1. Slide 1 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. CHAPTER 8 AN OVERVIEW OF ICD-9-CM

2. Slide 2 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. An Overview of the ICD-9-CM Classification System –_______ (illness) –_______ (death) ICD = International Classification of Diseases WHO’s ICD-9 used globally –World Health Organization ICD-9-CM = 9th Revision; CM, ________________ –Continuity of data (Cont’d…) Morbidity Mortality Clinical Modification

3. Slide 3 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Overview (…Cont’d) 1977: US develops ICD-9-CM version More code subsets define medical care ICD-9-CM data comparable to global data in _____ Updated ________ of each year Must use new codes as of October 1 Also updates _____ with no grace period ICD-9 October 1 April 1

4. Slide 4 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Medicare Medicare Catastrophic Act of ____ –Required use of ICD-9-CM codes for diagnosis Act later repealed, but codes still used Effective 2003, all claims must have valid diagnosis –Excludes ambulance suppliers 1988

5. Slide 5 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Uses of ICD-9-CM Facilities track facility ___ through codes Fiscal entities track health care ____ use costs (Cont’d…)

6. Slide 6 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Uses of ICD-9-CM (…Cont’d) Research –Health care quality –Future needs Newer cancer center built if patient use warrants (…Cont’d)

7. Slide 7 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Uses of ICD-9-CM Use and results evident every day –Newscaster reference to number of AIDS cases –Newspaper article about measles epidemic

8. Slide 8 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. ICD-9-CM Principles/Practices Four groups function together to maintain ICD-9-CM Centers for Medicare and Medicaid Services (CMS), formerly known as Health Care Financing Administration (HCFA) (Cont’d...)

9. Slide 9 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. ICD-9-CM Principles/Practices (...Cont’d) National Center for Health Statistics (NCHS) American Health Information Management Association (AHIMA) American Hospital Association (AHA)

10. Slide 10 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. ICD-9-CM Documents Medical Necessity Diagnoses establish medical necessity Services and diagnoses must correlate Correct diagnosis codes allow: –Accurate reimbursement –Fewer rejected claims –Reduced risk of sanctions/fines from audit

11. Slide 11 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Sample EHR Screen, Charge Capture

12. Slide 12 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. CMS-1500 Health Insurance Claim Form Figure: 8.2 (Courtesy U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services)

13. Slide 13 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Ethics Documentation must support diagnosis Example: –Services provided –Diagnosis justifies services If in doubt, check it out; don’t make assumptions

14. Slide 14 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Your Job Translate documentation into ICD-9-CM codes –Legionnaires’ disease = 482.84 Assign code to highest level specificity Medical record must substantiate diagnosis code assignment

15. Slide 15 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Format of the ICD-9-CM Volume _, Diseases, Tabular List (diagnosis) (17 chapters) Volume _, Diseases, Alphabetic Index to Diseases and Injuries (diagnosis) (3 sections) Volume 3, Procedures, Tabular List and Alphabetic Index (inpatient procedures) 1 2

16. Slide 16 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 1, Diseases, Tabular List Contains code numbers 001.0-999.9 Diagnosis codes describe condition V and E codes = ___________ information supplemental (Cont’d…)

17. Slide 17 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 1, Diseases, Tabular List (...Cont’d) Divided into: Chapter –______ _______ –__________ »_____________ Section Category Subcategory Subclassification

18. Slide 18 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Diseases, Alphabetic Index Appears first in book (may vary with publishers) Terms and code numbers verified in Volume 1 Never code directly from Index! Read all notes and follow instructions (e.g., see also) Tables (e.g., Drugs/Chemicals, Hypertension, Neoplasm)

19. Slide 19 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Procedures, Tabular List and Alphabetic Index Not used for physician services Index and Tabular List for code assignment of procedures and therapies _______ settings only Maximum 4 ____ –20.41 Simple mastoidectomy Inpatient digits

20. Slide 20 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 1, Tabular List Two major divisions –Classification of Diseases and Injuries (codes 001.0-_____) –Supplementary Classification (_ codes and _ codes) 999.9 V E

21. Slide 21 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. V Codes (V01.0-V91.9) Patient not __ but encounters health services –e.g., Vaccination Patient presents for treatment –e.g., Chemotherapy Some V codes are primary only (e.g., V58.11, encounter for chemotherapy) ill (Cont’d…)

22. Slide 22 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. V Codes (V01.0-V91.9) (…Cont’d) Factors that influence patient’s health status –e.g., _______________ [PHO] malignant tumor, organ transplant –Birth status and outcome of delivery Personal history of

23. Slide 23 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Classification of Diseases and Injuries Main portion of ICD-9-CM Codes from 001.0-999.9 Most chapters are organ systems –Digestive System –Respiratory System

24. Slide 24 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Divisions of Classification of Diseases and Injuries Chapters: 1 through __ Section: A group of related conditions 17

25. Slide 25 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 1, Diseases, Format Figure: 8.4 Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

26. Slide 26 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Category Code ________ : Represent single disease/condition (3 digits) Figure: 8.5 Category Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

27. Slide 27 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Subcategory Code __________: More specific (4th digit) Figure: 8.6 Subcategory Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

28. Slide 28 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Subclassification Code _____________ : More specific (5th digit) Subclassification Referenced from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

29. Slide 29 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Specificity in ICD-9-CM Codes Each digit adds to the ________ (detail) Figure: 8.8 specificity

30. Slide 30 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Remember Assign to the highest level possible, based on documentation If 4-digit code exists, do not report _-digit code If _-digit code exists, do not report 4-digit code 3 5

31. Slide 31 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Appendices in Volume 1 There are five appendices in official ICD-9-CM Private publishers may have more

32. Slide 32 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Appendix A, _________ of Neoplasms Used in conjunction with codes from Chapter 2, –Inpatient setting: Cancer registries and claim forms –M codes not placed on a billing claim form Morphology Neoplasm (Cont’d…)

33. Slide 33 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Appendix A, Morphology of Neoplasms (…Cont’d) Begins with __ followed by 5 digits –M8400/0, Sweat gland adenoma First four digits: ________ type of neoplasm Fifth digit: _______ (e.g., 0 = benign) M Histologic Behavior

34. Slide 34 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Appendix B, Glossary of Mental Disorders Deleted in 2004 Most psychiatric disorders are classified using: –The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)

35. Slide 35 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Appendix C, Drugs ______________________________ (AHFS) publishes list of all drugs Tracks drugs nationally; used by __________ Each drug coded with up to __-digit code (e.g., 84:04.04) American Hospital Formulary Service pharmacists six (Cont’d…)

36. Slide 36 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Appendix C, Drugs (…Cont’d) AHFS listing correlated to ICD-9-CM Table of _________________ New drugs not identified by name –Rather listed under heading “____” in Table of Drugs and Chemicals –Example: 84:04.04 antibiotics Drugs and Chemicals Drug

37. Slide 37 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Appendix D, Industrial Accidents Three-digit codes that identify __________ hazards Not placed on insurance or billing form Used by state and federal organizations (_____) Occupational Safety and Health Administration to summarize industrial accident data occupational OSHA

38. Slide 38 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Appendix E, Three-Digit Categories Presented by chapter Categories are labeled 1 through 17, followed by V and E code categories Provides quick overview of ICD-9-CM contents

39. Slide 39 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Sections Section _, Index to Diseases Section _, Table of Drugs and Chemicals Section _, Index to External Causes of Injuries and Poisonings (E Codes) –Never primary diagnosis –Medicare does not accept for professional billing 1 2 3

40. Slide 40 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Section 1, Index to Diseases Largest part of Volume 2—Index First step in coding, locate ____ bold term in the Index ________ indented 2 spaces to the right May have more than one subterm 3 digits = category codes 4 digits = subcategory codes 5 digits = subclassification codes main Subterms

41. Slide 41 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. A Word of Caution About the Alphabetic Index (Section I, Vol. 2) Some words in Index do not appear in Tabular—saves space Exact word may not be in code Tabular description –But found in Alphabetic Index –That is why you must locate term in Index and then locate Tabular (follow where Index directs)

42. Slide 42 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Section 2, Table of Drugs and Chemicals Drug name placed ___________ on left under heading “Substance” alphabetically Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders. (Cont’d…)

43. Slide 43 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Table of Drugs and Chemicals (…Cont’d) First column: “Poisoning” code for substance involved, wrong substance given or taken First-listed before manifestation condition (Cont’d…) Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

44. Slide 44 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Table of Drugs and Chemicals (…Cont’d) E codes identify how poisoning occurred –Example: If analgesics poisoning occurred by accident, E850.9 Correct order poisoning –3 codes required: Identify agent analgesic 965.9 Condition—coma 780.01 Accidental poison E850.9 Correct order adverse effect –2 codes required: Condition—coma 780.01 Therapeutic E935.9

45. Slide 45 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Table of Drugs and Chemicals: Headings _______: Unintentional _________ : Correct dosage, correctly administered, with adverse effects (example, allergic reaction) _____________ : (must be documented) : Intentionally inflicted by another person ____________ : Unknown intent Accident Therapeutic Suicide attempt Assault Undetermined

46. Slide 46 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. E Codes (E000-E999) Supplementary Classification of External Causes of Injury and Poisoning Alpha-numerical designations for injuries and poisonings (Cont’d…)

47. Slide 47 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. E Codes (E000-E999) (…Cont’d) Provides additional information about external causes Never a principal (_______) diagnosis Separate E code index –Locate the E Code index in your ICD-9-CM now inpatient

48. Slide 48 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Section 3, E Codes Alphabetic Index to External Causes of Injuries and _________ Provide ________ information about the nature of injury/poisoning and locality Never a _______ (inpatient) or ________ (outpatient) diagnosis Poisonings additional principal first-listed (Cont’d…)

49. Slide 49 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Section 3, E Codes (…Cont’d) Separate Index to External Causes Alphabetical, main terms in ____ Subterms are _______ two to right under main term Some words in Index not in Tabular—saves space That is why you must locate the term in the Index, then locate in Tabular bold indented

50. Slide 50 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Index to External Causes: Example Main terms are ____ of accident (Collision) Subterms are ____________ of the accident (motor vehicle) circumstances type Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

51. Slide 51 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Neoplasm In Volume 2, _____, locate Neoplasm Table under the alphabetic entry “N” Do not reference Neoplasm table when diagnostic statement states “mass” Index From Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

52. Slide 52 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Terms Main terms (bold typeface) –Subterms –Indented two spaces to right –Not bold Example Pain (Main term in bold) orbital region 379.91 (subterm indented)

53. Slide 53 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Alphabetic Index Nonessential modifiers enclosed in ___________ (does not have to be in diagnostic statement) _______ effect on code selection Clarify diagnosis –Example: Ileus (adynamic) (bowel)…. parentheses Have no

54. Slide 54 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. ICD-9-CM Conventions Punctuation: [ ] ( ) : } italicized and bold type [ ] Symbols: §  Abbreviations: NEC, NOS Notations: Includes, Excludes, Use Additional Code, And/With, Code if Applicable

55. Slide 55 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Abbreviations NEC: Not elsewhere _________ –No more specific code exists NOS: Not otherwise _______ –Unspecified in documentation classifiable specified

56. Slide 56 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. [ ] Brackets Enclose synonyms, alternative wording, or explanatory phrases Used to identify manifestation codes Helpful, additional information Can affect code Found only in __________ (001.0-999.9) Tabular List

57. Slide 57 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Etiology and Manifestation of Disease ______ = cause of disease ___________= symptom Etiology + Manifestation = __________ codes Etiology Manifestation Combination

58. Slide 58 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Combination Code Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

59. Slide 59 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Slanted Brackets [ ] Enclose ____________ of underlying condition –“Code first underlying disease” Used in the Alphabetic Index-Volume 2 manifestations

60. Slide 60 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Multiple Coding No combination code, use ________ code(s) in this order –250.4x –581.81 individual Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

61. Slide 61 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. ( ) Parentheses Contain non-essential _______ –Take them or leave them –Informational descriptive terms Found in Tabular List and Index Does not affect code selection modifiers

62. Slide 62 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Colon and Brace : Colon: In Tabular List, ________ a statement with one or more modifiers } Brace: In Tabular List, _______ statements to the right of the brace completes modifies

63. Slide 63 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Italicized and Bold Type Italicized –All _______ notes –Codes not used as principal diagnosis Bold –Codes and code titles in _________, Volume 1 Excludes Tabular List

64. Slide 64 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Lozenge and Section Mark  Lozenge: Indicates codes ______ to ICD-9-CM § Section: Can be _______ indicator unique footnote

65. Slide 65 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Includes, Excludes, and Use Additional Code Includes notes: In chapter, section, or category ________ notes: Conditions are coded elsewhere Use Additional Code: Assignment of other code(s) is necessary Excludes

66. Slide 66 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. And/With ____ : Means and/or –Example: 237.0, Neoplasm of uncertain behavior of pituitary gland and/or craniopharyngeal duct ____ : Means one condition with (in addition to) another condition –Example: 070.41, acute hepatitis C with hepatic coma And With

67. Slide 67 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Cross References Directs you: see, _______, see category “see” directs you to specific term –Example: Panotitis—“see” __________ “see also” directs you to another term for more information –Example: Perivaginitis (see also _______ ) see also Otitis media Vaginitis (Cont’d…)

68. Slide 68 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Cross References (…Cont’d) “see category” Volume 1, Tabular List, specific information about use of code –Example: Mesencephalitis (see also __________) 323.9; late effect—see category 326 Encephalitis

69. Slide 69 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Code, If Applicable, Any Causal Condition First May be ______ diagnosis if no causal condition applicable or known or documented Instructional note in Tabular List primary (Cont’d…)

70. Slide 70 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Code, If Applicable, Any Causal Condition First (…Cont’d) Example: 707.10, Ulcer of _____ limb, except decubitus; states: –Chronic venous hypertension with ulcer (459.31) If ulcer caused by chronic venous hypertension: –First: 459.31 chronic venous hypertension –Second: 707.10 ulcer of lower limb lower

71. Slide 71 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Notes Define terms Give further coding instructions –Example: Index: “Melanoma,” Note: “Except where otherwise indicated….” (Cont’d…)

72. Slide 72 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Notes Mandatory fifth digits also appear as notes (one reason to never code from Index) (…Cont’d) Figure: 8.12 From Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

73. Slide 73 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 2, Eponyms Disease or syndrome named for ______ –Example: Arnold-Chiari (see also __________ ) Sturge-Weber Prader-Willi person Spina bifida

74. Slide 74 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Procedures 90% of codes refer to surgical procedures (Cont’d…) Figure: 8.13 Volume 3, Surgical procedures. (Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.)

75. Slide 75 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Procedures 10% refer to diagnostic and therapeutic procedures (Cont’d…) (…Cont’d) Figure: 8.14 Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

76. Slide 76 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Procedures (…Cont’d) Procedures performed in a physician’s office or outpatient ASC are reported with CPT codes –Surgeon uses CPT to report services to inpatients Volume 3, Procedure codes are used by hospitals to code facility services provided to inpatients

77. Slide 77 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Chapter 0 –Procedures and ____________, Not Elsewhere Classified Chapters 1-15 –Operations on organ systems Chapter __ –Miscellaneous Diagnostic and Therapeutic Procedures –Most nonsurgical codes Interventions 16 Volume 3, Table of Contents (Cont’d…)

78. Slide 78 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Table of Contents (…Cont’d) Figure: 8.15 Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

79. Slide 79 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Tabular List Conventions in Volume 3 are the same as those in Volumes 1 and 2 “Code also...” Volume 3 –Additional information about coding various components or special adjunctive services or procedures –“…any synchronous” means occurring at the same time

80. Slide 80 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Alphabetic Index Contains terms that do not appear in Volume 3 Tabular List –Example: In Index, the entry Gastrostomy, subterm Janeway, directs you to _____ –Janeway not mentioned in Tabular List at code 43.19 43.19 (Cont’d…)

81. Slide 81 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Alphabetic Index (…Cont’d) Terms in ____ Subterms not in bold Never code directly from Index Index example follows Includes non-essential modifiers, as in Volume 1 bold

82. Slide 82 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Example Figure: 8.16 Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

83. Slide 83 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Alphabetic Index Index alphabetical Ignores single spaces and hyphens –Example: Opening and open reduction –“Opening” appears before “open reduction” because space between two words ignored –Opening –Openreduction (Cont’d…)

84. Slide 84 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Alphabetic Index (…Cont’d) Often necessary and permissible to report individual components of procedure –Example: During a procedure, a portion of intestine was removed and reconstruction of urinary bladder was performed Both ____________ (57.87) and ________ (45.51) are reported reconstruction resection (Cont’d…)

85. Slide 85 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Alphabetic Index (…Cont’d) Cross references of see, see also, and see category appear as they did in Volume 1 Many operations named for surgeon who developed procedure (_______) –These procedures located under person’s name or name of operation eponyms

86. Slide 86 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Tabular List Format same as Volume 1, Tabular List of Diseases, except Volume 3 codes have ___ digits before decimal two (Cont’d…)

87. Slide 87 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Volume 3, Tabular List (…Cont’d) Category, subcategory, and subclassification Figure: 8.17 Modified from Buck CJ: 2014 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition, St. Louis, 2014, Saunders.

88. Slide 88 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Bundling _______ and closing of surgical site included in all surgical procedures –Do not unbundle and code separately –If closure takes place during separate surgical procedure, closure may be _______ separately The Index also contains “omit code” that directs the service not be reported –Example: Craniotomy 01.24; as operative approach– omit code Opening reported

89. Slide 89 Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Conclusion CHAPTER 8 AN OVERVIEW OF ICD-9-CM