Occupational therapy ICD 10 codes

Occupational therapy ICD 10 codes are part of the International Classification of Diseases or ICD-10, a global, standardized coding system that incorporates clinical information into the claims processing system. These codes are essential when submitting a claim for service and describing the patient’s condition, diagnosis, symptoms, and treatment provided. While serving as identifiers, these codes also serve to ensure that accurate health information is documented when documents are shared among members of an interdisciplinary team.

What is an ICD-10 Code?

The International Classification of Diseases, 10th revision, is a globally recognized set of diagnosis and procedure codes that standardize the process for medical information collection and the classification of mortality statistics. The ICD-10-CM (Clinical Modification) is based on the ICD-10 statistical classification published by the World Health Organization and is used in the United States to classify diagnoses and reasons for visits in every healthcare setting. As part of the claims process, payers also need diagnosis and procedure codes to determine the medical necessity of the services provided.

Code structure

The ICD-10-CM is divided into an Alphabetic Index of corresponding codes and a Tabular List which is organized into chapters based on condition or body system and includes specific categories, and subcategories.

Codes are alphanumeric with three to seven characters, with each character adding specificity to the code. The first three characters of the ICD-10-CM code indicate a category of diagnosis with the next three characters (characters four through six) indicating the diagnosis' etiology, severity, anatomy, or causation. The seventh character is considered an extension that refers to the phase of the encounter and whether the service is within an active phase or initial encounter (A), a subsequent encounter or post-active phase (D), or a sequela (S) that treats the late effects of the diagnosis.

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Common Occupational Therapy ICD 10 codes

How to look up ICD-10 codes

ICD-10-CM Official Guidelines for Coding and Reporting recommend locating the diagnosis listed in the medical record using the Alphabetical Index first and then verifying the code using the Tabular List. The Tabular List provides more specific codes including laterality and any applicable 7th character. Icons are available at each code to indicate if the code has additional requirements or specificity options. 

Guidelines for The National Center for Health Statistics ICD-10-CM Browser Tool, is a public resource through the Centers for Disease Control and Prevention (CDC) for efficiently searching and selecting ICD-10-CM codes. 

Best practices for using Occupational Therapy ICD 10 Codes

After a claim is submitted, the first thing a payer sees are the occupational therapy ICD 10 codes. Although official guidelines admit that unspecified codes have acceptable uses, providers are encouraged to code to the highest specificity possible for each visit. 

Emphasis is placed on ensuring documentation is clear, complete, and consistent for accurate coding. To ensure specificity, confirm with the overseeing physician that the ICD-10-CM diagnosis code being used for the care plan is current and specific to why skilled services are needed. You can select multiple codes in your documentation but only one code will serve as a primary code for the encounter.

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Common coding errors to avoid in using Occupational Therapy ICD 10 codes 

• Incomplete documentation: Documentation is critical. Occupational therapists need clear documentation to justify the corresponding occupational therapy ICD 10 codes selected. Know the basics of what needs to be in your documentation and include key details, functional progress, and current objective measurements of functioning. This will document the medical necessity of services.

• Outdated codes: Codes are always revised and updated. Refer to your ICD-10-CM Tabular List to verify codes and ensure you are using the latest code for your condition. Payers also have information available about restrictions on occupational therapy ICD 10 codes that you can usually find in the insurance plan’s provider resources.

• Misreading and choosing the wrong code: When we are rushed or multitasking, we may accidentally mistype a letter or number which can change your occupational therapy ICD 10 codes. Use caution and confirm your code is correct before submitting your claim to ensure accuracy.

• Not coding to the highest level of specificity: Review your coding options to ensure you are coding to the highest level of specificity possible. This will save you time in the long run by preventing you from having to resubmit a denied claim.