William Farr and the Cholera Studies
International List of Causes of Death
Preparation for Coding Success
Deducing the Diagnosis: History
Deducing the Diagnosis: Medical Decision Making
Instructional Notes: Section I.A.
General Coding Guidelines: Section I.A.
What Is the Structure of the Diagnosis Codes?
Which Diagnosis Is Listed First?
Outpatient and Physician Office
What’s in Each Diagnosis Chapter?
Chapter 1: Certain Infectious and Parasitic Diseases (A00–B99)
Chapter 2: Neoplasms (C00–D49)
Chapter 3: Diseases of the Blood and Blood-Forming Organs (D50–D89)
Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00–E89)
Chapter 5: Mental, Behavioral, and Neurodevelopmental Disorders (F01–F99)
Chapter 6: Diseases of the Nervous System (G00–G99)
Chapter 7: Diseases of the Eye and Adnexa (H00–H59)
Chapter 8: Diseases of the Ear and Mastoid Process (H60–H95)
Chapter 9: Diseases of the Circulatory System (I00–I99)
Chapter 10: Diseases of the Respiratory System (J00–J99)
Chapter 11: Diseases of the Digestive System (K00–K94)
Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00–L99)
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00–M99)
Chapter 14: Diseases of the Genitourinary System (N00–N99)
Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00–O9A)
Chapter 16: Certain Conditions Originating in the Perinatal Period (P00–P96)
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q00–Q99)
Chapter 19: Injury, Poisoning, and Certain Other Consequences of External Causes (S00–T88)
Chapter 20: External Causes of Morbidity (V00–Y99)
Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00–Z99)
How Can You Code Your Conditions?
Hospital Procedures Versus Doctor’s Procedures
Why the Difference? How Did It Come About?
ICD-10-PCS Procedure Coding Guidelines
Selection of Principal Procedure
Medical- and Surgical-Related Sections (0–9)
Medical and Surgical Section (0)
Measurement and Monitoring Section (4)
Extracorporeal Assistance and Performance Section (5)
Extracorporeal Therapies Section (6)
Ancillary Sections (B–D and F–H)
Physical Rehabilitation and Diagnostic Audiology Section (F)
Substance Abuse Treatment Section (H)
Additional CPT Coding Guidelines
Evaluation and Management (E&M)
CMS-1500 Form or 837P (Professional) Format
CMS-1450 or UB-04 Form or 837I (Institutional) Format
Claims Processing and Adjudication
Prospective Payment: Inpatient Hospital
Prospective Payment: Ambulatory Surgical Centers
Prospective Payment: Skilled Nursing Facilities
Prospective Payment: Home Health Agency
Prospective Payment: Hospital Outpatient
Risk-Adjusted Payment: Medicare Advantage Plans
How Payment Methods Affect Coding
What Does This Have to Do with Coding?
2. Contact the Insurer or Other Third-Party Payer
1. Certain Infectious and Parasitic Diseases
4. Endocrine, Nutritional, and Metabolic Diseases
5. Mental and Behavioral Disorders
6. Diseases of the Nervous System
7. Diseases of the Eye and Adnexa
8. Diseases of the Ear and Mastoid Process
9. Diseases of the Circulatory System
10. Diseases of the Respiratory System
11. Diseases of the Digestive System
12. Diseases of the Skin and Subcutaneous Tissue
13. Diseases of the Musculoskeletal System and Connective Tissue
14. Diseases of the Genitourinary System
15. Pregnancy, Childbirth, and the Puerperium
16. Certain Conditions Originating in the Perinatal Period
17. Congenital Malformations, Deformations, and Chromosomal Anomalies
18. Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, NEC
19. Injury, Poisoning, and Certain Other Consequences of External Causes
20. External Causes of Morbidity