ICD-10 Format and Terminology (Pg. 53-54)

Renumbered CPT Codes Citations Crosswalk

• Appendix M in CPT contains the renumbered codes citations crosswalk.
• This section details the relationship between deleted codes and their replacements.
• Helps coders track changes and understand updated CPT codes.

International Classification of Diseases (ICD-10)

• ICD-10 has conventions that serve as visual guidance for coding.
• Uses a placeholder "x" for characters when a preceding digit space is empty.
• ICD-10 contains three volumes:
  • Volume 1: Tabular list
  • Volume 2: Instruction module
  • Volume 3: Alphabetical list

Main Terms, Sub Terms, and Nonessential Modifiers

• Main terms are in bold and are followed by default codes.
• Sub terms detail associated conditions and their etiologies.
• Nonessential modifiers, shown in parentheses, are supplementary information.

Common Necessary Terms in Coding

• Eponym: Disease named after a person (e.g., Hodgkin’s disease).
• NEC: Not Elsewhere Classifiable, used when no specific code exists.
• NOS: Not Otherwise Specified, applies when descriptions are incomplete.
• Code Also: Instruction notes indicating a second code may be required.

Categorization

• Category: Three-character alphanumeric code for a single disease or condition.
• Subcategory: Four or five-character alphanumeric subdivision of a category.

Inclusion and Exclusion Notes

• Inclusion Notes: Headed by "includes" to refine the category's content.
• Exclusion Notes:
  • Excludes 1: Indicates conditions that cannot coexist.
  • Excludes 2: Signifies that the listed condition does not include others potentially present.

Punctuation in ICD-10

• Brackets { }: Enclose synonyms or alternative phrasing; identify manifestation codes.
• Parentheses ( ): Used for nonessential modifiers in both index and list.
• Colons (:): Indicate incomplete terms needing modifiers in the Tabular List.

Sequelae

• Refers to conditions remaining after a patient's acute illness or injury.
• Example: Deviated septum due to a previous nasal fracture.

Providers and Payment Structure

• Providers include physicians, hospitals, and suppliers for Medicare patients.
• Beneficiary pays are comprised of deductibles, premiums, and co-insurance (20%).
• Medicare covers 80% of covered services.

Renumbered CPT Codes Citations Crosswalk

• Appendix M in CPT contains the renumbered codes citations crosswalk.
• This section details the relationship between deleted codes and their replacements.
• Helps coders track changes and understand updated CPT codes.

International Classification of Diseases (ICD-10)

• ICD-10 has conventions that serve as visual guidance for coding.
• Uses a placeholder "x" for characters when a preceding digit space is empty.
• ICD-10 contains three volumes:
  • Volume 1: Tabular list
  • Volume 2: Instruction module
  • Volume 3: Alphabetical list

Main Terms, Sub Terms, and Nonessential Modifiers

• Main terms are in bold and are followed by default codes.
• Sub terms detail associated conditions and their etiologies.
• Nonessential modifiers, shown in parentheses, are supplementary information.

Common Necessary Terms in Coding

• Eponym: Disease named after a person (e.g., Hodgkin’s disease).
• NEC: Not Elsewhere Classifiable, used when no specific code exists.
• NOS: Not Otherwise Specified, applies when descriptions are incomplete.
• Code Also: Instruction notes indicating a second code may be required.

Categorization

• Category: Three-character alphanumeric code for a single disease or condition.
• Subcategory: Four or five-character alphanumeric subdivision of a category.

Inclusion and Exclusion Notes

• Inclusion Notes: Headed by "includes" to refine the category's content.
• Exclusion Notes:
  • Excludes 1: Indicates conditions that cannot coexist.
  • Excludes 2: Signifies that the listed condition does not include others potentially present.

Punctuation in ICD-10

• Brackets { }: Enclose synonyms or alternative phrasing; identify manifestation codes.
• Parentheses ( ): Used for nonessential modifiers in both index and list.
• Colons (:): Indicate incomplete terms needing modifiers in the Tabular List.

Sequelae

• Refers to conditions remaining after a patient's acute illness or injury.
• Example: Deviated septum due to a previous nasal fracture.

Providers and Payment Structure

• Providers include physicians, hospitals, and suppliers for Medicare patients.
• Beneficiary pays are comprised of deductibles, premiums, and co-insurance (20%).
• Medicare covers 80% of covered services.

ICD-10 Coding System

• Three-character alphanumeric codes represent individual diseases or related conditions.
• Exclusion notes are indicated by the word “excludes” to clarify non-classifiable conditions:
  • Excludes 1 signifies that two conditions cannot coexist.
  • Excludes 2 denotes that the condition is not included in the previous code, but both conditions may be present together.

Sequelae and Late Effects

• Sequelae refer to conditions persisting after an acute illness or injury, also known as residual or late effects.
• Late effects may be documented as resulting from a previous condition, e.g., "due to an old nasal fracture."

Providers and Beneficiary Costs

• Providers include physicians, hospitals, and suppliers that deliver care or supplies to Medicare patients.
• Beneficiary costs include deductibles, premiums, co-insurance (20%), and non-covered services.
• Medicare covers 80% of expenses for covered services.

Structure of ICD-10

• ICD-10 comprises three volumes:
  • Volume 1 contains a tabular list of codes.
  • Volume 2 provides an instruction module for coding practices.
  • Volume 3 contains an alphabetical index for codes.

Coding Conventions

• ICD-10-CM employs typographic conventions as visual cues to assist coders in selecting accurate codes.

Explore the intricacies of the renumbered CPT codes citations crosswalk as outlined in Appendix M of the Current Procedure Terminology (CPT). This quiz examines the connections between deleted and new codes, and the conventions laid out for ICD-10 format. Test your understanding of these coding systems and their updates!