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ICD- 9-CM MEDICAL CODING & INSURANCE

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Page 1: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

ICD-9-CM

MEDICAL CODING & INSURANCE

Page 2: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Classification System International Comparison1988 Medicare Catastrophic Coverage ActUses: track costs and patient usageResearch—trends/demands

SLIDE #2 OVERVIEW

Page 3: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Code ethicallyDocumentations must support diagnosisTransform verbal or narrative descriptions of diseases,

injuries, conditions, and procedures into numeric designations

SLIDE # 3 ETHICS & YOUR ROLE

Page 4: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Volume I, Diseases. Tabular List (Diagnosis)Volume II, Diseases, Alphabetic Index (Diagnosis)Volume 3, Procedures, Tabular List & Alphabetic Index

(Inpatient)

SLIDE # 4 FORMAT OF ICD-9-CM

Page 5: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Contains code numbers001.0-999.9 Diagnosis codes describe conditionsV and E codes = Supplemental information

SLIDE # 5 VOLUME I, DISEASES, TABULAR LIST

Page 6: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Appears first in the bookTerms and code numbers in Volume INever code directly from the Index!

SLIDE # 6 VOLUME 2, DISEASES, ALPHABETIC INDEX

Page 7: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Index and Tabular List used for procedures and therapies Inpatient settings onlyProcedures and therapiesMaximum 4 digits. E.g. 20.41 Simple Mastoidectomy

SLIDE # 7 VOLUME III, PROCEDURES, TABULAR LIST AND ALPHABETIC INDEX

Page 8: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Chapters 1-17Section A Group of related conditions

SLIDE # 8 DIVISIONS OF CLASSIFICATION OF DISEASES & INJURIES

Page 9: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Category 3 digitsSubcategory 4 digitsSubclassification 5 digitsYou must code to the highest level of specificity. You must code a 5 digit if a subclassification is available

SLIDE # 9 CONDITION LEVELS

Page 10: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Determine the Main TermLocate the Main Term in the Alphabetic Index (Volume II)Review any subterms under the main term in the IndexFollow any cross-referencing instructions.E.g. “see”, “see also”.

SLIDE # 10 USING THE ICD-9-CM

Page 11: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Verify the codes (s) selected from the Index (Volume II) in the Tabular List (Volume I)

Refer to any instructional notations in the TabularAssign codes at the highest specificity.Code the diagnosis until all elements are completely

identified.

SLIDE #11 USING THE ICD, CONT.’

Page 12: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

NEC “Not elsewhere classifiable”: This abbreviation in the index represents “other specified” when a specific code is not available for a condition. You will be directed to the “other specified” in the Tabular.

NEC, when found in the Tabular, allows you to identify the code as “other specified”. This when there is no specific code identifying your condition.

NOS is equivalent to unspecified.

SLIDE # 12 ABBREVIATIONS

Page 13: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Acute: Short, relatively severe courseChronic: Persists over long period of time.What if they both exist?The index has separate entries for both conditions…Use both codes, and put the acute code first. Some codes combinations are represented by a single code

SLIDE # 13 ACUTE & CHRONIC

Page 14: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

Material extracted directly from Buck’s Step-By-Step Coding Text, Copyright 2008, Elsevier.Created for Kaplan University by Cindy Ogle

Page 15: ICD- 9-CM MEDICAL CODING & INSURANCE. Classification System International Comparison 1988 Medicare Catastrophic Coverage Act Uses: track costs

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