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Lesson 1 Coding fundamentals
ICD-9-ICD-10 fundamentals
20
Medical
Not Applicable
12/04/2013

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Term
The ICD-9-CM
Definition
The International Classification of Diseases, 9th Revision, Clinical Modificatiopn (ICD-9-CM)is designed for classifying patient morbidity (sickness) and Mortality (death) information for statistical purposes and for the indexing of health records by disease and operations, date storage and retrieval.
Term
The ICD-9-CM history
Definition
Based on the official version compiled by the World Health Organization (WHO) in Feb 1977 to provide accurate information (classification) of diseases, medical care review, ambulatory care, other medical care programs and basic health statistics
Term
The ICD-9-CM History cont
Definition
Designed to provide access to medical records through retrieval for medical research ,education, and administration, today codes are used to :1)facilitate payment of health services
2)Eval pts use of health care facilities (utilization patterns)
3)Study cost of health care
4)Research quality of care
5)Predict health care trends
6)Plan for future health care needs
Term
ICD-9-CM today
Definition
The use and results of coding are widespread today in our everyday lives. Anytime you hear about a specific number of AIDS cases, epidemic, etc you are seeing the results of the coding stats.
Term
ICD-9-CM classification system
Definition
By classification system, we mean that each condition or disease can be coded to only ONE CODE as much as possible to ensure the validity and reliability of the data
Term
ICD-9-CM stands for
Definition
International Classification of Diseases (CM) clinical modification
Term
List 4 of the 6 reasons why ICD-9-CM codes are used today
Definition
1)facilitate payment
2)Study cost of health care
3)Evaluate patients use of health care facility
4) research quality of care
Term
ICD-9-CM Format - volume 1
Definition
Volume 1 contains the disease and condition codes and the code descriptions. (nomenclature)as well as the supplementary classification of factors influencing health status and contact with health services (V codes) and external causes of injury and poisoning (E Codes)
Term
Volume 1 and 2:
Definition
Volume 2 is the alphabetical Index for volume 1.
Volume 1 and 2 are used in inpatient and outpatient settings, to substantiate the reason for receiving medical services. (medical necessity) by assigning diagnosis codes.
Term
Volume 3
Definition
Vol. 3 is used for coding surgical, therapeutic, and diagnostic codes. Volume 3 is used primarily for hospitals.
Term
where are these vol, 1,2,3 located?
Definition
Depends on the publisher, Vol.2 may be in the front or in the middle. Some publishers have volume 2, volume 1, volume 3 and others 1,2,3
Term
facts about ICD-9-Cm;
Definition
95% of insurance is filed electronically (EDI) under the 5010 claim format required by hippa.
Term
There are 4 main groups whose function it is to deal with in-depth coding principles
Definition
1) The centers for medicare and medicaid services (CMS)formerly known as the Health Care Financing Administration (HCFA)
2)National Center for Health Statistics (NCHS)
3) American Health Information Management Association (AHIMA)
4)American Hospital Association (AHA)
Term
Format
Definition
The ICD-9-CM is published in 3 volumes.
Vol 1: Diseases Tabular list
Vol 2: Diseases Alphabetical list
Vol 3: Procedures, tabular and alphabetical index
Term
Tabular List Vol 1
Definition
After referencing the index (vol 2) you will locate the codes identified in the tabular. YOU CAN NEVER CODE DIRECTLY FROM THE INDEX. You must always reference the index and then verify the code number in the tabular.
Term
Divisions in the tabular;
Definition
Volume 1: tabular list is the listing of all the codes available for assignment. including their description. When the exact word is not found in the alphabetical inde, you must trust the code provided in the Alphabetical index you must trust that the code provided in the alphabetical index to be correct because the index contains descriptive words that the tabular does not. Not listing all the possible descriptive terms in the the tabular save space.
Term
Divisions in the tabular cont.
Definition
Anything that can happen to the human body by way of injury or disease has a code in VOL 1.Although there are many things that can happen to us the people who devoloped the ICD indluded all but also organized it all in a systematic way. Volume 1 is divided into 2 major divisions.
Term
Volume 1 is seperated into 2 major divisions
Definition
1) Classification fo diseases and injury
2)Supplementary Classicications *Supplementary classification of factors influencing health status and contact with health services (V codes) (v01-V91)
* supplementary classication of external causes of injury and poisoning (E Codes)(E000-E999)
Term
Classification of diseases and injuries:
Definition
This is the main part of the ICD-9-CM Vol 1 tabular list : It consists of 17 chapters with codes ranging from 001 - 999.
Most chapters are based on body systems. (e.g.nervous system-{chapter 6}respiratory system {chapter 8} or digestive system {chapter 9} Some chapters are based on the cause or type of disease (e.g infections and parasitic dx {chapter 11}or neoplasms{chapter 2}
Term
Chapter
Definition
A chapter is the main division in the ICD-9-CM manual.
a section is a group of 3 digit categories that represent a group of 3 digit categories that represent a group of conditions or related conditions.
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