MODULE 2

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MODULE 2

• ??????????

ICD-10 AND ICD-9 CM
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What is medical coding?

• Its the process of assigning complicated sets of
  numbers to the diagnoses made,procedures and
  evaluation and management services performed by
  physician and healthcare providers.code are
  chosen after reviewing physician documentation in
  the patients medical record.

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Why is medical coding important?

• They are the only way that providers communicate
  the extent of their services to government and
  third party insurance payers.They are the basis
  for providers to be reimbursed for their
  services. They are also the primary means of
  qualifying what happens in a healthcare facility
  and are important in cost accounting and decision
  support system.

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What is classification of disease ?

• ??????????????????????????????(sickness)
  ?????????(death)??????????????????????????????????
  ???? ???????????????????????????????????????????
  ??????????????????????????????(data storage)
  ?????????????????(retrieval) ?????????????????????
  ??????????????????????????????????????????????????
  (category)???????????????????????????????

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????????????????????????????????????

• Administrative and planning
• resource allocation
• continuous quality assessment and improvement
• Educational and reserch
• Epidemiology and surviellance of disease
• Legal affairs
• Communicating tools in healthcare management

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ICD-10

• ??????????????????
• 1 ??? ?????? 1 ????
• DIAGNOSTIC CODING
• ????????????????? ???????????????????????????????
  ???????????????????????? ???????????????(MEDICAL
  CODERS)

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?????????????????

• ??????????????????????
• ???????????
• ????????????
• ????????????????
• ????????????????
• ????????????????????????????????
• ??????????

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???????? ?????????????

• ??????????????????????
• 1. Coma from Hypertensive Encephalopathy
• 2. NIDDM
• 3. Senile Cataract

????????? NIDDM ??????????? Non-Insulin- Dependent
Diabetes Mellitus
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???????? ?????????????

• 1. Coma from Hypertensive Encephalopathy
• 2. Non-Insulin-Dependent Diabetes Mellitus
• 3. Senile Cataract

????????????? ???????? Coma ??? ??????????????
??????????? Encephalopathy ??????????????? ??????
????????????
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???????? ?????????????

• 1. Hypertensive Encephalopathy
• 2. Non-Insulin-Dependent Diabetes Mellitus
• 3. Senile Cataract

?????????????????? ??????? I67.4 ??????
Hypertensive Encephalopathy
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???????? ?????????????

• 1. Hypertensive Encephalopathy I67.4
• 2. Non-Insulin-Dependent Diabetes Mellitus
• 3. Senile Cataract

?????????????????? 1 ??????????????????? I67.4
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???????? ?????????????

• 1. Hypertensive Encephalopathy I67.4
• 2. Non-Insulin-Dependent Diabetes Mellitus
• 3. Senile Cataract

???????????? ?????????????????
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ICD-10 Volume 3 - Alphabetical Index

• Section 1 ????????????????????????
• Section 2 ????????????????????????????????????????
  
• Section 3 ????????????????? ???????????????
  ?????????????????????????
• ???????????? 2 ?????(COLUMN) ??????? ??????
  ???????

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??????????????????????????????

• ?????? ???????????????
• ????????????? 1 ???????????????????????? 1 ???
• ????????????? 2 ???????????????????????? 2 ???
• ????????????? 3 ???????????????????????? 3 ???
• ????????????? 4 ???????????????????????? 4 ???
• ????????????? 5 ???????????????????????? 5 ???
• etc.

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????????????????????????

• ???????????????
• CONGENITAL
• INFECTION
• TRAUMA
• TUMOR
• ??????????????????????????????? ????
  ?????????????
• ???????????
• ????????????????? - ??????????, ?????????
  ????????? ???

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??????????????????????? 3

• ?????????????????( )
• ?????????????????????????????? ???????????????????
  ???? ????????????????????????? ???????????????????
  ????????
• ???????? Abscess(embolic)(infective)(metastatic)(m
  ultiple)(pyogenic)(septic)
• -brain (any part) G06.0
• ??????????? brain abscess ????????????? G06.0
  ????????????????????????????? ????????????????????
  ????????????? ???? embolic, infective,
  metastatic, multiple, pyogenic, septic ???????

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??????????????????????? 3

• ????????????????????????
• ??????????????????????????? ???
  ???????????????????????????????
  ?????????????????????????????? ???????????????????
  ??????????????????????????????????????????????????
  ???????
• ???????? Meningitis(basal)(cerebral)(spinal)
  G03.9
• -cryptococcal B45.1 G02.1

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??????????????????????? 3

• ????????? NEC
• NEC ????????????????????????????????? Not
  Elsewhere Classified ???????????????
  ????????????????????????????????????????????
  ????????????????????????????????????????
  ?????????????? ???????????????????????? ?????????
  ICD-10 ????????????????? ???????
  ??????????????????????????????????????????????????
  ???????????????????????????? ?????????????????????
  ???????????????????????????

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????????????????

• See ??????????? ?????????????????????? ??????????
  
• ????????????
• Candidosis see Candidiasis ???????????????????
• ??????????? Candidiasis ??? Candidosis
• Infection
• -bone see Osteomyelitis ???????????????????????
• ????????? Osteomyelitis

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????????????????

• see also ??????????? ?????????????????????
  ???????????????????????? ????????????
• Enlargement, enlarged see also Hypertrophy
• ??????????????????????????? Hypertrophy ????
• Osteoarthritis see also Arthrosis
• ??????????????????????????? Arthrosis ????

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????????????????

• see condition ??????????? ???????????????????????
  
• ???????????? ?????????????????????????????????
  
• ????????????
• Active see condition ????? Active
  ?????????????????????????? ??????????
  ????????????
• Chronic see condition ????? Chronic ??????
  ??????????? ????????????????????????????

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??????????? ?????????????????????? 3

• ???????????????????????????????????????
  ??????????????? ??????????????????????????????????
  ???????????????
• ??????????????????????? ????????????????? 1
  ???????? ??????????????????????? 3
  ?????????????????????????????

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ICD-10 Volume 1 - Tabular List

• ?????? 1 ??????, ??????????????????? 3 ????????
• ?????? 2 ???????????????
• ?????? 3 ??????????????????, ?????????????,?
  ????????????????
• ???????????-?????? ?????????????? ???
• 1(?) ??? 1(?)

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????????????????????????????? 1

• ?? CHAPTER
• ???? BLOCK
• ????????? CATEGORY
• ???? RUBRIC

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?????????????????????????????????? ICD-10

• 1. ?????????????????????????????????
• 2. ????????????????????
• CONGENITAL, INFECTION, TRAUMA, TUMOR
• 3. ????????????????????
• NERVOUS, EYE, ENT, CARDIOVASCULAR etc.
• 4. ?????,?????????
• 5. ???????????????????????????????????

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??????????????

• ?????????????
• Includes, Excludes
• This chapter contain the following blocks
• Notes or Definition
• ?????????

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????????????????

• ???????????????
• Includes, Excludes
• ?????????????????? 4 ???? 5
• Note, Definition
• ??????????????

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?????????????????????

• ????????????????? 3 ????????????
• ???????????? 4 ????????
• (??????????? ?? 3 ???? 5 ????????)
• ????????????????? ??????????????????????????
• ?????????????????????????????????????????
• ????????????????????????????????????????????????
• (4 ??? 5 ????????)

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?????????????

• 1. ?????????????????
• ????????????? .0 ??? .7
• 2. ?????????????????
• ????????????? .8 ??????????? NEC
• 3. ????????????????????
• ????????????? .9 ??????????? NOS

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??????????????????????????????????

• ????????????????????????
• ????? U ???????????????????? ?????????????????????
  ????????????
• ???????????????????????? ???????????????????????
• ICD-10-AM
• ICD-10-TM !!??

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????????? ??????????????????????

• ??????????? ???????????????? (Square
  Bracket)
• ???????????????? ??????????? ???????????????????
  ???????????????????????
• ???????? 2-12 ??????????????????????
• A30 Leprosy Hansen's disease
• C00.8 Overlapping lesion of lip
• See note 5 on p.182

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????????? ??????????????????????

• ????????? NOS ???????? Not Otherwise
  Specified
• ????????????????????????????? ????????????????????
  ?????????????????????????????????
  ????????????????????????? ????????? NOS
  ????????????????????????????????
• ????????
• J06.9 Acute Upper respiratory infection,
  unspecified
• Upper respiratory
• -disease, acute
• -infection

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????????? ??????????????????????

• ???????? AND
• ??????????????????? ??? ???? ????????????????????
  ????????????????????????????? AND ?????????
  ????????????????????
• ???? A18.0 Tuberculosis of bones and joint
• ?????????????? 3 ?????? ???
• 1. Tuberculosis of bones
• 2. Tuberculosis of joint
• 3. Tuberculosis of bones and joint

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????????? ??????????????????????

• ?????????? .- ???????????????????????
• ??????????????????????????????????
  ???????????????????????????????????????
  ??????????????????????????????????????????????????
  ???????????? ?????????????????????????????????
  ????????????????? ???????????????
  ????????????????? ???????????
• ?????????????? Incomplete Abortion
  ?????????????????????????? 3 ??????????? O06.-
  ?????????????????????????? O06.-
  ??????????????????? ?????????????????????? 1
  ????????????????? O06 Unspecified abortion

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????????????????????????? 1

• MORPHOLOGY OF NEOPLASMS
• ?????????????????? ICD-O
• (ICD- ONCOLOGY)
• ???????????????????? ???????????????????
• ???????????

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Guidelines for coding main condition and other
conditions 1

• General
• Optional additional codes
• Coding of conditions to which the dagger and
  asterisk system applies
• Coding of suspected conditions,symptom and
  abnormal findings and non-illness situations
• Coding of multiple conditions

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Guidelines for coding main condition and other
conditions 2

• Coding of combination categories
• Coding of external causes of morbidity
• Coding of sequelae of certain conditions
• Coding of acute and chronic conditions
• Coding of postprocedural conditions and
  complications

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Standards of Ethical Coding

• ??????????????????????????????????????????????????
  ?????????????????????????????????????? ICD-10
• ??????????????????????????????????????????????????
  ??????????????????????????????????????????????????
  ??????????????????????????????????????????????????
  ??????
• ??????????????????????????????????????????????????
  ???????????????????????????????????
• ??????????????????????????????????????????????????
  ?????????????????????????????? ???????????????????
  ??????????????????????????????????????
• ??????????????????????????????????????????????????
  ??????????????????????????????????????????????????
  ?????????????????????????
• ???????????????????????????????????????? ?.?
  ??????????????????????????????????????????????????
  ??????????????????????????????????????????????????
  ???????