ICD-10-CM: General Coding, Guidelines and Conventions Latest Update Graded A+

ICD-10-CM: General Coding, Guidelines and Conventions Latest Update Graded A+ Define: medical necessity - Care that is reasonable, necessary, and/or appropriate - Evidence-based clinical standards of care What does ICD-10-CM stand for? - International Classification of Diseases - Tenth Revision - Clinical Modification What is the ICD-10-CM? - diagnosis code set used to report diagnoses in all clinical settings What does ICD-10-PCS stand for? - International Classification of Diseases - Tenth Revision - Procedure Classification System What is the ICD-10-PCS? - Procedure code set used to report hospital inpatient procedures only What is the purpose of the ICD-10? - Developed by the World Health Organization (WHO) - A standard diagnostic tool for epidemiology, health management, and clinical purposes - Designed to compile and present statistical data on morbidity (the rate or frequency of disease) and mortality (the rate or frequency of deaths) - Classification system use to identify and record health conditions -Key storyteller to insurance companies (see medical necessity) How often is the ICD-10 updated? Dates? - ICD-10-CM/PCS is updated every year - October 1st -> major updates - April 1st -> updates ICD-10 Codebook Layout - A. Official ICD-10-CM guidelines for Coding and Reporting -- I.Coding Conventions -- II. General Coding Guidelines -- III. Chapter Specific Coding Guidelines - B. Alphabetic Index -- I. Index to Diseases and Injuries --- a. Table of Neoplasms --- b. Table of Drugs and Chemicals -- II. Index to External Causes of Injuries - Tabular List of Diseases and Injuries What is a Neoplasm? - a tumor or an abnormal clump of tissue that may be benign or malignant. It serves no useful function but grows at the expense of the healthy organism. What is a Benign Neoplasm? - growth not spreading by metastases or infiltration of tissue What is a Histoid Neoplasm? - a neoplasm in which structure resembles the tissues and elements that surround it. What is a Malignant Neoplasm? - growth that infiltrates tissue, metastasizes, and often recurs after attempts at surgical removal. - SYN: cancer What are the four types of Coding Conventions? 1. Instructional Notes 2. Punctuation Marks 3. Abbreviations 4. Symbols Define: Metastasis - movement of bacteria or body cells (esp., cancer cells) from one part of the body to another - change in location of a disease or of its manifestations or transfer from one organ or part to another not directly connected - Metastasize: to invade distant structures of the body. To disseminate widely. Coding Conventions: What are Main Terms? - bold text, capitalized and left alignment - describes the diseases, conditions, eponyms, injuries, drugs, and external causes followed by their corresponding code