ICD-9-CM Review

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The acronym ICD-9-CM means:

International Classification of Diseases, 9th Revision, Clinical Modification

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The three volumes of ICD-9-CM are:

Volume 1-Diseases: Tabular List, Volume 2-Diseases: Alphabetic Index, Volume 3-Procedures: Tabular List and Alphabetic Index

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E codes are used to describe:

external causes of injury/poisoning, site of incident, procedures as cause of abnormal reaction

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ICD-9-CM codes are updated at least:

Annually in October

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V codes and V code descriptions are located in:

Volume 1, ICD-9-CM

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Symbols, abbreviations, punctuation, and notations in ICD-9-CM are called:

conventions

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NEC is the acronym for:

Not Elsewhere Classifiable

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ICD-9-CM codes translate the _____ of services provided from verbal and narrative descriptions to nationally accepted reporting standards.

Medical necessity

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In the ICD-9-CM, NOS means:

Not Otherwise Specified

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Words contained within the brackets, provide the coder with:

synonyms, alternative wording, explanatory phrases, abbreviations

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The colon in the Tabular list tells the coder:

the terms below complete the term to make it assignable to a given category

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A symbol used to identify those codes that are not usually sequenced as the principal diagnosis is called:

italicized type

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In the Alphabetic Index of Volume 2, ICD-9-CM nonessential modifiers are:

terms enclosed in parentheses that have no effect on the selection of the code listed for the main term

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Codes that have mandatory fifth digits are:

codes that always require a 5th digit to fully describe them

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The Table of Drugs and Chemicals is located in:

Volume 2

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The classification not included in the Table of Drugs and Chemicals is:

Primary neoplasm

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Which of the following is not an adverse effect? rash due to drug, fever due to drug, diabetes mellitus, shortness of breath due to drug

diabetes mellitus

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All ICD-9-CM codes must be supported by:

documentation in the medical record

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ICD-9-CM contains ____ appendices in the Tabular List of Volume 1.

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ICD-9-CM contains which of the following: diagnostic codes for conditions beginning with the number 0, morphology of neoplasms, other verbiage used in correct coding

morphology of neoplasms

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This ICD-9-CM appendix was deleted:

Appendix B (Glossary of Mental Disorders)

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The ICD-9-CM manual was developed based on a text by what organization? American Medical Assocation, American Academy of Professional Coders, World Health Organization, Center for Medicare and Medicaid Services

World Health Organization

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Another name for the Supplementary Classification of Factors Influencing Health Status and Contact with Health Services

V codes

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What volume of the ICD-9-CM is used by hospitals to report inpatient procedures?

Volume 3

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What organization, in conjunction with the National Centers for Health Statistics, is responsible for maintenance of diagnosis classifications of ICD-9-CM, Volume 3?

Department of Health and Human Services

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What is defined as transforming written descriptions into numerical designations?

Coding

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Two insurance programs were established in 1965 by amendments to the Social Security Act known as:

Part A (Hospital)and Part B (Supplemental)

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The secretary of DHHS has delegated responsibility for Medicare to which department?

CMS (Centers for Medicare/Medicaid Services)

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Who administers funds for Medicare?

Social Security Admistration

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Who is eligible for Medicare?

People 65 & older, people eligable for disability & people with renal failure

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List the three components of the relative value unit:

Work, 0verhead, Malpractice

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What does RBRVS stand for?

Resource Based Relative Value Scale

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What is the fastest growing segment of our population today?

65 & older

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What is the name given to the groups that handle the daily operations of the Medicare program?

MACs (Medicare Administrative Contactors)

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What is Appendix A?

Morphology of Neoplasms

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What is Appendix B?

Glossary of Mental Disorders (Deleted in 2004)

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What is Appendix C?

Classification of Drugs

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What is Appendix D?

Industrial Accidents

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What is Appendix E?

Three-Digit Categories

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The ICD-9-CM is designed to classify what two things?

Causes of morbidity and mortality

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Which of the following is not a stated use for the ICD-9-CM: facilitate payment of health services, study health care costs, plan for future health care needs, evaluate appropriateness of treatment

Evaluate appropriateness of treatment

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Identify the format of the chapters in the ICD-9-CM Volume 1, Tabular List, in the proper sequence, from first to last:

Chapter, Section, Category, Subcategory, Subclassification

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List the four cooperating parties that agree on coding principles:

American Hospital Association; American Health Information Management Association; Center for Medicare and Medicaid Services; National Center for Health Statistics

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8 Steps (1)Identify the main ____ in the diagnostic statement

Term

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(2)Locate the main term(s) in the Alphabetic Index (Volume____)

Volume 2

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(3)Review any ____ under the main term in the index

Subterms

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(4)Follow any ______-____ instructions, such as see also.

Cross-reference

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(5)Verifiy the code(s) selected from the Index (Volume __)in the Tabular List (Volume ____)(referred to in ths text as the Tabular)

Volume 2, Volume 1

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(6)Refer to any instructional notations in the _____.

Tabular

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(7) Assign codes to the highest level of _____. For example, if a fourth digit is available, you cannot assign only a three-digit code, and if a fifth digit is available, you cannot assign only a four-digit code.

Specificity

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(8) Code the diagnosis until all ____ are completely identified.

Elements

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A combination code is a single code used to classify:

Two diagnoses, a diagnosis with an associated manifestation, a diagnosis with an associated complication

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Additional signs and symptoms that may not routinely be associated with the disease process being reported should be coded when present.

True

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In the outpatient setting, an impending condition should be coded as if it actually exists.

False

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When separate codes exist to identify acute and chronic conditions, the chronic code is sequenced first.

False

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It is acceptable to use only the Alhabetic Index to assign ICD-9-CM codes.

False

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When sequencing codes for residuals and late effects, the residual is sequenced first followed by a late effect code.

True

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A code is invalid if it has not been coded to the full number of digits available for that code.

True

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ICD-9-CM assumes a relationship between hypertension and renal failure.

True

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If a patient is admitted for an HIV-related condition, the first-listed diagnosis, is the related condition followed by the diagnosis code 042.

False

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A fifth digit of 1 should be assigned to 302.0X for someone who abuses alcohol by binge drinking.

False

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Another term to describe malignant hypertension is accelerated hypertension.

True

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Hypertension that is caused by another condition is called essential hypertension

False

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A fifth digit of 1 to indicate status asthmaticus can be assigned if the physician documents an acute exacerbation.

False

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If a patient's diabetes is documented as poorly controlled, a fifth digit for out of control should be assigned.

False

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If a patient receives insulin for diabetes, type 1 diabetes should be reported.

False

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the site to which a malignant neoplasm has spread is the:

metastatic site

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The site in which a malignant neoplasm originated is the:

primary site

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In order to code a gastrointestinal condition with hemorrhage, active bleeding must be present.

False

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It is common to use a fifth digit of 0 when coding complicaitns related to pregnancy.

False

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A pathologic fracture occurs in a bone that is weakened by disease.

True

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The perinatal period extends for 6 weeks following birth.

False

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Generally you do not assign a code from chapter 16 if a definitive diagnosis is documented.

True

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When an accident occurs, an E code should be the first-listed diagnosis.

False

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If a fracture and dislocation are present at the same site, assign only the fracture code.

True

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An infected laceration should be coded as a complicated wound

True

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A poisoning occurs when a drug has been correctly prescribed and properly administered and the patient develops a reaction.

False

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When coding a poisoning, the poisoning code is sequenced before any manifestation code.

True

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ICD-10-CM codes are alphanumeric.

True

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ICD-10-CM is indexed in a similar manner to ICD-9-CM.

True

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Like ICD-9-CM, ICD-10-CM contains 17 chapters.

False

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The American Medical Association is responsible for the development of ICD-10-PCS.

False

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In ICD-10-PCS, if a character is not applicable, the letter X is used.

False

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When implemented, the United States will be the first nation to use ICD-10.

False

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The term "fusion" means the freeing of a body part.

False

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An example of a procdure that involves inspection is.

Diagnostic arthroscopy

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Altering the route of passage of the contents of a tubular body part is a:

bypass

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ICD-10- was issued in 1993 by:

WHO (World Health Organization)

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Is examination of the back an organ system or body area examinaiton?

Body Area

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The four types of patient status are:

New, established, outpatient & inpatient

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The first outpatient visit is called the ____ visit, and the second visit is called the _____ visit.

initial, subsequent

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see category

directs coder to use Volume 1, Tabular List, for additional information

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subterms

terms indented under main terms, considered essential modifiers

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see

explicit direction to look elsewhere

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Notes

defines and give instructions

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modifiers

terms in parentheses or following main terms; they may or may not be essential

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