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Chapter 1 Reimbursement, HI PA A, and Compliance |
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1 | (24) |
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2 | (1) |
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Basic Structure of the Medicare Program |
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2 | (4) |
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Health Insurance Portability and Accountability Act |
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6 | (3) |
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9 | (2) |
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Outpatient Resource-Based Relative Value Scale (RBRVS) |
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11 | (5) |
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16 | (3) |
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19 | (3) |
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22 | (3) |
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Chapter 2 An Overview of ICD-10-CM |
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25 | (20) |
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26 | (1) |
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27 | (1) |
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27 | (4) |
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31 | (3) |
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Official Instructional Notations in the ICD-10-CM |
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34 | (7) |
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41 | (4) |
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Chapter 3 ICD-10-CM Outpatient Coding and Reporting Guidelines |
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45 | (28) |
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46 | (2) |
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48 | (1) |
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49 | (1) |
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49 | (1) |
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50 | (9) |
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59 | (1) |
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First-Listed Diagnosis and Coexisting Conditions |
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60 | (1) |
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61 | (2) |
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63 | (1) |
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63 | (1) |
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64 | (1) |
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65 | (1) |
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66 | (2) |
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68 | (1) |
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69 | (4) |
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Chapter 4 Using ICD-10-CM |
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73 | (21) |
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Organization of the Guidelines |
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74 | (1) |
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74 | (1) |
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Alphabetic Index and Tabular List |
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74 | (2) |
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76 | (2) |
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78 | (2) |
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80 | (2) |
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82 | (2) |
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84 | (2) |
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86 | (3) |
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Reporting Same Diagnosis Code More Than Once |
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89 | (1) |
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89 | (2) |
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91 | (3) |
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Chapter 5 Chapter-Specific Guidelines (ICD-10-CM Chapters 1-10) |
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94 | (50) |
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Certain Infectious and Parasitic Diseases |
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95 | (10) |
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105 | (10) |
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Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism |
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115 | (2) |
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Endocrine, Nutritional, and Metabolic Diseases |
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117 | (4) |
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Mental, Behavioral and Neurodevelopmental Disorders |
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121 | (3) |
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Diseases of the Nervous System |
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124 | (5) |
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Diseases of the Eye and Adnexa |
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129 | (2) |
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Diseases of the Ear and Mastoid Process |
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131 | (1) |
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Diseases of the Circulatory System |
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132 | (7) |
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Diseases of the Respiratory System |
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139 | (2) |
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141 | (3) |
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Chapter 6 Chapter-Specific Guidelines (ICD-10-CM Chapters 11-14) |
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144 | (15) |
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Diseases of the Digestive System |
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145 | (1) |
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Diseases of the Skin and Subcutaneous Tissue |
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146 | (3) |
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Diseases of the Musculoskeletal System and Connective Tissue |
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149 | (6) |
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Diseases of the Genitourinary System |
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155 | (1) |
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156 | (3) |
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Chapter 7 Chapter-Specific Guidelines (ICD-10-CM Chapters 15-22) |
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159 | (38) |
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Pregnancy, Childbirth, and the Puerperium |
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160 | (9) |
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Certain Conditions Originating in the Perinatal Period |
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169 | (1) |
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Congenital Malformations, Deformations, and Chromosomal Abnormalities |
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170 | (3) |
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Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified |
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173 | (4) |
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Injury, Poisoning, and Certain Other Consequences of External Causes |
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177 | (18) |
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195 | (2) |
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Chapter 8 Introduction to CPT |
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197 | (25) |
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The Purpose of the CPT Manual |
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198 | (1) |
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198 | (2) |
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200 | (14) |
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214 | (4) |
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218 | (1) |
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219 | (3) |
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Chapter 9 Introduction to the Level II National Codes (HCPCS) |
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222 | (21) |
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History of National Level Codes |
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223 | (6) |
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Updating the HCPCS Manual |
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229 | (1) |
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229 | (9) |
|
National Physician Fee Schedule |
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238 | (1) |
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239 | (4) |
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243 | (30) |
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244 | (1) |
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Modifiers - 22 through - 26 |
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244 | (5) |
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Modifiers - 32 through - 52 |
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249 | (7) |
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Modifiers - 53 through - 59 |
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256 | (5) |
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Modifiers - 62 through - 82 |
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261 | (6) |
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Modifiers - 90 through - 99 |
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267 | (2) |
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269 | (4) |
|
Chapter 11 Evaluation and Management (E/M) Services |
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273 | (64) |
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Contents of the E/M Section |
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274 | (1) |
|
Three Factors of E/M Codes |
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275 | (3) |
|
Office or Other Outpatient Code Guidelines |
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|
278 | (2) |
|
Various Levels of E/M Service |
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280 | (8) |
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288 | (1) |
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289 | (41) |
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330 | (3) |
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333 | (4) |
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337 | (21) |
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338 | (3) |
|
Anesthesia Section Format |
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341 | (1) |
|
Formula for Anesthesia Payment |
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342 | (10) |
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352 | (1) |
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353 | (2) |
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355 | (1) |
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355 | (3) |
|
Chapter 13 Surgery Guidelines and General Surgery |
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|
358 | (14) |
|
Introduction to the Surgery Section |
|
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359 | (1) |
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359 | (3) |
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362 | (1) |
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363 | (1) |
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363 | (2) |
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365 | (3) |
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368 | (1) |
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369 | (3) |
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Chapter 14 Integumentary System |
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372 | (34) |
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373 | (1) |
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373 | (1) |
|
Skin, Subcutaneous, and Accessory Structures |
|
|
374 | (9) |
|
Nails, Pilonidal Cyst and Introduction |
|
|
383 | (3) |
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|
386 | (10) |
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396 | (3) |
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399 | (2) |
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401 | (2) |
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|
403 | (3) |
|
Chapter 15 Musculoskeletal System |
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|
406 | (22) |
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|
407 | (1) |
|
Fractures and Dislocations |
|
|
408 | (5) |
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|
413 | (8) |
|
Application of Casts and Strapping |
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|
421 | (2) |
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|
423 | (2) |
|
|
425 | (3) |
|
Chapter 16 Respiratory System |
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|
428 | (19) |
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429 | (1) |
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430 | (1) |
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|
431 | (5) |
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|
436 | (1) |
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437 | (2) |
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439 | (1) |
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440 | (4) |
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|
444 | (3) |
|
Chapter 17 Cardiovascular System |
|
|
447 | (41) |
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|
448 | (2) |
|
Cardiovascular Coding in the Surgery Section |
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|
450 | (20) |
|
Cardiovascular Coding in the Medicine Section |
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|
470 | (11) |
|
Cardiovascular Coding in the Radiology Section |
|
|
481 | (4) |
|
|
485 | (3) |
|
Chapter 18 Hemic, Lymphatic, Mediastinum, and Diaphragm |
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|
488 | (10) |
|
Hemic and Lymphatic Systems |
|
|
489 | (4) |
|
Mediastinum and Diaphragm |
|
|
493 | (2) |
|
|
495 | (3) |
|
Chapter 19 Digestive System |
|
|
498 | (30) |
|
|
499 | (1) |
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|
500 | (1) |
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|
501 | (1) |
|
Tongue and Floor of Mouth |
|
|
501 | (2) |
|
|
503 | (1) |
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|
503 | (1) |
|
|
503 | (2) |
|
Pharynx, Adenoids, and Tonsils |
|
|
505 | (2) |
|
|
507 | (4) |
|
|
511 | (1) |
|
Intestines (Except Rectum) |
|
|
512 | (2) |
|
Meckel's Diverticulum and the Mesentery |
|
|
514 | (1) |
|
|
515 | (1) |
|
|
515 | (5) |
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|
520 | (2) |
|
|
522 | (1) |
|
|
523 | (1) |
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|
523 | (1) |
|
Abdomen, Peritoneum, and Omentum |
|
|
524 | (1) |
|
|
525 | (3) |
|
Chapter 20 Urinary and Male Genital Systems |
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|
528 | (33) |
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|
529 | (17) |
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|
546 | (12) |
|
|
558 | (3) |
|
Chapter 21 Reproductive, Intersex Surgery, Female Genital System, and Maternity Care and Delivery |
|
|
561 | (23) |
|
Reproductive System Procedures |
|
|
562 | (1) |
|
|
562 | (1) |
|
|
562 | (14) |
|
Maternity Care and Delivery |
|
|
576 | (5) |
|
|
581 | (3) |
|
Chapter 22 Endocrine and Nervous Systems |
|
|
584 | (16) |
|
|
585 | (3) |
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|
588 | (10) |
|
|
598 | (2) |
|
Chapter 23 Eye, Ocular Adnexa, Auditory, and Operating Microscope |
|
|
600 | (15) |
|
|
601 | (6) |
|
|
607 | (4) |
|
|
611 | (1) |
|
|
612 | (3) |
|
|
615 | (28) |
|
|
616 | (1) |
|
|
616 | (1) |
|
|
617 | (1) |
|
|
617 | (6) |
|
|
623 | (3) |
|
|
626 | (3) |
|
|
629 | (1) |
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|
629 | (4) |
|
|
633 | (5) |
|
|
638 | (1) |
|
|
639 | (4) |
|
Chapter 25 Pathology/Laboratory |
|
|
643 | (17) |
|
|
644 | (1) |
|
Organ or Disease-Oriented Panels |
|
|
644 | (1) |
|
|
645 | (1) |
|
|
646 | (1) |
|
Evocative/Suppression Testing |
|
|
647 | (1) |
|
Pathology Clinical Consultations |
|
|
647 | (2) |
|
Urinalysis, Molecular Pathology, and Chemistry |
|
|
649 | (1) |
|
Hematology and Coagulation |
|
|
650 | (1) |
|
|
651 | (1) |
|
|
652 | (1) |
|
|
653 | (1) |
|
|
654 | (1) |
|
Cytopathology and Cytogenic Studies |
|
|
654 | (1) |
|
|
654 | (2) |
|
|
656 | (1) |
|
|
657 | (3) |
|
|
660 | (37) |
|
|
661 | (1) |
|
Introduction to Immunizations |
|
|
662 | (5) |
|
|
667 | (2) |
|
|
669 | (1) |
|
|
669 | (3) |
|
|
672 | (1) |
|
|
673 | (2) |
|
Special Otorhinolaryngologic Services |
|
|
675 | (1) |
|
|
676 | (1) |
|
Noninvasive Vascular Diagnostic Studies |
|
|
676 | (1) |
|
|
677 | (2) |
|
Allergy and Clinical Immunology |
|
|
679 | (1) |
|
|
680 | (1) |
|
Neurology and Neuromuscular Procedures |
|
|
680 | (2) |
|
Central Nervous System Assessments/Tests |
|
|
682 | (1) |
|
Health Behavior Assessment and Intervention |
|
|
683 | (1) |
|
|
683 | (2) |
|
Chemotherapy Administration |
|
|
685 | (2) |
|
|
687 | (1) |
|
Special Dermatological Procedures |
|
|
688 | (1) |
|
Physical Medicine and Rehabilitation |
|
|
688 | (2) |
|
Medical Nutrition Therapy |
|
|
690 | (1) |
|
Osteopathic Manipulative Treatment (OMT) |
|
|
690 | (1) |
|
Chiropractic Manipulative Treatment (CMT) |
|
|
691 | (1) |
|
Non-Face-to-Face Nonphysician Services |
|
|
691 | (1) |
|
Special Services, Procedures, and Reports |
|
|
691 | (1) |
|
Other Services and Procedures |
|
|
692 | (1) |
|
Home Health Procedures/Services |
|
|
692 | (1) |
|
Medication Therapy Management Services |
|
|
692 | (1) |
|
|
693 | (4) |
|
|
|
Chapter 27 Inpatient Coding |
|
|
697 | (67) |
|
Differences Between Inpatient and Outpatient Coding |
|
|
698 | (1) |
|
Selection of Principal Diagnosis |
|
|
699 | (9) |
|
Reporting Additional Diagnoses |
|
|
708 | (3) |
|
Present on Admission (POA) |
|
|
711 | (1) |
|
Development of the ICD-10-PCS |
|
|
711 | (11) |
|
|
722 | (4) |
|
Appendix A Online Resources |
|
|
726 | (1) |
|
TruCode® 30 day access upon clicking (available at http://evolve.elsevier.com/trucode) |
|
|
|
TruCode® Instructions and Practice Exercises |
|
|
|
TruCode® Practice Exercises |
|
|
|
|
|
|
|
|
|
ICD-10-CM Official Guidelines for Coding and Reporting |
|
|
|
ICD-10-PCS Official Guidelines for Coding and Reporting |
|
|
|
1995 Guidelines for E/M Services |
|
|
|
1997 Documentation Guidelines for Evaluation and Management Services CPT, ICD-10-CM, ICD-10-PCS, and HCPCS Update Links Study Tips WebLinks |
|
|
|
Content Updates - Student |
|
|
|
Appendix B Exercise, Quick Check, and Toolbox Answers |
|
|
727 | (24) |
|
Appendix C Learning Objective and Glossary Review Answers |
|
|
751 | (6) |
|
|
757 | (7) |
Glossary |
|
764 | (15) |
Figure Credits |
|
779 | (4) |
Coder's Index |
|
783 | (9) |
Index |
|
792 | |