So, our first code, we're going back to the category from I12. So, we're going to land on I12.0, which is hypertensive chronic kidney disease with stage five chronic kidney disease or end-stage renal disease. And so, it says right here under here, use additional code to identify the stage of chronic kidney disease. So, it says to use code N18.5 or N18.6.

[00:49:29]And we're going to be using chronic kidney disease stage five, we're going to be using N18.5 because it doesn't um, say to use end stage It doesn't say end stage renal disease. It says stage five. So, that is why we're going to be using code N18.5 and not N18.6.

[00:49:49]So, those are going to be those two codes. And then, lastly, we have to code for the myocardial disease. And so, that is going to take us to our third code, which is going to be I51.5, which is our myocardial degeneration.

[00:50:07]And then, if you go under here, it accounts for myocardial disease. So, that is going to be how we're going to sequence it, I12.0, N18.5, and I51.5.

[00:50:21]And I see that a lot of people got that in the chat. So, if you got that right, or if you were close to getting it right, definitely big shout-out. I know it's intimidating when you just look at a scenario and there aren't any multiple choices on there and you have to just take codes straight out of there. But, if you gave it a shot, or you got it right, amazing job. I hope that the explanation helped.

[00:50:46]Let me know if you have any follow-up questions, or you can put it in the, um, survey, um, link as well, um, if you want to ask anonymously, and then I will get back to you with that. So, amazing job. And now, we are going to move on. I will stop sharing my screen, and then we are going to move on to our last scenario of the night.

[00:51:06]I'm loving the participation, so let's keep it up and let's end on a great note, cuz this class has been outstanding tonight so far.

[00:51:16]Okay. So, moving on. So, Mrs. Wagley is admitted after being found unresponsive at home. The patient had right-sided hemiplegia and aphasia from a previous CVA. The provider documents a current cerebral infarction due to occlusion of the right middle cerebral artery as the final diagnosis, and the patient is transferred for rehabilitation.

[00:51:46]So, I know it's kind of a big scenario, but let's break it down. And what keywords are we going to be taking out of this scenario? Let me know in the chat. I'll give you guys a few seconds. You got it.

[00:53:31]All right, if you're still typing, still put it in the chat.

[00:53:36]All right. So, I am focusing on, and I think everyone put it in the chat, um, the right-sided hemiplegia from a previous CVA, the aphasia, again, from a previous CVA. So, when I'm saying CVA, I mean the cardiovascular, the, um, what we were talking about beforehand. Um, and then, the right middle cerebral artery is also what I am taking out of that.

[00:54:05]So, if you got that one right, amazing job. And now, we are going to move on to our guideline.

[00:54:14]So, let me know what we think of the guideline is going to be in the chat. You are doing Oh, yes, I agree. You are doing great.

[00:54:24]This is the final stretch.

[00:54:27]So, bear with me. All right, let me know what guideline we are thinking for this scenario.

[00:54:56]>> [snorts] >> Okay.

[00:55:33]Yes, definitely still put your answers in the chat, but yes, the guideline that we're going to be picking, there's two guidelines we can use, I69D2 and I69D1.

[00:55:45]So, the sequela of the cerebral disease codes from category I69 with codes from category I60 through I67.

[00:55:54]And the sequela of cerebrovascular disease, category I69, sequela of cerebrovascular disease. So, if you put one or both of them in the chat, amazing job.

[00:56:09]And now, using those guidelines, we are going to put it all together, and we are going to select our ICD-10-CM codes.

[00:56:20]All right.

[00:56:22]You guys got it. I'll give you guys a few seconds for this one. And as always, we'll switch over to the PowerPoint, and we will go over it all together.

[00:56:30]>> [snorts] [snorts] >> All right, I know this one was probably one of the more in-depth scenarios that we're going to do. I know I saved it for last, so everyone that's still working on it, as always, I'm just switching over. So, everyone hold their horses. I'll stop sharing my screen super quick, and switch over one last time.

[00:58:52]Okay.

[00:58:55]I won't read this big long scenario again, but as you guys know, because we just went over it, the keywords we are taking out of this scenario are going to be our right-sided hemiplegia from the previous CVA, the aphasia from the previous CVA, and the right middle cerebral artery, the occlusion, rather, of the right cerebral or the middle cerebral artery.

[00:59:21]So, we are going to move on to our guidelines.

[00:59:27]So, these are going to be the two guidelines, the I69D1 and the I69D2.

[00:59:33]So, I'm focusing on the IC 92 right now just because right off the bat they're talking about the previous CVA.

[00:59:42]Um so, we obviously want to code what they're coming in for. So, what they're getting treated right now is going to be the occlusion of the right middle cerebral artery. And so, that's what we're going to focus on first. So, again, it's going to be a category from the code I60 through I67.

[01:00:05]And oh, I totally didn't bring this up.

[01:00:08]So, yeah, so this is what we were talking about before with the dominance being specified or not with that true or false that we went over in the beginning. Um so, right here if it's not documented, what we're defaulting to dominant. Um so, it says that he's doing the right-sided hemiplegia, the right middle artery. So, that's how we're going to determine if it's dominant or not dominant.

[01:00:34]So, our first code like I said, what we're going to be focusing on first, what he's getting treated for is going to be our cerebral infarction due to unspecified occlusion or stenosis of the right middle cerebral artery. So, this is going to be our code, our first code that's going to be between these categories, this I63.511.

[01:00:57]So, that's going to code for the final diagnosis. And then, we're also going to to right here, it says to code from I69 if related to an old CVA. And we do have some um things that are related to the old CVA, so we are going to be using them.

[01:01:19]So, right here, first off, we are going to code for our hemiplegia or and hem- hemi- per- oh my gosh, hemiparesis following cerebral infarction affecting right dominant side. And the reason that we're coding it as dominant is because the right side is being affected and we are defaulting it right here to dominant. So, that is why we are picking the right dominant side. So, that code is going to be I69.351.

[01:01:50]And then, we also are going to have to code and account for the aphasia that is also from a previous CVA. So, we are going to go back and select another code from I- that from the I69 category. And this is going to be the aphasia following cerebral infarction. And the code for that is going to be I69.320.

[01:02:18]Alrighty. I know that was a lot.

[01:02:24]How are we feeling?

[01:02:26]Did the guidelines make sense? Or I mean, I think if you do I69.320 yeah.

[01:02:37]That's how you would This is how you would sequence them. But, does that make sense?

[01:02:43]I know that we were all definitely on the right track. I know some people killed it and we're on the right track.

[01:02:50]I hope that if we were a little confused, I hope that this scenario made sense.

[01:03:00]Cuz that was definitely That was definitely one of the more difficult scenarios that we've gone over in the classes. I know that was like a lot of codes and a lot of um keywords and stuff to take out of it. So, but you guys were amazing. That participation was amazing.

[01:03:18]And we are ending right on time. But, I'm glad that Yes, I'm glad that you guys are feeling good. I hope you guys are feeling good, feeling confident. I'm always so impressed by how much you guys are participating in these classes and interacting.

[01:03:34]Um as always, if you do have any questions though that were not addressed um that are related to any of the scenarios that we went through or anything like that, definitely we will post a link the survey link in the chat again. So, definitely before you guys go, let us know if you have any questions related to that and I will definitely get back to you tomorrow. I'm usually super quick about it. Um or just give us some overall feedback cuz we love to hear your feedback cuz we want to make sure these classes are good and interactive and fun for you guys.

[01:04:09]Um but we appreciate you as always taking time out of your Monday to be here and code with us. Thank you as always to Miss Olga for putting that link in the chat. And thank you so much, Miss Vena.

[01:04:22]We love our wonderful team. And you guys have a wonderful rest of your week. And yes, please hit the like button before you leave.

[01:04:31]Miss Olga put it in the chat.

[01:04:34]So, it should be right above you. So, definitely click on that. And I hope to see everyone here next week for our week six ICD-10-CM guidelines. Have a wonderful rest of your night.

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