Coding Rules Current as at 18-Oct-2016 08: 31

Published 15 June 2015,
for implementation 01 July 2015.

Ref No: Q2976 | Published On: 15-Jun-2015 | Status: Current

SUBJECT: Assignment of the condition onset flag for multiple conditions/sites classifiable to one ICD-10-AM code.

Q: 

Where a patient has multiple conditions/sites classifiable to a single ICD-10-AM code that qualifies for different condition onset flag values, which condition onset flag value should be assigned? For example, a stage I pressure injury on the ankle (arising during admission) and a stage I pressure injury on the foot (present on admission). Both are discrete pressure injuries classifiable to one ICD-10-AM code, L89.09 Pressure injury, stage I, other site of lower extremity (excluding heel and toe).

A:

The goal of the condition onset flag (COF) is to provide:

an insight into the kinds of conditions patients already have when entering hospital and those conditions that arise during the episode of admitted patient care. A better understanding of those conditions arising during the episode of admitted patient care may inform prevention strategies particularly in relation to complications of medical care (ACS 0048 Condition onset flag.)

Therefore, where multiple conditions/sites are classifiable to a single ICD-10-AM code that qualifies for different condition onset flag values, assign COF 1 Condition with onset during the episode of admitted patient care.

Improvements to the ACS will be considered for a future edition.