Practice Quiz

Medical Coding

Category - ICD-10-CM Volumes 1 and 2

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Do “borderline” codes exist in the ICD-10-CM?
  1. Yes, “borderline” codes exist for all diagnosis in the ICD-10-CM
  2. No, “borderline” codes do not exist for any diagnosis in the ICD-10-CM
  3. Yes, “borderline” codes exist, but only for some diagnoses in the ICD-10-CM when the documentation clearly states a “borderline” diagnosis
  4. Yes, “borderline” codes do exist in the ICD-10-CM and are only used when a condition isn’t clarified in the providers’ documentation at the coder’s discretion.
Explanation
Answer: C - “Borderline” codes do exist for some diagnoses and must be confirmed using the notations in the ICD-10-CM coding book. These codes may only be used if the provider specifically states this in the medical record.
If “borderline” is unclear in the documentation and there are any questions about the diagnosis in the documentation, then the coder should query the provider for clarification.
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