Attention all coders, especially in the dermatology, cardiology, and OBGYN fields. Please see the following 2017 ICD-10-CM Coding Guideline and Coding Changes:

1. Guideline I.B.19 was added after the initial publication of the 2017 ICD-10-CM:Code assignment and Clinical Criteria

The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. The provider’s statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis.

This affects both ICD-10-CM coding and CPT assignment. A physician must document the diagnosis for lesion excisions as either benign or malignant, coders can no longer use the pathology report to determine the correct ICD-10-CM code or the CPT code.

This also means that the attending physician must document the type of infection in order for coders to code infections accurately.

2. ICD-10-CM guideline I.C.9: Diseases of the Circulatory System (I00-I99) was added for 2017:

A significant change has been made when coding for hypertension regarding “with” documentation, additional instruction to chronic kidney disease documentation and coding for hypertensive crisis.

Because the word “with” is used in the Alphabetical Index, a causal relationship can be assumed without physician documentation between hypertension and kidney involvement.

3. Two new additions for Pregnancy, Childbirth, and the Puerperium:

  • Zika virus disease code has been added to the A92 code section in order to track the disease: A92.5
  • Code Section O11 has been expanded to add new codes for pre-existing hypertension:
    • O11.4 Pre-existing hypertension with pre-eclampsia, complicating childbirth
    • O11.5 Pre-existing hypertension with pre-eclampsia, complicating the puerperium

If you have any questions or would like to learn more, contact your Dean Dorton advisor or Adam Shewmaker ( or Brandy Montgomery (