Chapter 8 — Further Reading

Tier 1 — Verified canonical sources

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.A — "Conventions for the ICD-10-CM." This is Chapter 8 in the source's own words, and it is roughly six pages. It covers the index and tabular structure, the format and appearance of the code set, use of codes for reporting purposes, placeholder characters, the seventh character, abbreviations (NEC and NOS), punctuation, use of "and" and "with," "see" and "see also," and — at I.A.12 — the Excludes notes and the Excludes1 exception described in Case Study 1.

If you read one thing after this chapter, read Section I.A. It is free, it is short, and it is the authority for everything the chapter just taught you.

ICD-10-CM Alphabetic Index and Tabular List files, free from CMS and NCHS. Having the files means you can text-search the whole index, which is occasionally the fastest way to find a main term you cannot guess.

ICD-10-CM addenda files, published with each annual update. Chapter 8's Case Study 2 is about what happens when nobody reads them. They list every addition, deletion, and revision — including revisions to instructional notes, which is the category that produces silent errors.

AHA Coding Clinic for ICD-10-CM and ICD-10-PCS. Subscription. The recognized source of official advice, and the place where index and tabular ambiguities are actually resolved. A great many questions that feel unanswerable from the Guidelines have been addressed here, including questions about main term selection and about specific Excludes notes.

ICD-10 Coordination and Maintenance Committee materials. Case Study 1's Excludes1-to-Excludes2 conversions are proposed, discussed, and documented here.

CMS ICD-10-CM guidance and FAQs, including the 2015 interim guidance on Excludes1 that became the current exception.

Tier 2 — Attributed, specifics unverified

AAPC and AHIMA educational material on index and tabular navigation. Both publish substantial free content on main term selection, the Excludes notes, and the specialty tables. Useful as a second explanation — particularly for the Table of Neoplasms, which benefits enormously from being walked through by someone else — and not authority.

Code book publisher navigation aids. Professional editions carry color coding, symbols, and margin indicators for Excludes notes, seventh-character requirements, and codes requiring additional characters. These are genuinely helpful and they are publisher conventions, not part of the code set — two publishers may mark the same thing differently, and neither marking is authoritative.

Specialty society coding guidance on the categories a given clinical area uses most. Frequently the most practical source for "which main term do I use for this," because it is written by people who look up the same twenty conditions every day.

Coding forums and practice communities. Genuinely useful for the specific question this chapter raises most — which main term? — because that question is hard to answer from a reference and easy to answer from someone who has done it. Follow every answer to the index before relying on it.

Published coding practice sets and workbooks. §8.10's five lookups are a sample; the skill is built by volume, and a practice set with worked answers is the most efficient way to get that volume. Chapter 39 §39.7 covers preparation more fully.

Tier 3 — Illustrative and constructed

The index excerpts in §8.2, §8.3, and §8.10 — the Pain(s) entry with its joint subterms, the Hypertension nonessential modifiers, and the specialty table excerpts. These reproduce the structure of real index and table entries and are abridged for teaching. The complete entries are longer, and the abridgment is itself a reason to work from your own book rather than from this one.

The five lookups in §8.10 and their named wrong turns.

Case Study 2 in its entirety — the nine-year coder, the category expansion, the new instructional note, and the fourteen-month silent underreporting. Constructed. The mechanism — a loud failure detected in days and a silent one detected by an outside party over a year later — is entirely ordinary and is the reason §8.1 states its rule as an absolute.

The actual assignment

Read Section I.A of the current Official Guidelines. Six pages. Then do the five lookups in §8.10 with your own book, out loud, recording the path for each — main term, subterms, index result, what the Tabular added.

Then do them again in a month. The second time will take a third as long, and the difference between those two times is the skill this chapter exists to build.