Chapter 28- Diagnostic Coding Basics

Question 1

Board Notes:
Diagnostic Coding:

Answer 1

has been used to standardize diagnoses.

Question 2

Purpose:

Answer 2

to prove medical necessity so that insurance companies can reimburse.

Question 3

Who is responsible?

Answer 3

World Health Organization (WHO)

Question 4

Mortality:

Answer 4

death rate

Question 5

Medical necessity:

Answer 5

insurance companies determine medical necessity based on the diagnostic and procedural codes submitted on the claim.

Question 6

Diagnosis:

Answer 6

determination of disease/ condition.

Question 7

Etiology-

Answer 7

underlying cause/ origin of a disease.

Question 8

Epidmiological:

Answer 8

data

Question 9

Reimbursement:

Answer 9

to make repayment for an expense or a loss incurred. * Payment for services rendered.

Question 10

Alphabetical index:

Answer 10

A-Z of Dx

Question 11

Tabular Index:

Answer 11

Codes in alphanumerical order,

Question 12

L.89

Answer 12

letter stands for the body system.
L89 - is the category,

Question 13

G20-

Answer 13

code for Parkinson’s disease.
- anything after that is more specific about it.
- The more issues the more money 000

Question 14

U codes:

Answer 14

new conditions/ diseases

Question 15

Z codes:

Answer 15

prophylactic/ preventative care

Question 16

Code HIV:

Answer 16

this indicates only that the virus is present.

Question 17

NOS:

Answer 17

Not otherwise specified.

Question 18

If no dx then code ____:

Answer 18

signs & symptoms

Question 19

Abstract:

Answer 19

to collect important information from the health records.

Question 20

Sequela:

Answer 20

An abnormal condition resulting from a previous disease.
(Lingering effect)

Question 21

Essential modifiers:

Answer 21

terms that specify the code.
- under the main term.

Question 22

What is placeholder X?

Answer 22

is used to fill out the empty character spaces.

Question 23

Carcinoma:

Answer 23

cancer

Question 24

Benign:

Answer 24

noncancerous, it’s good.

Question 25

Malignant:

Answer 25

bad

Question 26

Carcinoma in site:

Answer 26

situated in one site, doesn’t spread.

Question 27

Primary site:

Answer 27

the original site, where did the cancer start.

Question 28

Post partum:

Answer 28

The pomerium, or first 6 weeks after the first of the baby & after delivery.

Question 29

Burns are coded by:

Answer 29

coding each burn separately, burns are coded by site and degree and by the extent of body surface involvement.

Question 30

EAQ:
1. Where will the MA begin the search for a diagnostic code?

Answer 30

Alphabetic Index

Question 31

The alphabetic index:

Answer 31

is organized by main terms, modifying terms and sub terms.

Question 32

Main terms:

Answer 32

are usually the condition. disease, illness, or injury

Question 33

Modifying terms:

Answer 33

modify main terms.

Question 34

2. Where will the MA look first when choosing a diagnostic code?

Answer 34

Alphabetic Index

Question 35

3. In the code S32.009A (initial encounter for a wedge compression fracture of an unspecified lumbar vertebra), which does the A indicate?

Answer 35

Initial encounter

Question 36

4.