Medical Insurance: An Integrated Claims Process: Medical Insurance Chap. 4 Flashcards

HIPAA-mandated diagnosis code set as of October 1, 2014

three- to seven-character alphanumeric representation of a disease or condition

part of the ICD-10-CM listing diseases and injuries alphabetically with corresponding diagnosis codes

part of the ICD-10-CM listing diagnosis codes in chapters alphanumerically

summary table of code numbers for neoplasms by anatomical site and divided by the description of the neoplasm

index in a table format of drugs and chemicals that are listed in the Tabular List

index of all external causes of disease and injuries classified in the Tabular List

physician's description of the main reason for a patient's encounter

typographic technique that provides visual guidance for understanding information

word the identifies a disease of condition in the Alphabetic table

ICD-10-CM code listed next to the main term in the Alphabetic index that is most often associated with a particular disease or condition

word of phrase that describes a main term in the Alphabetical index

cause or origin of a disease of condition

supplementary word of phrase that helps define a code in ICD-10-CM

name of phrase formed from or based on a person's name

abbreviation indication the coded to use when a disease of condition cannot be placed in any other category

term that indicates the coded to used when no information is available for assigning the disease of condition a more specific code; unspecified

characteristic sign of symptom of a disease

code for diagnosis that is the patient's main condition; in cases involving an underlying condition and a manifestation, the underlying condition is the first-listed code

single code describing both the etiology and the manifestation(s) of a particular condition

character "x" inserted in a code to fill a blank space

necessary assignment of a seventh character to a code; often for the sequence of an encounter

three-character code for classifying a disease of condition

four- or five- character code number

Tabular List entries addressing the applicability of certain codes to specified conditions

Tabular List entries limiting applicability of particular codes to specified conditions

exclusion note used when two conditions could not exist together, such as an acquired and a congenital condition; means "not coded here"

exclusion note meaning that a particular condition is not included here, but a patient could have both conditions at the same time

use of ICD-10-CM classification system to capture the side of the body that is documented; the fourth, fifth, and sixth characters of a code specify the affected side(s)

general rules, inpatient (hospital) coding guidance, and outpatient (physician's office/clinic) coding guidance from the four cooperating parties (CMS advisers and partiipants from the AHA, AHIMA, and NCHS)

first-listed diagnosis

additional illness that either has an effect on the patient's primary illness or is also treated during the encounter

illness or condition with severe symptoms and a short duration

illness or condition with a long duration

conditions that remain after an acute illness or injury has been treated and resolved

in inpatient coding, the condition is established after study to be chiefly responsible for the admission of the patient

ICD-10-CM code for an external cause of a disease or injury

abbreviation for codes from the 21st chapter of the ICD-10-CM that identify factors that influence health status and encounters that are not due to illness or injury

patient's description of the symptoms or other reasons for seeking medical care

previous HIPAA mandated diagnosis code set

acronym for general equivalence mappings, reference tables or related ICD-10-CM and ICD-9-CM codes