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


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


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


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


terms and symbols used to provide instructions for using diagnostic codes


current procedure terminology

cross references

directions to look in other areas for the correct code


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


a fixed dollar amount payable to the hospitals for patient care


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


a condition or procedure named after a person or place


the cause of a disease


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


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


signs or symptoms of a disease


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


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


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


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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