HP 212C – Unspecified Codes Discussion – University of Arkansas

The use of “unspecified” codes has been a common topic of discussion in the industry. There is a sense that unspecified codes will corrupt the reliability of the data we compile based on these codes. There seems to be a consensus that the use of these codes is bad and should be avoided. Here is an article specifically addressing the issue of unspecified ICD-10 codes. “Another disadvantage of unspecified codes is that they fail to document patient’s complexity.” “Physicians who use lots of unspecified codes might start hearing, “Why can’t you see 25 or 28 patients a day? Why not put in a mid-level clinician to do this work?” Dr. Mazzola noted. Unspecified codes do often represent a missed opportunity, Mendenez agreed: “Many physicians’ documentation supports a more specific code; they’re just not using it.

Implement the concept of unspecified codes when used in code selection.

Include ALL the following aspects in the discussion:

• After reading the attached article, do you agree with the author? Why or Why Not?
• Support your agreement or disagreement by providing an article that shares an example of an unspecified ICD-10-CM code.
• What is the more specific code/s that should be used instead of the unspecified code in the article you attached?
• Discuss with your peers why this would be a more related coding choice.