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ICD-10-CM
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The I-10 was developed by the National Center for Health Statistics (NCHS) to replace I-9 Volumes I and II.
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Improvements in ICD-10-CM
Expanded injury codes
Combination diagnosis/symptom codes
Expansion of injury codes allows for greater specificity.
7th character describes the encounter (for example, A, D, or S)
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Improvements
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ICD-10-CM Structure
Addition of chapters for
Chapter titles in the I-10 remain similar to the I-9
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GEMs Files
ICD-10-CM codes
Figure: 2.1
GEMs mapping files I-9 to I-10
(Courtesy U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.) 
(Cont’d…)
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GEMs files do not contain decimal points within the codes. For example, in the GEMs file for I-9 code 001.1 is 0011 and for I-10 code A00.1 is A001.
In Figure 2-1, column 1 displays I-9 codes and column 2 displays I-10 codes.
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GEMs Files
ICD-10-CM codes mapped to ICD-9-CM codes
GEMS mapping files I-10 to I-9 (Courtesy U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.)
Figure: 2.2
(…Cont’d)
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GEMs Flag (Column 3)
Three types of flags
Flags: 00000 and 10000
Combination
Requires a combination of codes to map from one system to another
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Column 3 of the GEMs file displays flags.
There are five times more codes in the I-10 (69,000+) to the I-9 (14,000+).
I-9 code may be linked to more than one I-10 code.
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Index
 
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I-10 Index is alphabetic, with the main terms in bold type and subterms indented under the main term.
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ICD-10-CM Chapters
Chapter 12 Diseases of the Skin and Subcutaneous Tissue (L00–L99)
Chapter 13 Diseases of the Musculoskeletal System and Connective Tissue (M00–M99)
Chapter 14 Diseases of the Genitourinary System (N00–N99)
Chapter 15 Pregnancy, Childbirth, and the Puerperium (O00–O9A)
Chapter 16 Certain Conditions Originating in the Perinatal Period (P00–P96)
Chapter 17 Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q00–Q99)
Chapter 18 Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00–R99)
Chapter 19 Injury, Poisoning, and Certain Other Consequences of External Causes (S00–T88)
Chapter 20 External Causes of Morbidity (V01–Y99)
Chapter 21 Factors Influencing Health Status and Contact with Health Services (Z00–Z99 )
Chapter 1 Certain Infectious and Parasitic Diseases (A00–B99)
Chapter 2 Neoplasms (C00–D49)
Chapter 3 Disease of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism (D50–D89)
Chapter 4 Endocrine, Nutritional, and Metabolic Diseases (E00–E89)
Chapter 5 Mental, Behavioral and Neurodevelopmental Disorders (F01–F99)
Chapter 6 Diseases of the Nervous System (G00–G99)
Chapter 7 Diseases of the Eye and Adnexa (H00-H59)
Chapter 8 Diseases of the Ear and Mastoid Process (H60–H95)
Chapter 9 Diseases of the Circulatory System (I00–I99)
Chapter 10 Diseases of the Respiratory System (J00–J99)
Chapter 11 Diseases of the Digestive System (K00–K95)
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Tabular
Each section begins with unique letter and codes arranged in numerical order
ICD-10-CM Tabular, R codes. (Modified from Buck CJ: 2013 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2013, Saunders.)
Figure: 2.10
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Official Instructional Notations
Figure: 2.11
Includes notation. (From Buck CJ: 2013 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2013, Saunders.)
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I-10 has instructional notations providing guidance to the coder.
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Excludes1
Figure: 2.12
Excludes1 notation in I-10. (From Buck CJ: 2013 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2013, Saunders.)
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What Excludes note is a pure excludes? (Excludes1)
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Excludes2
Excludes2 notation. (From Buck CJ: 2013 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2013, Saunders.)
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Code First/Use Additional Code
Figure: 2.14
I-10 Tabular, Code first notation. (From Buck CJ: 2013 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2013, Saunders.)
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Code Also
Figure: 2.16
I-10 Tabular, Code also notation (From Buck CJ: 2013 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2013, Saunders.)
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Severity of the condition.
Reason for the encounter.
7th Character and
Placeholder X
Codes <6 characters that have a 7th character requirement, X is placeholder
Figure: 2.18
X as the placeholder. (From Buck CJ: 2013 ICD-10-CM Standard Edition DRAFT (Softbound), St. Louis, 2013, Saunders.)
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Conclusion
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