ICD-10 Code Set Flashcards
Who developed the International Classification of Diseases?
World Health Organization(WHO) in 1948
What two code sets is this system divided into?
- The International Classification of Diseases, 10th Revision, Clinical Modification(ICD-10-CM)
- International Classification of Diseases, 10th Revision, Procedure Coding System(ICD-10-PCS)
Who maintains the ICD-10-PCS?
Centers for Medicare and Medicaid Services(CMS)
When are the ICD-10-PCS updated?
Annually beginning October 1st
What are ICD-10-PCS used for?
Hospitals to report inpatient procedures, including devices and reflecting various technologies used.
What two agencies collaborate to maintain the ICD-10-CM?
Nationa; Center for Health Statistics and WHO
What is the ICD-10-CM used for?
This allows providers, facilities, and third-party payers the ability to communicate patient conditions, illnesses, and injuries.
How many sections are the ICD-10-CM Official Guidelines divided into?
Four
What is Section I in the ICD-10-CM Official Guidelines?
Conventions, General Coding Guidelines, and Chapter Specific Guidelines
What is Section II in the ICD-10-CM Official Guidelines?
Selection of Principal Diagnosis
What is Section III in the ICD-10-CM Official Guidelines?
Reporting Additional Diagnoses
What is Section IV in the ICD-10-CM Official Guidelines?
Diagnostic Coding and Reporting Guidelines for Outpatient Guidelines
What is the Number One Rule when using the ICD-10-CM Coding Manual?
Always find the main term in the alphabetic index first.
What is an ICD-10-CM code made up of?
Three to Seven Alphanumeric Characters
What do the first three characters in an ICD-10-CM code mean?
These are diseases, injuries, external causes, and factors that influence health and encounters for health services.
What do the fourth through sixth characters in an ICD-10-CM code mean?
These specify clinical details such as anatomic site, acuity, and manifestation.
What does the seventh character in an ICD-10-CM code mean?
This extension defines the episode(initial, subsequent, and sequela)
What is the character for the Initial Encounter and what does that mean?
A, the patient is undergoing active treatment
What is the character for the Subsequent Encounter and what does that mean?
D, after the patient has received active treatment and is in the recovery phase
What is the character for Sequela and what does that mean?
S, these are the late effects of an injury or illness
What do diagnosis codes establish?
Medical Necessity for procedures, services, or supplies.
