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ch.2 key terms
3-2-1 code it!
| Question | Answer |
|---|---|
| category | three-character ICD-10-CM disease code within a section. |
| cooperating parties for the ICD-10-CM/PCS | AHA, AHIMA, CMS, and NCHS. |
| encoder | software that automates the coding process; software search features facilitate the location and verification of diagnosis and procedure codes. |
| encounter | face-to-face contact between a patient and a health care provider who assesses and treats the patient's condition; Medicare uses the term encounter in the guidelines for coding and reporting to indicate all health care settings, inpatient hospital adm. |
| essential modification | (subterms) quality the main term by listing alternative sites, etiology, or clinical status. |
| etiology | causes of disease |
| general equivalent mapping (GEM) | published cross-walks of codes that facilitates the location of corresponding diagnosis and procedure codes between two codes sets, such as ICD-9-CM and ICD-10-cm. |
| ICD-10 Coordinating and Maintenance Committee | NCHS and CMS Department of HHS federal agencies that are responsible for overseeing all changes and modifications to ICD-10-CM (NCHS) and ICD_10-PCS(CMS). |
| Index to Disease and Injuries | alphabetical listing of ICD-10-CM main terms and codes. |
| International Classification of Diseases (ICD) | published by the World Health Organization and used to classify mortality data from death certificates. |
| legacy coding system | classification system that is used as archive data; it is no longer supported or updated . |
| main term | printed in boldfaced type and followed by the ICD-10-CM code number . |
| Medicare Prescription Drug, Improvement, and Modernization Act (MMA) | federal legislation that requires all codes sets to be valid at the time services are provided. |
| morbidity | (disease) data from inpatient and outpatient records, including physician office records. |
| mortality | death |
| nonessential modifier | qualifying word contained in parentheses after the main term in the ICD-10-CM index to Disease and Injuries that does not have to be included in the diagnostic or procedural statement for the code number listed after the parentheses to be aasigned. |
| Official ICD-10-CM Guidelines for coding and Reporting | Rules developed to accompany and complement official conventions and instructions provided in ICD-10-CM. |
| Official ICD-10-PCS Guidelines for coding and Reporting | Rules developed to accompany and complement official conventions and instructions provided in ICD-10-PCS. |
| placeholders | use of the letter "x" in curtain ICD-10-CM codes allow for future expansion. |
| subcategory | ICD-10-CM codes that contain four, five, six, or seven characters; subcategories codes that required additional characters are invalid if the fifth, sixth, or seventh character(s). |
| subterm | qualifying word listed below the main term in the ICD-10-CM Index to Diseases and Injuries ; list alternate sites, etiology, or clinical status. |
| Tabular list of Diseases and Injuries | chronological list of ICD-10-CM codes, divided into 21 chapters based on body system or condition. |