The International Classification of Diseases, Clinical Modification (ICD-9-CM), is used in assigning codes to diagnoses associated with inpatient, outpatient, and physician office utilization in the U.S. Volume 1: The numeric listing of diseases, classified by etiology and anatomical system, as well as a classification of other reasons for encounters and causes of injury. This is called the tabular section of ICD-9-CM. Volume 1 is used by all health care providers and facilities. Volume 2: The alphabetic index used to locate the codes in Volume 1. Volume 2 is used by all health care providers and facilities Volume 3: A procedural classification with a tabular section and an index. This set of procedure codes is used only by hospitals to report services. Category I: Procedures that are consistent with contemporary medical practice and are widely performed.
Category II: Supplementary tracking codes that can be used for performance measures. Category III: Temporary codes for emerging technology, services and procedures. It is important to become familiar with each category and how the codes will be used. It is also important to know when codes from another system, such as HCPCS Level II, are required. Category I codes are the five-digit numeric codes included in the main body of CPT. Category I is the section that coders usually identify with when talking about CPT. These codes represent procedures that are consistent with contemporary medical practice and are widely performed. Category I codes are updated annually and are broken down into six sections. 1. Evaluation and Management
5. Pathology and Laboratory
Evaluation and management codes are the most commonly billed codes in medicine. These are the codes for every office visit/encounter a physician
has with a patient.
V codes are used to describe encounters with circumstances other than disease or injury. V codes are used either as a first listed or contributing code depending on the situation. E codes are supplemental codes that capture the external cause of injury or poisoning, the intent and the place where the event occurred. E codes are intended to provide data for injury research and prevention strategies. E codes are never to be used as a primary diagnosis code.
The HCPCS level II is a comprehensive and standardized coding system that describes classifications of like products that are medical in nature by category for the purpose of efficient claims processing. For each HCPCS code, there is a descriptive terminology that identifies a category of like items. These codes are used primarily for billing purposes. Level I, are based on and identical to CPT codes, the codes developed by the American Medical Association.
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