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KE E & M Review

Evaluation and Management Review

What is a New Patient one who has not received any medical services within the last three years
What is an established Patient? one who has received medical services within the last 3 years from the physicians from the same group
What is Chief complaint? a statement describing the symptom, problem, diagnosis, or condition that is the reason a patient seeks medical care.
What does ICD stands for? Internationl Classification of Disease
What is ICD Manual 3 volumes? Vol 1 Disease: Tabular List(which contains the V and E codes) - Vol 2 Disease: Alphabetic Index (inpatient and outpatient setting) - Vol 3 Procedures: Tabular List and Alphabetic Index(Use codes and diagnostic procedures primarily by hospitals)
To ensure that you have chosen the correct code locate code in the alphabetic index and cross-reference this code in the Tabular List
E Codes are codes use to? describe the reason or external cause of injury and poisoning
V Codes are codes use to? identify health care encounters that occurs by circumstances or problems. (Example code assigned if the tumor is no longer present or if the patient is not receiving treatment, BUT is returning for follow-up care.)
Tabular List codes range from? 001-999
Tabular List consists of? 17 chapters based on either body system or cause or type of disease.
TList Chapters are? main division in the ICD- 9-CM divided into sections (Example Endocine, Nutritional and Metabolic Diseases and Immunity Disorders (240-279)
TList Sections are? group of 3-digit categories representing a group of conditions or related conditions divided into categories (Example Disorders of Thyroid Gland (240-246)
TList Categories are? 3-digit codes representing a single disease or condition. (Example 242 Thyrotoxicosis with or without goiter)
TList Subcategories are? 4-digit code (one digit after the decimal point) which more specific than category code (3-digit) in terms of cause, site, or manifestation of the condition. MUST be use if available. (Example 242.0 Toxic diffuse goiter)
TList Subclassification are? provides a 5-digit code which gives the hightest specificity of description to a condition. Must be use if available. (Example 240.01 Toxic diffuse goiter with thyrotoxic storm)
What are the Alphabetic Index (Vol 2) 3 sections? 1. Index to Disease 2. Table of Drugs and Chemicals 3. Index to External causes of Injury (E codes)
What does Hypertension Table do? classifies the condition
What is Neoplasm Table? are codes assigned if the tumor has been removed and the patient is still receiving chemotheraphy treatment or radiation.
What does NPI stands for? National Provider Identifier number
Who assigns the NPI#? CMS
What are CMS 2-part coding system codes Level 1 codes(5 position numeric codes)for physician & Level 2 codes (National Codes)(5 position alpha-numeric codes for physician and non-physician NOT found in the CPT Level I.
Where are CMS 2-part coding systems found? Level 1 in CPT manual. Level 2