AHA Coding Clinic® for ICD-9 - 2010 Quarter 1; Clarifications
5th Digits for Pattern of Use for Alcohol and Drug Abuse/Dependence
Please provide clarification regarding the fifth digit subclassification for categories 303 - 305 to indicate the patient's pattern of drug and alcohol abuse. In Coding Clinic , Second Quarter 1991, page 11, advice was provided to allow facilities to use documentation from "technical and professional personnel other than the attending physician" for the purpose of assigning fifth digits. In addition, examples were given regarding the corresponding fifth digits. We understand that coding should be based on the documentation of a provider as defined in the Official Guidelines for Coding and Reporting - the physician or any qualified health care practitioner who is legally accountable for establishing the patient's diagnosis. Since technical and professional personnel such as rehabilitation counselors and other professionals are not legally responsible for establishing the patient's diagnosis, we wonder if their documentation could be used to provide further specificity for the selection of the fifth digits for these codes? ...
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Article Overview
This article addresses a coding clarification for pattern-of-use subclassification in alcohol and drug abuse/dependence categories and discusses how guidance from Coding Clinic relates to documentation sources and the Official Guidelines for Coding and Reporting. It is relevant to coding professionals, compliance staff, and clinicians who support diagnosis documentation and ICD-9-CM code assignment.
Why This Topic Matters
Understanding the documentation basis for pattern-of-use subclassification affects accurate diagnosis coding and consistency with official reporting guidance. The article is useful for organizations reviewing older ICD-9-CM behavioral health coding practices and documentation standards.
What You Will Learn
- What the article is clarifying about pattern-of-use subclassification for substance abuse/dependence categories
- How the article relates Coding Clinic guidance to documentation sources
- Which general documentation standards are being referenced for diagnosis assignment
- How this topic fits within alcohol and drug abuse/dependence coding practice
Who Should Read This
- Medical coders
- Coding compliance staff
- Health information management professionals
- Clinical documentation specialists
- Physicians and other qualified health care practitioners
Code Ranges Discussed
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