SOLUTIONS GRADED A+
◉ What is ICD-10 used for in the US? Answer: Classify morbidity data
from IP and OP records, physician offices, and National Canter for a
health Statistics surveys, reimbursement purposes, and greater
specificity of diagnoses.
◉ Who updates and approves the ICD-10 code sets? Answer: AHA,
AHIMA, CMS, and NCHS
◉ Who publishes coding clinic? Answer: AHA (American Hospital
Association)
◉ Which act requires all providers to use the same code sets, healthcare
transactions, and identifiers? Answer: HIPAA
◉ HIPAA requires which code sets to report clinical information?
Answer: CPT, HCPCS, ICD-10-CM, National Drug Codes
◉ How many characters long is an ICD 10 CM code? Answer: 3-7
◉ When assigning a code, which hierarchy is followed? Answer: 1.
Coding guidelines
,2. Alphabetic Index
3. Tabular List
◉ Can coding clinic supersede Official guidelines, alphabetic index, or
tabular list? Answer: No
◉ Does CMS endorse coding clinic? Answer: Yes
◉ What is coding advice in coding clinic based on? Answer: The
statistical classification scene of ICD-10-CM and definitions specified in
UHDDS.
◉ How long are subcategories in ICD-10-CM? Answer: Four or 5
characters, so codes within a subcategory can be 3-7 characters long
◉ What does an ICD-10-PCS code need to reflect? Answer: The
procedure performed and the physician's intent or objective for the
procedure.
◉ What does a whipple procedure consist of? Answer:
Pancreaticoduodenectomy
,◉ What does the first character in a PCS code describe? Answer:
General category or section of the procedure being described (medical,
surgical, ancillary)
◉ What does the second character in a PCS code describe? Answer:
Body system or region within the body that is the focus of the procedure
◉ What does the third character in a PCS code describe? Answer: Root
operation or the intent of the procedure
◉ What does the fourth character of a PCS code describe? Answer:
Body part, or specific part of the body system on which the procedure is
performed.
◉ What does the fifth character of a PCS code describe? Answer:
Approach or technique used to reach the site of the procedure
◉ How many approaches are there in ICD-10-PCS? Answer: Seven
◉ What does the sixth character in a PCS code describe? Answer:
Whether a device was implanted, the type of device, and it's purpose
◉ What does the seventh character of a PCS code describe? Answer:
Qualifier - which is unique for different procedures that completes the
picture of the code
, ◉ What is the purpose of the DRG system? Answer: For creating
national and world healthcare statistics.
◉ What is the DRG system designed to promote? Answer: International
comparability in the collection, processing, clarification, and
presentation of healthcare statistics.
◉ What is one of the most difficult aspects of CDI? Answer: The
separation of an inferred condition from the application of the most
specific ICD 10 code,
◉ In coding guidelines, what does the term provider mean? Answer:
Physician or any qualified healthcare practitioner legally accountable for
establishing a patient's diagnosis
◉ Can specificity of a debridement come from a wound nurse's note?
Answer: Yes
◉ What do coding guidelines say about signs and symptoms? Answer:
They are not to be used as principal diagnosis when a related definitive
diagnosis has been established.