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APG

ambulatory patient group: Apayment system similar to DRG but designed for the ambulatory care facility

CMS

centers for medicare and medicaid services: the federal agency responsible for maintaining and monitoring the medicare program beneficiary services and medicaid and state operations

comorbidity

an ongoing condition that exists with another condition for which the patient is receiving treatment

compliance plan

a structured format stating office policies and procedures for identifying and correcting inaccurate documentation and billing cirteria

complication

a disease or condition that arises during the course of or as a result of another disease and that modifies medical treatment requirements

conventions

terms and symbols used to provide instructions for using diagnostic codes

CPT

current procedure terminology

cross references

directions to look in other areas for the correct code

DRG

diagnosis-related group: a patient-classification system to categorize patients who are medically related with respect to diagnosis or treatment or who are statistically similar with regard to length of hospital stay

DRG RATE

a fixed dollar amount payable to the hospitals for patient care

DSM-V

Diagnostic and Statistical Manual of mental disorders Fith edition: A reference for coding psychiatric disorders or conditions

E Codes

coder for external cause of injury or disease

eponym

a condition or procedure named after a person or place

etiology

the cause of a disease

ICD-9-CM

International Classification of Diseases, Ninth Revision, Clinical Modification the source of diagnosis coding required by insurance carriers and government agencies

index

another term for ICD-9-CM volume 2 the alphabetical listing of terms to describe injuries or diseases

Manifestation

signs or symptoms of a disease

NEC

not elsewhere classified: a category of codes to be used only when the coder lacks information required to code the term to a more specific category

nonessential modifiers

terms listed in parentheses that provide supplemental information but do not affect the code selection

NOS

not otherwise specfied: this abbreviation is equivalent to "unspecified"

Rubric

3 digit root code for the classification of illness disease, or injury

specificity

coding a diagnostic statement to the highest degree reportable within the ICD-9-CM manual using fourth and fifth digits when available while avoiding overuse of unspecified codes

Tabular List

another name for ICD-9-CM volume 1 the numerical listing of diseaseand injury

V Codes

supplemental codes that are used when a patient presents fore something other than illness or disease example eye exam hearing exam

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