You have been invited to be a guest speaker for nursing class that is learning a
ID: 346646 • Letter: Y
Question
You have been invited to be a guest speaker for nursing class that is learning about the importance of proper documentation. You have been asked to speak on different procedure coding systems and why the documentation of procedures is important.
Discuss the followings:
1. Historical information on ICD-9-CM
2. ICD-10-PCS
3. CPT
4. HCPCS
5. In which healthcare setting is each procedure coding system used
6. The different section/parts of each coding system (for example CPT has Category l, Category ll, and Category lll codes)
7. Who is responsible for development and maintenance of each system
8. What is included in each coding.
Explanation / Answer
1. Historical informaration on ICD-9-CM
ICD-9-CM means International Classification of Diseases, Ninth Revision, Clinical Modification is the adaptation of international ICD 9 standard list of 6 character alpha numeric code by the U.S health system which gives description of the diagnosis.Such code helps the doctors in recording patient's symptoms in standard format and could be useful in claiming the reimbursement and also for the research works.These standard codes are entered into patient's electronic health record and can be used for billing , diagnostics, etc.The information is classified and codified into the system which includes information about injury, symptoms ,causes of injury and mental disorder. ICD nine was officially ratified by World Health Organisation conference in the year 1975 .
2. ICD-10-PCS
ICD-10-PCS (The International Classification of Diseases , 10th Revision,Procedure Coding System) is a U.S calaloging sysytem which was released in 1990s is an advanced version of ICD- 9-CM .It tracks the various health interventions done by medical professionals. It replaced the previous version ICD 9 CM in 1993 as it is more data enriched.It has more codes which supports the current health information needs. It is developed by CMS ( Centres For Medicare & Medicaid Services with the help of 3M Health Managemet .
3. CPT
CPT (Current Procedural Terminology) , a medical code set, used in reporting the surgical, medical & diagnostic procedures and services . This reports are used by physicians,health insurance comapanies, and rating organizations. It is used in conjunction with ICD-9-CM or ICD-10-CM numerical diagnostic coding while processing the electronic medical bill.
CPT has 3 categories
1.Category 1
2.Category 2
3.Category 3.
Category 1 has further 6 sections they are ecoluation and management, anesthesiology, surgery,radiology pathology & laboratory & medicine.
Category 2 consist of medical code sets of the suplimentary tracking code that are used to measure the performamce and collect the information about the quality of service delivered.This code set has an optional use .
Category 3
It consist of temporary code list that includes emerging technology , services and procedures to carry out the operations.
4. HCPCS
It is an acronym for HEALTH COMMON PROCEDURE CODING SYSYTEM .It is a standardize code set which is used by the physicians and health insurance comapanies to ease the procedure of passing claims.There are two types
1.The Level I HCPCS code set
2.The Level I HCPCS code set
The level I includes CPT which is developed and owned by the American Medical Association (AMA).The level II is quite advanced version code set which has 5 character alpha numeric codes representing medical supplies, durable medical goods, prosthetics, orthotics and supplies ,etc.
Answers to question 5 , 6, 7 & 8 is already explained in above given information .
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