Key Terms Flashcards
an alphabetical listing of diagnoses, located in section 1, volume 2 of the ICD-9-CM codebook
alphabetical index
an alphabetical listing of causes and places of injuries and poisoning , located in section 3 of volume 2 of ICD-9-CM codebook, right after the table of drugs and chemicals
alphabetical index to external causes of injury and poisoning
three-digit related codes within each section of a chapter in the volume 1 tabular list of codes in the ICD-9-CM codebook
category
the first major division in the tabular list in volume 1 of the ICD-9-CM codebook. Chapters represent body systems or types of conditions
chapter
secondary diagnoses and conditions that influence treatment; diagnoses that coexist
comorbidity
a code is chosen for a less severe condition than is recorded in the patient’s medical record, or for a lesser procedure than was actually performed; undercoding
downcoding
an explanatory code that lists the external causes and places of occurrence for injuries and poisonings
E-code
the code with the greatest level of detail that matches the patient’s medical record with the greatest accuracy
greatest level of specificity
a table to assist with code choices for hypertension; part of the alphabetical index in Section 1 of Volume 2 of the ICD-9-CM codebook
hypertension table
International Classification of Diseases, Ninth Revision, Clinical Modification, the version of the diagnosis codebook used in the United States for diagnosis coding until the date ICD-10-CM is implemented
ICD-9-CM
International Classification of Diseases, Tenth Revision, Clinical Modification, the next version of the diagnosis codebook that will be used in the United States. It could be used as early as October 2007.
ICD-10-CM
the word to look up in an alphabetical index in ICD-9-CM, a condition, disease, or injury
main term
sickness or statistical incidence of disease
morbidity
death or statistical incidence of death
mortality
a table to assist with code selection for neoplasms; located in the alphabetical index in Section 1 of Volume 2 of the ICD-9-CM codebook
neoplasm table
the practice of using a short list of diagnosis codes and using those codes for all patients, regardless of whether the codes match actual diagnoses and conditions
pigeonholing
the condition that prompted an outpatient visit or treatment or the underlying cause for a hospital visit
primary diagnosis
the condition that is found after study to be chiefly responsible for hospitalization
principal diagnosis
resource-based relative value system, the prospective payment system used my Medicare to pay physicians. It considers the CPT code in relation to work, overhead expenses, and malpractice (risk). A geographical adjustment is then made to account for cost of living differences throughout the nation
RBRVS
a diagnosis that contributes to a condition; for an outpatient visit, it may include the underlying cause
secondary dignosis
related groups of codes within a chapter in the tabular list in Volume 1 of ICD-9-CM; the major divisions within each chapter
section
the fourth digit in an ICD-9-CM code; further defines the codes within a category in the Volume 1 tabular list of codes
subcategory
the fifth digit in an ICD-9-CM code; adds more specificity to distinguish between codes within a subcategory in the Volume 1 tabular list of codes
subclassification
a table to assist with code selections that identify drugs and other chemicals. It is located in Section 2 of Volume 2 in ICD-9-CM, right after the alphabetical index
table of drugs and chemicals
a numerical list of diagnosis codes presented in a format similar to a table; it is located in Volume 1 of ICD-9-CM and is arranged by body system or types of conditions
tabular list
a code is chosen for a more severe condition or for a more extensive procedure than is documented in the patient’s medical record; overcoding
upcoding
a supplemental code that describes reasons other than illness for which a person might encounter the health care system; many V-Codes cannot be uses as a principal or primary diagnosis
V-Code
