ICD-10-CM Coding Chapter Six with Complete Solutions

ICD-10-CM Coding Chapter Six with Complete Solutions ICD International Classification of Diseases (ICD) is published by the World Health Organization (WHO) and is used to classify mortality (death) data from death certificates. In 1994, WHO published the 10th revision of ICD with a new name, International Statistical Classification of Diseases and Related Health Problems, and reorganized its three-digit categories. (Although the name of the publication was changed, the familiar abbreviation ICD remains in use.) ICD-9-CM The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) was developed in the United States and implemented in 1979 to code and classify morbidity (disease) data from inpatient and outpatient records, including provider-based office records. ICD-10-CM The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) was developed in the United States and is used to classify morbidity (disease) data from inpatient and outpatient records, including provider-based office records. ICD-10-PCS The International Classification of Diseases, 10th Revision, Procedure Classification System (ICD-10-PCS) was developed in the United States and is used to code and classify procedures from inpatient records only. All provider offices, outpatient health care settings (e.g., home health care, hospice), and health care facilities (e.g., hospitals, long-term care facilities) report __________________ diagnosis codes. ICD-10-CM ICD-10-CM and ICD-10-PCS, also abbreviated as ICD-10-CM/PCS, replaced ______________ on October 1, 201 ICD-9-CM All provider-based offices and outpatient health care settings (including hospice and home health care) report _______ and _______ codes for procedures and services. This includes physicians, nurse practitioners, and physician assistants who provide services to inpatients during their hospitalization (e.g., initial hospital care, subsequent hospital care, surgical procedures). CPT; HCPCS level II Upon implementation of the ICD-10-CM (and ICD-10-PCS) coding systems, the International Classification of Diseases, 9th Revision, Clinical Modification (ICD- 9-CM) became a _______, which means it will be used to archive data but will no longer be supported or updated by the ICD- 9-CM Coordination and Maintenance Committee. legacy coding system (or legacy classification system) Because ICD-9-CM was used since 1979 in the United States to classify inpatient and outpatient/provider-based office diagnoses (Volumes 1 and 2) and inpatient procedures (Volume 3), _______ will be annually published by the National Center for Health Statistics (NCHS) and Centers for Medicare and Medicaid Services (CMS). general equivalence mappings (GEMs) The National Center for Health Statistics (NCHS) and Centers for Medicare and Medicaid Services (CMS) annually publish _______, which are translation dictionaries or crosswalks of codes that can be used to roughly identify ICD-10-CM codes for their ICD-9-CM equivalent codes (and vice versa). general equivalence mappings (GEMs) The format of ICD-10-CM is similar to ICD-9-CM Volumes 1 and 2 in that both coding systems use a(n) disease index to initially locate codes for conditions and a tabular list to verify codes. When coders have questions about documented diagnoses or procedures/ services, they should use a _______ to contact the responsible physician to request clarification about documentation and the code(s) to be assigned.. physician query process ICD-10-CM far exceeds ICD-9-CM in the number of codes provided, having been expanded to (1) _______, (2) _______, (3) _______. Assigning the sixth and seventh characters when available for ICD-10-CM codes is mandatory because they report information documented in the patient record. (1) include health-related conditions, (2) provide much greater specificity at the sixth digit level, and (3) add a seventh digit extension (for some codes) _______ is an entirely new procedure classification system that was developed by CMS for use in inpatient hospital settings only. ICD-10-PCS ICD-10-PCS uses a _______ that provides a unique code for all substantially different procedures. multiaxial seven-character alphanumeric code structure (e.g., 047K04Z) Some companies also publish _______, which automate the coding process. This means that computerized or web-based software (Figure 6-2) is used instead of coding manuals. encoders The National Center for Health Statistics (NCHS) and the Centers for Medicare and Medicaid Services (CMS) are the U.S. Department of Health and Human Services (DHHS) agencies that comprise the _______. ICD-10-CM/PCS Coordination and Maintenance Committee Automating the medical coding process is the goal of _______, which uses a natural language processing engine to "read" patient records and generate ICD-10-CM and HCPCS/CPT codes. computer-assisted coding (CAC) The Medicare Catastrophic Coverage Act of 1988 mandated the reporting of _______ diagnosis codes on Medicare claims. ICD-9-CM Effective October 1, 2015, ICD-10-CM and ICD-10-PCS replaced _______. ICD-9-CM Medicare defines medical necessity as _______. "the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury." A(n) _______ is a face-to-face contact between a patient and a health care provider (e.g., physician, nurse practitioner) who assesses and treats the patient's condition. encounter The procedure or service is performed to treat