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24 terms

coding chapter 1

STUDY
PLAY
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