ICD-9-CM Introduction Terminology

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Acute

refers to the condition that is the primary reason for the current encounter.

Addenda

official updates to ICD-9-CM published continuously since 1986, that become effective on October 1st of each year.

Adverse

any response to a drug that is NOXIOUS and unintended and occurs with proper dosage.

Aftercare

an encounter for something planned in advance, for example, cast removal.

AHFS

American Hospital Formulary Service.

Alphabetic Index

the portion of ICD-9-CM that lists definitions and codes in alphabetic order. Also called VOLUME 2.

Category

refers to diagnoses codes listed within a specific (3) three-digit category, for example category 250, Diabetes Mellitus.

Cause

that which brings about any condition or produces any effect.

Chronic

continuing over a long period of time or recurring frequently.

Coding

the process of transferring written or verbal descriptions descriptions of diseases, injuries and procedures into numerical designations.

Combination

a code that combines a diagnosis with an associated secondary process or complication.

Complication

the occurrence of (2) two or MORE diseases in the same patient at the same time.

Concurrent

when a patient is being treated by more than one provider for different care conditions at the same time.

Conventions

refers to the use of certain abbreviations, punctuation, symbols, type faces, and other instructions that must be clearly understood in order to use ICD-9-CM.

CPT

Current Procedural Terminology. Litsting of codes and descriptions for procedures, services and supplies published by the American Medical Association. Used to bill insurance carriers.

Diagnosis

a written description of the reason(s) for the procedure, service, supply or encounter.

Down coding

the process were insurance carriers reduce the value of a procedure, and the resulting reimbursement, due to either (1) a mismatch of CPT {Current Produral Terminology} code and description or (2) ICD-9-CM code does not justify the procedure or level of service.

E Codes

specific ICD-9-CM codes used to identify the cause of injury, poisoning and other adverse effects.

eponyms

medical PROCEDURES or CONDITIONS named after a person or a place.

etiology

the cause(s) or origin of a disease.

HCFA 1500

Uniform Health Insurance Claim form used for billing services to Medicare and othe insurance carriers.

hierarchy

a system that ranks items one above another.

ICD-9-CM

INTERNATIONAL CLASSIFICATION of DISEASES, 9th Revision, CLINICAL MODIFICATION.

ICD-10

INTERNATIONAL CLASSIFICATION of DISEASES, 10th Revision.

late effect

a residual effect (condition produced) after the acute phase of an illness or injury has ended.

Main Term

refers to listings in the Alphabetic Index appearing BOLDFACE type.

manifestation

characteristic signs or symptoms of an illness.

multiple

refers to the need to use more than one ICD-9-CM code to fully identify coding a condition.

Primary code

the ICD-9-CM code that defines the main reason tor the current encounter.

Residual

the long-term condition(s) resulting from a previous acute illness or injury.

Rule Out

refers to a method used to indicate that a condition is probable, suspected, or questionable but unconfirmed. ICD-9-CM has no provisions for the use of this term.

Secondary

code(s) listed after the PRIMARY CODE that further indicate the cause(s) code for the current encounter or define the need for higher levels of care.

Sections

refers to portions of the Tabular List that are organized in groups of (3) THREE- DIGIT code numbers. For example, MALIGNANT NEOPLASM of LIP, ORAL CAVITY and PHARNYX - {140-149}.

Sequencing

the process of listing ICD-9-CM codes in teh proper order.

Specificity

refers to the requirement to code to the highest number of digits possible, 3 THREE, 4 FOUR or 5 FIVE, when choosing an ICD-9-CM code.

Sub-term

refers to listings appearing in the Alphabetic Index under MAIN TERMS and always indented (two spaces) to the right.

Subcategories

refers to groupings of (4) FOUR-DIGIT codes listed under (3) THEE-DIGIT categories.

Tabular List

the portion of ICD-9-CM that lists codes and definitions in NUMERIC order. Also referred to as VOLUME 1.

V Codes

specific ICD-9-CM codes used to identify encounters for reasons other than illness or injury, for EXAMPLE, immunization.

Volume 1

see TABULAR LIST

Volume 2

see ALPHABETIC INDEX

Volume 3

procedure codes used only for hospital coding. Volume 3 contains both a numeric listing and an ALPHABETIC INDEX.

SUPPLEMENTARY CLASSIFICATIONS

There are (2)TWO supplemental classifications included in the TABULAR LIST (Volume 1): V Code(s): Supplemental Classification of Factors Influencing Health Status and Contact with Health Services (V01-V91). E Code(s): Supplemental Classification of External Causes of Injury and Poisoning (E000-E999.

APPENDICES

The Tabular List (Volume 1) includes (4) FOUR appendices.

Chapter of the Tabular List (Volume 1) is Structured into (Volume 1) is structured into (4) FOUR components, Namely:

Section(s): groups of (3) THREE-DIGITS code numbers
Categories: (3) THREE-DIGIT code numbers
Subcategories: (4) FOUR-DIGIT code numbers
Fifth-Digit Subclassifications: (5) FIVE-DIGIT code numbers.

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