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Chapter 5 Diagnostic coding
Terms in this set (22)
Appropriate diagnosis coding can mean
The financial success or failure of a medical practice.
A physician's fee profile
Is a compilation of each physician's charges and the payments made to him or her over a given period of time for each specific professional service rendered to a patient.
Diagnosis that relate to a patient's previous medical problem but have no bearing on the patient's present condition are not
(First listed condition) is the main reason for the encounter
Listed subsequently, may contribute to the condition or define the need for a higher level of care but is not the underlying cause.
Used in inpatient hospital coding, is the diagnosis obtained after study that prompted the hospitalization .
Some diagnostic codes are considered questionable when used as the first diagnosis on admission of a patient to the hospital ( For example Obesity, Benign Hypertension, Controlled Diabetes)
Diagnosis coding for office and outpatient services provided after October 1, 2014, is performed using the
In 1948, the WHO developed the official version of the
ICD in Geneva, Switzerland
To facilitate the coding process between ICD-9-CM and ICD-10-CM systems, a common translation tool referred to as the general equivalence mappings (GEMs)
Is a comprehensive translation tool that can be used to accurately and effectively translate codes.
ICD-10-CM is updated
Annually and contains a Tabular List of Diseases
Are rules or principles for determining a diagnostic code when using diagnostic code books such as each space, typefaces, indentations, punctuation marks, symbols, instructional notes, abbreviations, cross reference notes, and specific usage of the words and, with and due to.
Not elsewhere classifiable
Not otherwise specified
Brackets [ ]
Are used in the Tabular List to enclose synonyms, alternative wording, or provide explanatory phrases.
Parenthesis ( )
Are used in the Alphabetic Index and the Tabular List to enclose supplementary words that may further define the condition but do not affect the code number assigned.
Are used in the Tabular List after an incomplete term that requires additional modifiers to appropriately assign the code.
Is a situation in which a single code is used to classify two diagnoses or a diagnosis with an associated secondary process ( manifestation) or a diagnosis with an associated complication.
Is a LATE EFFECT or condition produced after the acute phase of an illness.
Is another name for a symptom complex, which is a set of complex signs, symptoms, or other manifestations resulting from a common cause or appearing in combination, presenting a distinct clinical picture of a disease or inherited abnormality.
Is a spontaneous new growth of tissue froming an
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