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ICD-9 & CPT Coding MIBC

ICD-9 & CPT Coding

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ICD-9 & CPT Coding. MIBC. What is Medical Coding?. Every time a patient receives professional health care in a physician’s office, hospital outpatient facility or ambulatory surgical center (ASC), the provider must document the services provided. - PowerPoint PPT Presentation

Text of ICD-9 & CPT Coding

ICD-9 & CPT Coding

ICD-9 & CPT CodingMIBCWhat is Medical Coding?Every time a patient receives professional health care in a physicians office, hospital outpatient facility or ambulatory surgical center (ASC), the provider must document the services provided.

The medical coder will abstract the information from the documentation, assign the appropriate codes, and create a claim to be paid by the third party insurance.Medical CoderMedical CoderThorough knowledge of anatomy and medical terminology. It is also important to become familiar with different types of insurance plans, regulations,and the coding communitys critical resource books: CPT and ICD-9-CM along with their corresponding codes and guidelines.

Usingcoding books, the medical coder assigns correct codes to record the service levels for the procedures performed and to account for supplies used to treat the patient during an encounter with the physician. Proper assignment of ICD-9-CM codes corresponds with the physicians diagnoses and completes the story of the patients illness or injury.International Classification of Diseases and Conditions, 9th Edition alphanumeric designations given to every diagnosis, description of symptoms and cause of death attributed to human beings.

Used by government health authorities to track diseases and conditions and show uniformity

ICD-9, 3 VolumesVolume 1: TABULAR LISTVolume 2 : ALPHABETIC INDEX Volume3: HOSPITAL PROCEDURES The correct coding process is to locate a term and its code in the Alphabetic Index (Volume 2) and to verify the code in the tabular (Volume 1)Codes can be 3-5 digits long depending on the specifity needed to code the disease/condition

How to Find A DX CodeA 6 year old boy with chronic tonsillitis receives a tonsillectomy.

1st: Identify the main term as the DX: What is wrong? 2nd: Identify the main term as the procedure: What are they doing? 3rd: Recognize that age may play a key factor in assigning the correct/accurate code

ICD-9 IndexICD-9 Tabular

Current Procedural TerminologyEvery medical, diagnostic, or surgical procedure or service has an associated 5-digit CPT code assigned to itThe standard for doctors, coders, patients, and insurance companies to label and identify medical services and procedures

CPTThe CPT manual has an Index and Tabular as well

The Index is located in the back of the manual

The Tabular is located at the front of the CPT manualCategorized by body systems (Urinary, Respiratory)

CPT Index

CPT Tabular

Medical BillerThe medical coder provides the medical biller with the information necessary to process a claim for reimbursement by the appropriate insurance agency.

And Last but not LeastIn October 2014, the Medical Billing and Coding world will implement a new standard of coding.We will evolve from 17,000 ICD-9 codes to approximately 141,000 ICD-10 codes