As we count down the remaining months in the transition to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), the cooperating parties for ICD-10-CM have approved new guidelines offering clarification of some conventions. The latest version of the guidelines can be found at along with the latest ICD-10-CM code files. This article includes excerpts of the guidelines that are of importance to pediatricians and coders, using boldface to indicate new text in excerpts from the guidelines.

The first change is found in Section IA, Conventions for the ICD-10-CM. A clarification regarding nonessential modifiers provided in the alphabetic index and tabular list is added to the paragraph under item 7 describing how parentheses are used. This is intended to alleviate confusion when a nonessential modifier is incongruent with a sub-term entry.

Parentheses are used in both the Alphabetic Index and Tabular List to enclose supplementary words that may...

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