Chapter 28- Diagnostic Coding Basics Flashcards
Board Notes:
Diagnostic Coding:
has been used to standardize diagnoses.
Purpose:
to prove medical necessity so that insurance companies can reimburse.
Who is responsible?
World Health Organization (WHO)
Mortality:
death rate
Medical necessity:
insurance companies determine medical necessity based on the diagnostic and procedural codes submitted on the claim.
Diagnosis:
determination of disease/ condition.
Etiology-
underlying cause/ origin of a disease.
Epidmiological:
data
Reimbursement:
to make repayment for an expense or a loss incurred. * Payment for services rendered.
Alphabetical index:
A-Z of Dx
Tabular Index:
Codes in alphanumerical order,
L.89
letter stands for the body system.
L89 - is the category,
G20-
code for Parkinson’s disease.
- anything after that is more specific about it.
- The more issues the more money 000
U codes:
new conditions/ diseases
Z codes:
prophylactic/ preventative care
Code HIV:
this indicates only that the virus is present.
NOS:
Not otherwise specified.
If no dx then code ____:
signs & symptoms
Abstract:
to collect important information from the health records.
Sequela:
An abnormal condition resulting from a previous disease.
(Lingering effect)
Essential modifiers:
terms that specify the code.
- under the main term.
What is placeholder X?
is used to fill out the empty character spaces.
Carcinoma:
cancer
Benign:
noncancerous, it’s good.
Malignant:
bad
Carcinoma in site:
situated in one site, doesn’t spread.
Primary site:
the original site, where did the cancer start.
Post partum:
The pomerium, or first 6 weeks after the first of the baby & after delivery.
Burns are coded by:
coding each burn separately, burns are coded by site and degree and by the extent of body surface involvement.
EAQ:
1. Where will the MA begin the search for a diagnostic code?
Alphabetic Index
The alphabetic index:
is organized by main terms, modifying terms and sub terms.
Main terms:
are usually the condition. disease, illness, or injury
Modifying terms:
modify main terms.
- Where will the MA look first when choosing a diagnostic code?
Alphabetic Index
- In the code S32.009A (initial encounter for a wedge compression fracture of an unspecified lumbar vertebra), which does the A indicate?
Initial encounter
4.
