For all of the following examples, pay close attention to the Approximate checkbox. If an ICD-10 code in the Mapping results has the “Approximate” checkbox checked, then the ICD-10 code is only an approximate code and should not be assumed to be the correct code for your particular case. It may be the correct code for your specific case, but it may not be. If it is not specific enough you might get a rejection, not get paid, or worse, you might be underpaid and not realize it (you will probably know if you don’t get paid at all, but it’s harder to know if you were underpaid).
Just as with the Codes in the list sections (Index, E-Codes, Drugs, and Neoplasms), clicking on the ICD-10 code in the Mapping results will route you directly to that code in the Tabular Listing, where you can see other similar codes and descriptions. Look very carefully at the other related codes to see if another ICD-10 code might be more detailed or specific than your “approximate” code. Many times it can be as simple as “right” or “left” or an “upper” or “lower” instead of “unspecified” that will make all of the difference in how it impacts the claim adjudication.
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