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Ch4Medical Insurance

Medical Insurance: An Integrated Claims Approach Process

E-Code An alphanumeric code used to identify the external cause of an injury or poisoning
Unspecified Refers to a code that should be used for an incompletely described condition.
Addenda Annual updates to the ICD-9-CM diagnostic coding system.
Category A 3-digit code that covers a single disease or related condition
V-Code An alphanumeric code used for an encounter that is not due to illness or injury.
Manifestation The Characteristic signs and symptoms associated with a disease.
Eponym A condition or procedure that is named for the physician who discovered it.
Convention Typographic technique or standard practice that provides visual guidelines for understanding printed material.
Main Term The medical term in boldfaced type that identifies a disease or condition in the Alphabetic index.
Supplementary term A nonessential word or phrase that helps define a diagnosis code.
T/F IN selecting correct diagnosis codes, the chapters of the Tabular List are first searched, and the code is then verified in the Alphabetic Index. False
T/F Subcategories are 4-digit diagnosis codes that define the etiology, site, or manifestation of a disease. True
T/F In the alphabetic index, a see cross-reference must be followed. True
T/F The etiology of a disease is the reason the patient presents for treatment. True
T/F The 5th-digit requirement refers to the need to show a subclassification code for a particular diagnosis. True
T/F A code that appears in italics is a secondary code and is not sequenced first. True
T/F The Coding instruction "use an additional code" means that supplying another code is optional. False
T/F A patient has an appointment for complaint of flulike symptoms. While the patient is in the office, the physician decides to conduct a complete physical examination. A V code is used as the primary diagnosis code for the encounter. True
T/F When a diagnosis is being confirmed by tests or other procedures, only the patient's sign, symptoms, or vague condition are coded, not the possible or suspected disease. True
T/F A patient's past, cured conditions have no applicability to the coding of current encounters except when late effects are noted. True
Outpatient coding is based on which volume or volumes of the ICD-9-CM? A. Volume 1 B. Volumes 1 & 2 C. Volumes 1,2, & 3 D. Volumes 2 & 3
The Medical terms in the alphabetic index are arranged by: A. The condition or problem B. The anatomical site C. The etiology and the manifestation D. The Signs and Syptoms
An Unintentional, harmful reaction to a correct dosage of a drug is called: A. a late effect B. a coexisting condition C. an adverse effect D. a manifestation
A condition that remains or recurs after an acute illness has finished is called: A. a late effect B. a coexisting condition C. an adverse effect D. a manifestation
A colon after a term in an excludes or includes note indicates that: A. term is not complete w/o 1 or more of the additional terms listed. B. term requires a manifestation code C. synonyms/alternate wordings/explanations that follow may appear in the diagnostic statement D. term requires a code for the underlying diseas
To code an encounter for chemotherapy, list the codes in the following order: A. E code, condition code B. condition code, E code C. V code, condition code D. Condition code, V code
The diagnostic statement "patient presents for removal of a cast" requires the use of which of the following types of codes. A. E B. V C. R D. M
If a patient is treated for both an acute and a chronic condition, each of which has a separate code, how should the codes by listed? A. V code, condition code B. Chronic code, acute code C. Acute code, V Code D. Acute code, chronic code
A late effect may be indicated in documentation by the use of the expression(s): A. due to an old...or due to previous... B. malignant C. missile, puncture, with foreign body D. primary or secondary
If fracture is not documented as closed or open, it is coded as: A. open B. fissured C. greenstick D. closed
What are the 3 steps in the diagnostic coding process? 1. Determine reason for encounter 2. Locate the term in the alphabetic index 3. Verify the code in the tabular list
What are the 3 key coding guidelines for selecting correct diagnosis codes? Code... 1. the primary diagnosis, followed by current coexisting conditions. 2. to the highest level of certainty. 3. to the highest level of specificity.
What does ICD-9-CM stand for? International Classification of Diseases, 9 revision, Clinical Modification
How is the ICD-9-CM coding book organized? Volume 2; Alphabetic Index Volume 1; Tabular List Volume 3; Procedures
What does volume 1 ad 2 entail? Disease and Injuries
What year did the law under HIPAA pass for mandated diagnosis coding from ICD-9-CM? 1996
When does the USA switch to ICD-10-CM? Oct. 1, 2013
Created by: crazedsmyle
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