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Chapter 5 Coding

Fill in theblank
When submitting insurance claims for patients seen in a physician’s office or in an outpatient hospital setting, the ___________________________diagnosis is listed first Primary diagnosis
When submitting insurance claims for patients seen in a inpatient hospital setting, the ___________________________diagnosis is used. Principal diagnosis
Claims to insurance carriers oftentimes are denied due to lack of ___________________________, which indicates that the procedure provided was not payable for the diagnosis submitted. medical neccesity
The abbreviation ICD-10-CM means ________. International Classification of Diseases Tenth Revision Clinical Modification
The official version of the International Classification of Diseases was developed by the__________. World Health Organization
ICD-10-CM requires ___________________________ documentation in the medical record than the previous coding system, ICD-9-CM. greater
ICD-10-CM is the coding system for reporting inpatient services by hospitals and replaces ___________________________ of the ICD-9-CM coding system. Volume 1 & 2
ICD-10-CM is the standard code set required under ___________________________ legislation and must be used by covered entities when assigning diagnostic codes. HIPPA
Volume 2, Diseases, is a/an ___________________________index or listing of code numbers Alphabetic
Volume 1, Diseases, is a/an ___________________________listing of code numbers Tabular
When using the ICD-10-CM coding system, the ___________________________ is used as a placeholder to save space for future code expansion. X
Conventions are ___________________________used in the diagnostic code books to assist in the selection of correct codes for the diagnosis encountered. Rules or principals
The abbreviation NEC appearing in the ICD-10-CM code book means __________________________. Not elsewhere classifable
___________________________ are used to enclose synonyms in the Tabular List. Brackets
If a condition is documented in the medical record, but it is not specified as to whether the condition is acute or chronic, then the ___________________________ code should be assigned default code
When selecting a code that corresponds with the condition stated in the medical record, the coder should first locate the term in the ___________________________and then confirm the code in the____. alphabetic index, tabular list
The instructional note ___________________________ listed in the Tabular List assists the coder as to when it is appropriate to report a secondary code. dash
A condition that is produced after the acute phase of an illness is listed as the main term ___________________________in the Alphabetic Index sequela or late effect
When reporting a condition which affects the left side of the patient, the character _______ is reported to indicate laterally 2
The neoplasm table has column headings for __________, and ___________. Malignant , benign
In juvenile diabetes, the patient’s _____________________ does not function and produce enough insulin. pancreas
When coding for diabetes in pregnancy, a code from category ______ is assigned as the primary diagnosis. 024
_________hypertension is indicative of a life-threatening condition. Malignant
Full-term uncomplicated _________________________ deliveries are always reported with the code O80. vaginal
When reporting accidents and injuries, a seventh character of “A” identifies that the encounter is __________. inital
If documentation states that the incident related to a poisoning was a suspected suicide attempt, the code would be reported from the column entitled ___________________________.” undetermined
If a patient falls and fractures his or her wrist, the fracture code is the primary code, followed by a/an ___________________________code to explain how the accident occurred. External cause
Created by: lin_linxo