Understanding ICD-9-CM Coding Understanding ICD-9-CM Coding Mary Jo Bowie Regina Schaffer Mary Jo Bowie Regina Schaffer
Section One
Introduction to Coding and Coding Professions CHAPTER 1
Copyright © 2010, Delmar, Cengage Learning 4 Introduction Coding is the assignment of numerical or alpha-numerical digits and characters to diagnostic and procedural phrases.
Copyright © 2010, Delmar, Cengage Learning 5 Coding Is a Language Used by insurance companies Used by healthcare providers Use is vital to care and treatment of patients Coder needs to be able to “translate” this language
Copyright © 2010, Delmar, Cengage Learning 6 International Classification of Disease, Ninth Revision, Clinical Modification ICD-9-CM Systematic division of groups of diagnoses and procedures
Copyright © 2010, Delmar, Cengage Learning 7 World Health Organization Headquartered in Geneva, Switzerland Responsible for publishing revisions to ICD every 10 years Every revision prompts name change
Copyright © 2010, Delmar, Cengage Learning 8 Annual Modifications U.S. Department of Health and Human Services oversees two agencies responsible for annual modifications: –National Center for Health Statistics –Centers for Medicare and Medicaid Services
Copyright © 2010, Delmar, Cengage Learning 9 Purpose of ICD-9-CM Codes Reflects signs, symptoms, disorders, diseases, examinations or other reasons for the services billed Gives payers a clear picture of the reasons for the services billed
Copyright © 2010, Delmar, Cengage Learning 10 Professional Coding Associations Educate Train Credential
Copyright © 2010, Delmar, Cengage Learning 11 American Health Information Management Association AHIMA Professionals who manage, organize, process, and manipulate patient data Knowledge of medical records Coding and reimbursement Research Credentialing
Copyright © 2010, Delmar, Cengage Learning 12 American Academy of Professional Coders AAPC Elevate standards of professional coders Education and networking Coding and reimbursement Certification
Copyright © 2010, Delmar, Cengage Learning 13 Other Professional Organizations American Association of Medical Assistants (AAMA) Certified Medical Assistants (CMA) American Medical Technologist (AMT) Registered Medical Assistant (RMA)
Copyright © 2010, Delmar, Cengage Learning 14 Employment Opportunities Numerous opportunities Hospitals Physician offices Clinics Long-term care facilities Insurance companies Billing agencies
Copyright © 2010, Delmar, Cengage Learning 15 Health Insurance Portability and Accountability Act HIPAA Public Law Administration Simplification Standardized code sets