FY 2019 Official Guidelines for Coding & Reporting were released on Thursday and contain notable changes.

The National Center for Health Statistics (NCHS) has released and posted the fiscal year (FY) 2019 official guidelines for coding and reporting ICD-10-CM.

Oct 1, 2018 will bring some notable changes that will help with coding accuracy and drive clinical coded data integrity. The Conventions address “WITH,” by providing some clarification language. The word “with” or “in” should be interpreted to mean “associated with” or “due to” when it appears in a code title, the Alphabetic Index (either under a main term or subterm), or an instructional note in the Tabular List.

The General Guideline section has additions and revisions to #14 addressing “Social Determinant” codes Z55-Z65. Also changes to General guideline #19, “Coding for Healthcare Encounters in Hurricane Aftermath, which includes Coding for Healthcare Encounters in Hurricane Aftermath.”

Some chapter specific guidelines for FY2019 include the following:

  • Chapter 1 (Sepsis due to postprocedural infection)
  • Chapter 2 (Current malignancy versus personal history of malignancy)
  • Chapter 5 (Factious Disorder)
  • Chapter 9 (Hypertension with Heart Disease; Hypertensive Chronic Kidney Disease; and Subsequent Acute Myocardial Infarction)
  • Chapter 15 (Drug use during pregnancy, childbirth and the puerperium)
  • Chapter 18 (Glascow coma scale)

Be sure to learn more about these and other changes and be ready for Oct. 1. All hospital inpatient and outpatient (including physician office) coding professionals are to be used for discharges occurring from Oct. 1, 2018 through Sept. 30, 2019. It’s also important for clinical documentation integrity specialists (CDISs) to review the changes.

Click here to visit the NCHS page. 


Gloryanne Bryant, RHIA, CDIP, CCS, CCDS

Gloryanne is an HIM coding professional and leader with more than 40 years of experience. She has an RHIA, CDIP, CCS, and a CCDS. For the past six years she has been a regular speaker and contributing author for ICD10monitor and Talk Ten Tuesdays. She has conducted numerous educational programs on ICD-10-CM/PCS and CPT coding and continues to do so. Ms. Bryant continues to advocate for compliant clinical documentation and data quality. She is passionate about helping healthcare have accurate and reliable coded data.

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