Icd-10-Cm And Icd-10-Pcs Coding Handbook / Nelly Leon-Chisen

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ICD-10-CM

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International Classification of Diseases, Tenth Revision, Clinical Modification; consists of diagnosis codes. Also, consists of a clinical modification of the World Health Organization's (WHO's) ICD-10.

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ICD-10-PCS

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International Classification of Diseases, Tenth Revision, Procedure Coding System; consists of procedure codes. Also, is a classification of operations and procedures developed for use in the United States; it is not a part of the WHO classification.

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ICD-10-CM and ICD-10-PCS have been developed to replaced what ?

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ICD-9-CM.

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What is a classification system?

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It is an arrangement of elements into groups according to established criteria.

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In ICS-10-CM and ICD-10-PCS, what are the elements of classification?

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The elements are diseases, injuries, surgeries and procedures, which are grouped into appropriate chapters and sections.

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How many characters are the categories for ICD-10-CM?

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Three character categories

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How many characters are the codes for ICD-10-PCS?

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Seven character codes

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These groups are the common basis of classification for general medical statistical use. True or False?

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True

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They help to answer questions about groups of related causes and provide the capacity of the systematic tabulation, storage and retrieval of disease-related data.

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Each alpha-numeric code represents a counting unit, with the three character categories forming the basis for data tabulation.

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In ICD-10-CM (3 character categories) many disease & injury categories have been expanded by 4th, 5th and 6th characters that provide additional specificity but remain collapsible to the 3 character category.

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In ICD-10-CM, there are categories that use an additional 7th character value to provide additional information regarding the encounter.

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ICD-10-CM and ICD-10-PCS are what type of classification system?

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Closed, they provide one and only one place to classify each condition and procedure.

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The official coding advice is provided by whom?

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Through the AHA Coding Clinic, published by the Central Office of the AHA. The official advice is developed through the editorial board for the Coding Clinic and is approved by the 4 cooperating parties-AHA, AHIMA, CMS and NCHS.

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When and who released ICD-10-CM?

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The World Health Organization implemented it in the United States in1993.

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ICD-10-CM contains only diagnosis codes.

ICD-10-CM is in public domain.

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The codes and code titles can not be changed except thru the Coordination and Maintenance Process overseen jointly by the NCHS and CMS.

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ICD-10-CM consists of nearly 69,000 codes.

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The classification of external causes of injury and poisoning and the classification of factors influencing health status and contact with health services are incorporated with ICD-10-CM.

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The 4 main objectives in the development of ICD-10-PCS were:

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Completeness-all substantially different procedures should have a unique code
Expandability-the structure should allow for the easy incorporation of unique codes as new procedures are developed
Multi-axial structure-each code character having the same meaning within a specific procedure section and across procedure sections, whenever possible.

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The guiding principles that were followed in developing ICD-10-PCS were:

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Diagnostic info. is not included in the procedure description
Explicit "not otherwise specified" (NOS) options are not provided
"Not elsewhere classsified" (NEC) options are provided on a limited basis
All possible procedures are defined regardless of the frequency of occurrence, if a procedure could be performed, a code was created

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ICD-10-PCS represents nearly 72,000 codes.

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ICD-10-CM began replacing ICD-9-CM which has been in use in the United States since 1979.

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ICD-9-CM is no longer able to meet the pressing requirements for increased granularity (an informatics term for the size of a data unit in relation to the pool of data) and specificity in a hospital coding system.

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Over the years many of the ICD-9-CM categories have become full making it difficult to create new codes. The structural integrity of the ICD-9-CM procedure classification has already been compromised with new code numbers assigned when new numbers haven't been available.

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ICD-10-PCS uses a table structure that permits the specification of a large number of codes on a single page in the tabular division.

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138 countries have implemented ICD-10 for mortality and 99 countries have implemented it for morbidity reporting. MORBIDITY refers to the disease state of an individual, or the incidence of illness in a population. MORTALITY refers to the state of being mortal (living), or the incidence of death (number of deaths) in a population.

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ICD-10-PCS codes WILL BE used by hospitals for inpatient procedures.
ICD-10-PCS codes WILL NOT be used in outpatient transactions or by physicians.

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True or False? ICD-10-CM consists of diagnosis and procedure codes.

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False, ICD-10-CM consists of diagnostic codes & ICD-10-PCS consists of procedure codes.

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True or False? The compliance date for ICD-10-CM & ICD-10-PCS in the U.S. was initially expected to be October 1, 2013.

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True

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True or False? Three character categories are used in ICD-10-CM, and seven character codes are used in ICD-10-PCS.

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True

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True or False? Both ICD-10-CM and ICD-10-PCS were developed by the World Health Organization (WHO).

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False, ICD-10-CM was developed by WHO and ICD-10-PCS was developed by CMS

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True or False? ICD-10-CM and ICD-10-PCS were developed because ICD-9-CM had become outdated and there were physical numbering constraints.

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True

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Comparing ICD-9-CM and ICD-10-CM:

Many similarities especially regarding the classification format and conventions.
The code structure has changed slightly to accommodate code expansion and improvements to the classification.
ICD-9-CM has a "Hypertension" table but ICD-10-CM does not.
ICD-10-CM uses a dash (-) at the end of an index entry to indicate that additional characters are required, ICD-9-CM does not.

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Differences of ICD-9-CM and ICD-10-CM:

They both are divided into Index and Tabular lists.
The Alphabetic Index is divided into 2 sections, the Index of Diseases and Injuries & the Index to External Causes.
There is also a Neoplasm Table and a Table of Drugs and Chemicals.

The same indention pattern and alphabetization rules are found in both.

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ICD-10-CM has retained several conventions (rules of conduct) already familiar to users of ICD-9-CM:
Instructional notes, abbreviations, cross-reference notes, punctuation marks and relational terms. Also, there are 2 types of "excludes" notes-each one with a different use.

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