ICD-10-CM: General Coding,
Guidelines and Conventions Exam A+
Graded
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
-What is an Eponym? - -- a name for anything (disease, organ, function,
place) adapted from the name of a particular person or sometimes a
geographical location
-What do Parenthetical Terms which follow the main term represent? - --
nonessential modifiers (does not change the meaning of the main term)
-- supplemental terms
-- provides additional information
Guidelines and Conventions Exam A+
Graded
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
-What is an Eponym? - -- a name for anything (disease, organ, function,
place) adapted from the name of a particular person or sometimes a
geographical location
-What do Parenthetical Terms which follow the main term represent? - --
nonessential modifiers (does not change the meaning of the main term)
-- supplemental terms
-- provides additional information
