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Ch 5 Key Terms
3-2-1 Code It!
| Question | Answer |
|---|---|
| acute care facility (ACF) | hospital that provides health care services to patients who have serious, sudden, or acute illness or injuries and/or who need certain surgies. |
| acute care hospital | see short-term hospital |
| admitting diagnosis | provisional or tentative diagnosis entered in a field on the inpatient face sheet by admissions office staff; it is often a sign or symptom |
| ancillary service | diagnostic and/or therapeutic service provided to inpatients and outpatients. |
| axis of classification (ICD-10-PCS) | the sections, body parts, root operations, and so on that comprise the 7-character ICD-10-PCS code |
| bed count | see bed size |
| bed size | total number of inpatient beds for which a facility is licensed by the state; facility must be equipped and staffed to care for these patient admissions |
| behavioral health care hospital | health care facility that specializes in treating individuals with mental health diagnoses |
| comorbidity | coexisting condition that is treated during the same encounter as or impacts the medical management of another condition |
| complication | condition that occurs during the course of an inpatient hospital episode |
| critical access hospital (CAH) | located more than 35 miles from any hospital or another CAH; state certified as being a necessary provider of health care to area residents |
| general hospital | acute care facility that provides emergency care, general surgery, and inpatient admission services based on licensing by the state |
| Index (ICD-10-PCS) | organizes ICD-10-PCS main terms in alphabetical order, providing the first 3-4 characters of a code as well as direction to a specific location in the Tables |
| inpatient | patient who remains overnight in a facility for 24 hours or more and who is provided with room and board and nursing services |
| long-term acute care hospital (LTACH) | health care facility designed specifically for patients who need functional restoration and/or rehabilitation and medical management for an average of three to six weeks; average inpatient stay of 25days plus extended medical care (chronic conditions) |
| long-term hospital | see long-term acute care hospital |
| maximizing reimbursement | reimbursement that is not permitted because it involves selecting and reporting as principal diagnosis the ICD-10-CM code that results in the highest level of reimbursement for the facility whether that diagnosis meets the criteria for selection or not |
| multiaxial structure (ICD-10-PCS) | a value from each of seven hierarchies is assigned to construct an ICD-10-PCS code |
| multihospital system | two or more hospitals owned, managed, or leased by a single organization; these may include acute, long-term, pediatric, rehabilitation, or psychiatric care facilities |
| newborn patient | patient who receives infant care upon birth and, if necessary, receives neonatal intensive care |
| optimizing reimbursement | determining which of several diagnoses to report as the principal diagnosis when multiple diagnoses equally meet the criteria for selection as the principal diagnosis |
| other (additional) diagnoses | any condition that coexists at the time of admission, that develops subsequently, or that affects the treatment received and/or the length of stay |
| other significant procedure | surgical in nature, carries an operative or anesthetic risk, requires highly trained personnel, or requires special facilities or equipment; also called a secondary procedures |
| principal diagnosis | condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital care |
| principal procedure | performed for definitive treatment rather than for diagnostic or exploratory purposes, necessary to treat a complication, or is most closely related to the principal diangosis |
| rehabilitation hospital | health care facility that admits patients who are diagnosed with trauma or disease and who need to learn how to function |
| secondary procedure | see other significant procedure |
| short-term hospital | average length of stay (LOS) of 4-5 days and a total LOS of fewer than 25 days |
| single hospital | hospital that is self-contained and not part of a larger organization |
| specialty hospital | health care facility that delivers care to a particular population of patients or type of disease |
| subacute care patient | receives specialized services such a s chemotherapy, injury rehabilitation, ventilator support, wound care, and other types of health care services provided to seriously ill patients |
| swing bed | allows a rural hospital to admit a nonacute care patient |
| tables (ICD-10-PCS) | used to construct a complete and valid ICD-10-PCS code; contains terms and rows that contains values needed to construct a valid code |
| Uniform Hospital Discharge Data Set (UHDDS) | established by the federal government to define data collected for inpatient hospitalizations |
| value (ICD-10-PCS) | characters assigned to each of seven unique hierarchies, which construct a valid ICD-10-PCS code |
Created by:
Cristinacholi
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