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These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated.
NEW! Pharmacology in each body system and a Pharmacology Basics appendix help you recognize drugs and medications in medical reports. NEW! More than 50 new images bring terminology to life. NEW! Additional procedural terms supply a more complete picture of the number and kind of procedures you will encounter on medical reports. NEW! Normal Lab Values appendix familiarizes you with normal and abnormal lab values so you know when to search a medical record for possible additional diagnoses. NEW! Tablet and mobile-optimized Evolve activities offer an easily accessible source for extra interactive practice and learning.
ICD-10-CM 2019: The Complete Official Codebook provides the entire updated code set for diagnostic coding. This codebook is the cornerstone for establishing medical necessity, determining coverage and ensuring appropriate reimbursement.
Code more efficiently and effectively with Carol J. Buck's 2014 ICD-10-CM Draft Edition. Designed by coders for coders, this reference combines Netter's Anatomy illustrations and the Official Guidelines for Coding and Reporting. It simplifies ICD-10 diagnosis to ensure the most accurate billing and optimal reimbursement for outpatient medical services. Full-color images and clear explanations of A&P, pathology, and medical terminology make it easy to develop the knowledge needed to assign the appropriate ICD-10-CM codes. - At-a-glance Guide to the Updates lists all new and revised codes, providing quick access to the annual changes. - Official Guidelines for Coding and Reporting (OGCRs) are listed and also integrated within the code set, providing fast, easy access to the official coding rules. - Unique! Full-color Netter's anatomy art is cross-referenced within the Tabular List to help you understand anatomy and how it will affect choosing codes. - More than 150 full-color illustrations provide visual orientation and help you understand difficult terminology, diseases/conditions, or coding in a specific category. - Additional elements within specific codes define terms and supply additional coding instruction to aid in understanding difficult terminology, diseases and conditions, or coding in a specific category. - Symbols and highlights show which codes are an Unacceptable Principle Diagnosis and identify codes that call for the use of additional character(s). - NEW! Updated 2014 Draft Code set. - NEW! American Hospital Association's Coding Clinic® citations provide reference information regarding official ICD-10-CM coding advice that will enhance understanding of specific codes. - NEW! CC (Complications & Comorbidities) and MCC (Major Complications & Comorbidities) Exclusions call attention to CC and MCC exceptions.
ICD-10-CM 2021: The Complete Official Codebook provides the entire updated code set for diagnostic coding, organized to make the challenge of accurate coding easier. This codebook is the cornerstone for establishing medical necessity, determining coverage and ensuring appropriate reimbursement. Each of the 21 chapters in the Tabular List of Diseases and Injuries is organized to provide quick and simple navigation to facilitate accurate coding. The book also contains supplementary appendixes including a coding tutorial, pharmacology listings, a list of valid three-character codes and additional information on Z-codes for long-term drug use and Z-codes that can only be used as a principal diagnosis. Official coding guidelines for 2021 are bound into this codebook. FEATURES AND BENEFITS Full list of code changes. Quickly see the complete list of new, revised, and deleted codes affecting the FY 2021 codes, including a conversion table and code changes by specialty. QPP symbol in the tabular section. The symbol identifies diagnosis codes associated with Quality Payment Program (QPP) measures under MACRA. New and updated coding tips. Obtain insight into coding for physician and outpatient settings. New and updated definitions in the tabular listing. Assign codes with confidence based on illustrations and definitions designed to highlight key components of the disease process or injury and provide better understanding of complex diagnostic terms. Intuitive features and format. This edition includes full-color illustrations and visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, codes associated with CMS hierarchical condition categories (HCC), Medicare Code Edits (MCEs), manifestation codes, other specified codes, and unspecified codes. Placeholder X. This icon alerts the coder to an important ICD-10-CM convention--the use of a "placeholder X" for three-, four- and five-character codes requiring a seventh character extension. Coding guideline explanations and examples. Detailed explanations and examples related to application of the ICD-10-CM chapter guidelines are provided at the beginning of each chapter in the tabular section. Muscle/tendon translation table. This table is used to determine muscle/tendon action (flexor, extensor, other), which is a component of codes for acquired conditions and injuries affecting the muscles and tendons Index to Diseases and Injuries. Shaded guides to show indent levels for subentries. Appendices. Supplement your coding knowledge with information on proper coding practices, risk adjustment coding, pharmacology, and Z codes.
Gives specialists in the clinical neurosciences a detailed and authoritative instrument for coding virtually all recognized neurological conditions. Both neurological diseases and neurological manifestations of general diseases and injuries are included in this comprehensive coding tool. The volume is part of a growing family of specialty-based adaptations of ICD-10 which retain the core codes of the parent classification while providing extended detail at the fifth character and beyond. Now in its second edition ICD-NA has been revised to reflect current clinical concepts in the neurosciences as well as the new coding system introduced with ICD-10. The classification was finalized following extensive consultation with numerous professional organizations and international experts thus ensuring the representation of as many viewpoints as are practical and consistent. While remaining directly compatible with ICD-10 ICD-NA offers clinicians and researchers much greater precision allowing them to match an explicit diagnosis with a detailed code at the five- six or seven-character level. In addition a comprehensive alphabetical index and the extensive use of inclusion and exclusion terms provide considerable assistance in finding the correct category for any condition diagnosed. Apart from these opportunities for recording greater diagnostic detail the direct compatibility with ICD-10 facilitates comparisons between statistics compiled according to ICD-NA and national morbidity and mortality statistics compiled according to ICD-10. These features enhance the flexibility of ICD-NA making it suitable for use in morbidity statistics hospital record indexing and epidemiological research by government and other health agencies collecting statistical data under relatively few main headings or by individual physicians and researchers requiring a convenient tool for indexing their clinical and teaching material in sufficient detail. The revised classification should also facilitate the collection of epidemiological data comparisons of the prevalence of individual neurological diseases and identification of the risk factors for these diseases at both national and international levels. In addition to the detailed tabular list of neurological and related disorders the volume includes an explanation of the basic principles of classification and instructions for coding morphology codes for neoplasms relevant to neurology and neurosurgery and a 90-page index of diagnostic terms given in standard or official nomenclatures together with synonyms and eponyms.
This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.
- Full-color format includes consistent color-coded symbols, and is specifically designed to meet the needs of hospital inpatient, outpatient, and professional coding.
2013 ICD-10-CM Draft Edition -- E-Book
- NEW! Age and Sex edits from the Medicare Code Editor alert you to codes that are used only with patients of a specific age or sex, helping to ensure accurate reporting - Present on Admission symbol highlights the diseases that will always be coded as present on admission. - Hospital Acquired Condition symbol notes specific conditions that will always be coded as hospital acquired for easier recognition.