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Chapter 18&19 MEAS108
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Terms in this set (39)
The notation within ICD using directions like see or see also after the main terms in the index; notes that another term maybe appropriate when coding the referenced diagnosis
Cross-reference
Code set based on a system maintained by WHO whose use is mandated by HIPAA for reporting diseases, conditions, signs, and symptoms
ICD
The patient's primary reason for seeking care
Chief complaint
The alphanumeric designation used to communicate the diagnosis to third-party payers o the healthcare claim form
Diagnosis code
One of two ways diagnoses are listend in IDC; diagonses appear in alpha order wit their corresponding diagnoses codes
Alphabetic Index
Type of ICD-9 code set that identifies external causes of injuries and illnesses
E code
One of two ways diagnoses are listed in ICD; diagnoses codes are listed in numeric order with additional instructions regarding the use of the code for each diagnosis
Tabular List
The first diagnosis listed for OUTpatient claims as the PRIMARY reason for the patient's visit
Primary diagnosis
Analysis of the connection between diagnostic and procedural information in order to evaluate the medical necessaity of the reported charges
Code linkage
Another term for the physician's assessment of the patient's condition
Diagnosis
The first diagnosis listed for INpatient claims as the PRINCIPAL reason found, after study, for the patient's hospitalization
Principal diagnosis
An ICD-9 code used to identify healthcare encounters for reasons other than illness or injury, such as annual exams and immunization
V code
The list of abbreviation, punctuation, symbols, typefaces, and instructional notes providing guidelines for using the ICD code set
Conventions
Causes and severity of illness
Morbidity
Subdivisions of the alpha index for ICD-10 chapters containing clinical descriptions of the code range for coding
Subcategories
The cause of a disease or condition
Etiology
The 3-digit code subdivision in ICD-10
Categories
The organization that maintain and updates ICD
WHO
Divisions of ICD-10 named for a body system or specific disease type
Chapters
Causes of death
Mortality
Similar care being provided by more than one physician
Concurrent care
A reference with the most commonly used systems of codes
CPT
The period of time after many procedures for follow-up care that is considered included in the payment for that procedure
Global period
One or more two-digit alphanumeric codes assigned in addition to the CPT code to show that some special circumstances applies to the service or procedure
Modifier
Any CPT code that includes more than one procedure in its description
Bundled code
Codes that represent medical procedures, diagnostic tests, and examinations to evaluate patient's condition
Procedure code
Codes used when discussing questions or concerns regarding test results, prognosis, risks, options, treatments instructions, importance of compliance, risk factor reduction, and patient/family education
Counseling
Lab test frequently ordered together that are organ- or disease- orientated
Panel
Codes used to describe the wide range of time, effort, skill, and locations used by physicians for different patients to diagnose conditions and plan treatment
E/M code
Codes that cover many supplies and DME; also referred to as nation codes; services and procedures may not be found in CPT
HCPCS Level 2 codes
CPT codes that is only reported in addition to primary code
Add-on code
The act of separately listing services or procedures instead of using available codes that includes all services provided
Unbundling
Care provided to unstable, critically ill patients; constant bedside attention is needed with explicit information as to time spent
Critical care
Purposely choosing a code of higher level than that of the service provided
Upcoding
Patient who has not received professional services from physician within the last 3 years
New patient
Analysis of the connection between diagnostic and procedural information in order to evaluate medical necessity
Code linkage
Term used when the insurance carrier bases reimbursement on a code level lower than the one submitted by the provider
Downcoding
Care provided at the request of another healthcare provider
Consultation
Patient who has been seen by the physician within the last 3 years
Established patient
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