Understanding Health Insurance--Chapter 6A
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Created by:
christi_floyd on June 22, 2011
Description:
ICD-9-CM Coding
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13 terms
Terms | Definitions |
|---|---|
 Mortalit | Death |
| Morbidity | Disease |
| National Center for Health Statistics (NCHS) | U.S. Department of Health and Human Services agencies responsible for overseeing all changes and modifications to the ICD-9-CM. |
| Advance Beneficiary Notice (ABN) | Acknowledges patient responsibility for payment if Medicare denies the claim. |
| Encoder | Automates the coding process using computerized or Web-based software; instead of manually looking up conditions (or procedures) in the coding manual index, the coder uses the software's search feature to locate and verify diagnosis and procedure codes. |
| Diagnositic Coding and Reporting Guidelines for Outpatient Services: Hospital-Based and Physician Office | Developed by the federal government for use in reporting diagnoses for claims submission. |
| First-listed diagnosis | Used in the outpatient setting, this term is used (instead of the inpatient setting's principal diagnosis), and it is determined in accordance with ICD-9-CM's coding conventions (or rules) as well as general and disease-specific coding guidelines. |
| Outpatient | A person treated in one of four settings: ambulatory setting, physician's office, hospital clinic, ER, outpatient dept, same-day surgery unit, hospital observation where patient's length of stay is 23 hours, 59 minutes, and 59 seconds or less. |
| Principal diagnosis | The condition determined after study which resulted in the patient's admission to the hospital. |
| Qualified diagnosis | A working diagnosis that is not yet proven or established. |
| Tabular List of Diseases (Volume 1) | Contains 17 chapters that classify diseases and injuries, two supplemental classifications, and four appendices. |
| V Codes | Located in the Tabular List of Diseases and are assigned for patient encouters when a circumstance other than a disease or injury is present. |
| E Codes | Located in the Tabular List of Diseases, describes external causes of injury, poisoning, or other adverse reactions affecting a patient's health. |
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