1. ICD- 9-CM MEDICAL CODING & INSURANCE

2.  Classification System  International Comparison  1988 Medicare Catastrophic Coverage Act  Uses: track costs and patient usage  Research—trends/demands SLIDE #2 OVERVIEW

3.  Code ethically  Documentations must support diagnosis  Transform verbal or narrative descriptions of diseases, injuries, conditions, and procedures into numeric designations SLIDE # 3 ETHICS & YOUR ROLE

4.  Volume I, Diseases. Tabular List (Diagnosis)  Volume II, Diseases, Alphabetic Index (Diagnosis)  Volume 3, Procedures, Tabular List & Alphabetic Index (Inpatient) SLIDE # 4 FORMAT OF ICD-9-CM

5.  Contains code numbers  001.0-999.9 Diagnosis codes describe conditions  V and E codes = Supplemental information SLIDE # 5 VOLUME I, DISEASES, TABULAR LIST

6.  Appears first in the book  Terms and code numbers in Volume I  Never code directly from the Index! SLIDE # 6 VOLUME 2, DISEASES, ALPHABETIC INDEX

7.  Index and Tabular List used for procedures and therapies  Inpatient settings only  Procedures and therapies  Maximum 4 digits. E.g. 20.41 Simple Mastoidectomy SLIDE # 7 VOLUME III, PROCEDURES, TABULAR LIST AND ALPHABETIC INDEX

8.  Chapters 1-17  Section A Group of related conditions SLIDE # 8 DIVISIONS OF CLASSIFICATION OF DISEASES & INJURIES

9.  Category 3 digits  Subcategory 4 digits  Subclassification 5 digits  You must code to the highest level of specificity.  You must code a 5 digit if a subclassification is available SLIDE # 9 CONDITION LEVELS

10.  Determine the Main Term  Locate the Main Term in the Alphabetic Index (Volume II)  Review any subterms under the main term in the Index  Follow any cross-referencing instructions. E.g. “see”, “see also”. SLIDE # 10 USING THE ICD-9-CM

11.  Verify the codes (s) selected from the Index (Volume II) in the Tabular List (Volume I)  Refer to any instructional notations in the Tabular  Assign codes at the highest specificity.  Code the diagnosis until all elements are completely identified. SLIDE #11 USING THE ICD, CONT.’

12.  NEC “Not elsewhere classifiable”: This abbreviation in the index represents “other specified” when a specific code is not available for a condition. You will be directed to the “other specified” in the Tabular.  NEC, when found in the Tabular, allows you to identify the code as “other specified”. This when there is no specific code identifying your condition.  NOS is equivalent to unspecified. SLIDE # 12 ABBREVIATIONS

13.  Acute: Short, relatively severe course  Chronic: Persists over long period of time.  What if they both exist?  The index has separate entries for both conditions…  Use both codes, and put the acute code first.  Some codes combinations are represented by a single code SLIDE # 13 ACUTE & CHRONIC

14. Material extracted directly from Buck’s Step-By-Step Coding Text, Copyright 2008, Elsevier. Created for Kaplan University by Cindy Ogle