Conventions Flashcards
What do brackets enclose in the tabular?
Synonyms, alternate wording or explanatory phrases
What do brackets enclose in the alphabetic index mean?
Manifestation codes
Index : see
Explicit direction to look elsewhere
Index: see also
Go elsewhere only if all the information you are searching for cannot be located
Index :see category
Directs to tabular for important information about that specific code
And (tab and index)
And or
With (tab and index)
Associated with or due to
Index of diseases main terms
Disease, condition, nouns, adjectives
eponyms (named for person) are listed as well as the main term for the disease
Never anatomical sites
Main terms alphabetic index of procedures
Procedure performed
Never anatomical sites
What is coded first, the manifestation or the etiology?
Etiology
If a patients’a condition is listed as both acute and chronic and the conditions are listed as separate entries in the alpha index at the same indentation level, what is the first listed?
Code acute first
Name the life threatening asthmatic status with symptoms of severe intractable wheezing and airway obstruction not relieved by medication
Asthmaticus
How would you code multiple burns?
Separate code for each side
Sequence burn with highest degree first
How would you code burns of varying degrees at the same site
Code only the highest degree
How would you code an infected burn site?
Code 958.3 as an additional diagnosis (post traumatic wound infection)
When the category 946 be used?
ONLY when the burn location is not documented
When would you code from category 948?
Site of burn not documented
There’s a need for more data for the burn unit to evaluate burn mortality
There was a mention of third-degree burn involving a 20% or more of the body surface
And category 948 what does the fourth digit signify?
The total percentage of body surface involved all degrees
Category 948 what doesthe fifth digit signify
The percentage of body that is third-degree
Category 948 when is the fifth digit of zero assigned?
When zero to 10% of the total body surface is third degree
What is the rule of nines
An estimation of body surface involved
According to The rule of nines which parts of the body make up 18% individually
The left leg right leg anterior trunk and posterior trunk
According to the rule of nines which body parts make up 9% individually
The head and neck the left and the right arm
According to the rule of nines what percentage is the genitalia
One percent
When determining the rule of nines what type of patient might the hospital need to change the percentage?
Infants children or obese patients.
Documentation of redness at edge of the wound represents cellulitis (true or false)
The physician must document cellulitis
True or false: kidney disease is the correct terminology over chronic renal failure
True
Chronic kidney disease is coded based upon the severity, what does the fourth digit identity?
Fourth digit the stage
Stages one through five equal fourth digit one through 5
The fourth digit of six is end stage renal disease
When coding a congenital anomaly when would you code for the manifestations?
You would only code the manifestations if they are not an inherent component of the congenital anomaly.
Is there an age limit to when a congenital anomaly can be coded?
No many symptoms don’t show until much later in life.
What is the axis for coding coronary artery bypass graft?
The number of arteries involved
What are category II codes?
HCPCS category II covers therapeutic, preventative, patient safety and patient management codes
Which diagnosis should be listed first with sequencing inpatient codes according to UHDDS?
The principal diagnosis
If a patient is admitted for acute myocardial infarction and the condition has been ruled out, would you still code Ami as the principal?
No
