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Coding-chapter 15 Flashcards

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7222831276Uniform hospital discharge data set (UHDDS)A standard data set adopted by the federal government for collection of data for Medicare and Medicaid.0
7222831277CodingConverting verbal or written descriptions into numerical and alphanumerical designations. he most impor- tant factor in coding is the accuracy of the codes.1
7222831278Medical codingThe translation of medical terms for diagno- ses and procedures into code numbers selected from standard- ized code sets.2
7222831279Chief Complaint (CC)A description of a patient's medical problem that the patient reports to the physician.3
7222831280Etiology isThe cause of a disorder. A claim is sometimes classified according to its etiology.4
7222831281Coding for coverageChanging a code to match what the insurance company will pay for, rather than to accurately reflect the procedure that was performed.5
7222831282Level I codesThese codes repeat the CPT's five-number codes for physician procedures and services.6
7222831283Level II codesThese codes consist of more than 2400 five- digit alphanumerical codes for items that are not listed in CPT-4. Most of these items are supplies, materials, or injec- tions that are covered by Medicare. Level II codes start with a letter followed by four digits, such as J7630. here are 18 sec- tions, each covering a related group of items.7
7222831284Level III codesCommonly called local carrier codes, these codes are created and used only by the insurance companies that process Medicare for HCFA in the various geographical regions they are assigned.8
7222831285FraudAn act of deception used to take advantage of another person or entity. Claims fraud occurs when physi- cians or others falsely represent services or charges to payers.9
7222831286Evaluation and Management codes99201-9949910
7222831287Anesthesia codes00100-01999; 99100-9915011
7222831288Surgery codes10021- 6999012
7222831289Radiology codes70010 -7999913
7222831290Pathology and Laboratory80047-8939814
7222831291Medicine90281-99099; 99151-99199; 99500-9960715
7222831292Category II Codes0001F-7025F16
7225603129CPTCurrent Procedural Terminology, Procedure codes17
7225608803Main Text (Tabular List)Six sections (1) evaluation and management, (2) anesthesia, (3) surgery for all body systems, (4) radiology, (5) pathology and laboratory, and (6) medicine.18
7225677549CPT codesfive-digit numbers19
7225679288CPT manualAlphabetic Index Tabular List20
7225685457Bullet point (•)new procedure code21
7225688089Triangle (symbol)change in the code's description22
7225691125Plus sign (+)add-on codes addition to another procedure23
7225694124Arrow (➔)with a circle around it refers to the CPT Assistant24
7225695816Asterisk (*)surgical procedure only25
7225700921Facing trianglesplaced at the beginning and end of new or revised information26
7225707417Semicolon ( ; )everything to its left is applicable to indented shorter descriptions that follow.27
7225710615circle with a linemodifier -51 is not assigned to the code and the procedures are not add-on procedures.28
7225712871lightning boltproduct is pending FDA approval.29
7225715805dot surrounded by a circledenotes moderate sedation30
7225721452Code linkageconnection between the diagnostic and procedural information on a health-care claim31
7225723507UpcodingUsing a code on a claim form that indicates a higher level of service than that which was actually performed.32
7225727375Double billingSubmitting two claims for one encounter33
7225729557Correct Coding Initiative (CCI)A computerized system used by Medicare to prevent overpayment for procedures.34
7225732482Mutually exclusive codesCodes that are identified in the coding book as not permitted to be used on the same claim form with other specified codes35
7225967365Certain Infectious and Parasitic Diseases ICD-10-CMA00-B99 ICD-9-CM 001-13936
7225975319Neoplasms ICD-10-CMC00-D49 ICD-9-CM 140-23937
7225984553Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism ICD-10-CMD50-D89 ICD-9-CM 208-28938
7225992204Endocrine, Nutritional, and Metabolic Diseases ICD-10-CME00-E8939
7225998544Mental and Behavioral Disorders ICD-10-CMF01-F99 ICD-9-CM 290-31940
7226004757Diseases of the nervous system ICD-10-CMG00-G99 IDC-9-CM 320-38941
7226012527Diseases of the Eye and Adnexa ICD-10-CMH00-H5942
7226016360Diseases of the Ear and Mastoid Process ICD-10-CMH60-H9543
7226021689Diseases of the circulatory system100-199 ICD-9-CM 390-45944
7226027885Diseases of the Respiratory system ICD-10-CMJ00-J99 ICD-9-CM 460-51945
7226030253Diseases of the Digestive system ICD-10-CMK00-K94 ICD-9-CM520-57946

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