Introduction to Medical Coding

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Answer the following as matching.

Coding

purely an academic exercise, finding the correct codes to cover a patient's diagnosis or procedure is simply a way to organize data into a simpler form.

Billing

the more practical function. It's the act of using those medical codes to charge an insurance company for a service.

ICD

The International Classification of Diseases

ICD-9

The nineth revsion of the International Classification of Diseases

ICD-9-CM

Clinical Modification of The 9th revision of the International Classification of Diseases

Volume 1

Disease Classification: Tabular List of Disease

Volume 2

Disease Classification: Alphabetic Index to Disease

Volume 3

Procedure Classification: Alphabetic Index and Tabular List of Procedures

CPT

Current Procedural Terminology Manual

HCPCS

Healthcare Common Procedure Coding System

HCPCS - Level I

The American Medical Association's Current Procedural Terminology Manual (CPT). includes all the codes you'll need for coding any medical service, treatment, or procedure doctors and their staff members provide to their patients

HCPCS - Level II

The National Coding Manual - devised by the federal government, are alphanumeric and supplement the CPT manual by providing codes for other services and equipment, like ambulance services and prosthetic devices

Medical Coding

essential for the accruate tranmission of procedures and diagnosis data between health care providers and the many insurance companies

CMS

Centers for Medicare and Medicaid Services

What do E/M codes describe?

The patient visit itself.

What form lists all the conditions and treatments that a particular type of medical practice sees most often?

The superbill.

How many types of codes will you find listed in the ICD-9-CM?

Three.

What do insurance companies pay for?

Services and procedures.

Together, what do all the different types of medical codes on a claim form tell the insurance company?

A complete story about one particular doctor-patient encounter.

When did medical insurance companies begin offering medical plans that would cover the costs of routine, preventive, and emergency health care procedures?

After World War II

What's the big difference between the ICD-9-CM and the CPT manual?

The ICD-9-CM is for finding the code for the patient's problem, and the CPT manual is for finding the code for the doctor's solution.

What is the difference between the ICD-9-CM Hospital Edition and the ICD-9-CM Physician Edition?

The Hospital Edition includes all three volumes, while the Physician Edition only includes the first two volumes.

What are the two levels of HCPCS?

The CPT manual and the National Coding Manual

Under what circumstances can someone reveal information from a patient's medical records without the patient's authorization?

When all information that would identify the patient has been deleted, as when a doctor writes a paper about a condition.

How are coding and billing different?

Coding is a purely academic exercise—it's just a way to organize medical data.

Which of the six sections that make up the CPT manual's main tabular portion (the front half of the book) is the largest?

The Surgery section

In which subsection of the CPT manual will you find the procedure codes for a simple, complete mastectomy?

Surgery: The Female Genital System

What does the prefix myelo indicate in medical terminology?

Relating to bone marrow.

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