right side is affected, but the record
doesn’t indicate whether the patient is
right- or left-handed, the code for “
dominant side” should be assigned.
Some patients recover from a stroke
without any residual effects. If the record
indicates the patient has a history of
stroke but there is no documentation of
any sequelae, the history can be reported
with code Z86.73 [Personal history of
transient ischemic attack (TIA), and cerebral infarction without residual deficits].
This code should not be assigned together
with any of the stroke sequelae codes.
In summary, although the codes are
different, the ICD- 10 coding guidelines
for stroke are very similar to those in
ICD- 9. With appropriate training and
practice, coding staff should have no difficulty assigning accurate ICD- 10 codes
for this condition.
Melody W. Mulaik is president and co-founder of
Coding Strategies, Inc. She is a nationally recognized
speaker and has delivered numerous presentations at
AHRA annual meetings and conferences. Melody is a
member of AHRA, has published extensively, and may
be contacted at email@example.com.