ICD-10-CM
A grouping of similar diseases and procedures organized for easy, retrieval of related information.
What is ICD-10-CM?
Multiaxial
What is the term to describe the ability of a nomenclature to express the meaning of a concept across several axes?
Copyrighted and published by the AMA.
What is CPT?
Developed by the US Department of Health and Human Services to identify services typically reimbursed by Medicare and Medicaid that do not appear in CPT.
What is HCPCS (Healthcare Common Procedure Coding System?
This section was added to the CPT book in 1992.
What is the name of the section dedicated to evaluation and management (E/M) services?
Federal legislation enacted to provide continuing health coverage, control fraud and abuse in healthcare, reduce healthcare costs, and guarantee the security and privacy of health information.
What is HIPAA?
Identifies what procedure is being performed according to the objective of the procedure, the approach, device used, and so forth.
What is an ICD-10-PCS code?
Main sections are further broken down into subsections and subcategories according to the type of service provided and the body system or disorder involved.
What are Category I codes?
Plays a pivotal role in the accurate and complete collection of health services data.
What is "health record documentation"?
A wide variety of skills and the amount of effort, time, responsibility, and medical knowledge that physicians dedicate to the prevention, diagnosis, and treatment of illnesses and injuries as well as the promotion of optimal health.
What are the various levels that describe E/M codes?
Annually
How often are code books update?
The name of the company that was awarded a contract by CMS to develop a new procedure coding system.
What is 3M
Three types of supplementary codes.
What are Category II codes, Category III codes, and modifiers?
Five-digit Category 1 CPT codes.
What is Level 1 of HCPCS?
In 2021, the AMA revised the criteria for office and outpatient visits.
What are the two E/M level services?
"With" or "without"
What are the subterms listed at the beginning of all the subterms, rather than in alphabetical order?
Each code consists of seven characters based on the details of the procedure documented that specify the section, the body system, root operation, body part, approach, device, and qualifier.
What is a value?
Can be reported along with many of the Category 1 CPT Codes.
What is a modifier?
AKA National Codes
What are Level II HCPCS codes?
A patient who has not received any professional services from the physician or qualified healthcare professional within the past three years.
What is a "New" patient?
Nonessential Modifiers
What are the series of terms that appear in parentheses following a main term or subterm?
Letters not used in ICD-10-PCS.
What are the letters I and O?
CMS-1500 Claim Form
What is the standard paper billing document used for physician claims?
Begins with the Alphabetic Index.
What is the first step for finding HCPCS codes?
A patient who has received professional services from the physician or qualified healthcare professional within the past three years.
What is an "established patient"?