Medical Coding Basics-1
Medical Coding Basics
For learning medical coding three different manuals are used. They are
1. ICD
2. CPT
3. HCPCS
These manuals or books are updated every year with revised & new codes. The first manual ICD contains an extensive list of different codes given to different diseases. ICD stands for international classification of diseases. This manual consists of three sections or volumes in it. The volumes one & two are used for office visit coding & the volume III is used for hospital coding.
In the beginning of the manual there is guide to the 2009 ICD-9-CM updates which discusses about the new codes & deleted codes. After that from page number 1 up to page no 78 there is guidelines are provided regarding coding & reporting. From page no. 80 up to page no. 631 there is volume 2 alphabetical index appears first before the volume 1. The alphabetical index contains an extensive list of the names of different diseases & symptoms or signs. In this index with each name of disease or symptom or sign a number is assigned. With this number the coder has to search the exact code assigned for a particular condition in the volume 1. The volume one contains a tabular list arranged systematically for different diseases & conditions which affect body systems.
In short the alphabetical index of volume 2 guide us about the series in the table of volume 1 where we have to check the exact code of a disease or condition.
medical billing training online will focus on these in detail.
Anatomy of ICD-9 Code
Example 789.09 is ICD code for pain abdomen multiple sites.
Here,
789 the first three digits stand for the disease type or organ system affected.
0 the first digit after the decimal determines a sub classification of the main condition or disease state.
9 The second digit after the decimal in the code specifies the condition or diagnosis further. Pain in abdomen can be in different regions. The last digit specifies the exact region. In this case pain in multiple sites is coded by the last digit 9 which differentiate it from other codes.
Important Note:
Always try to code to the highest degree of specificity. Carry the numerical code to the 4th or 5th digit when necessary. Remember, there are only approximately 100 valid three digit codes; all other ICD-9 codes require additional digits four or five.
How to search a code for a disease in the ICD manual
Search first the name of the disease or sign or symptom in the alphabetical index of volume 2. Then look the number assign to it & then search that number in the tabular index of volume 1.
Example: 1
You want to search the code for typhoid fever.
Look for typhoid fever in the alphabetical index. It is given on the page number 253. The assigned code no. to typhoid fever is 002.0 in the alphabetical index.
Now search 002.0 in the tabular index for its precise code. The typhoid & paratyphoid fever are tabulated in the series 002 on Page no. 633 in volume one & the exact code for typhoid fever is 002.0
Example: 2
You want to search the code for night blindness.
Look for night blindness in the alphabetical index first. It is given on page no 133 & the assign code is 368.60. Search the code given to night blindness in the tabular index of volume 1. On the page no. 740 night blindness is listed in the category code of 365.6 series. In this series night blindness unspecified is given 368.60 as the exact code for it.
Note: While searching a condition in the alphabetical index of ICD manual always search for a condition associated with an anatomical site. Don’t search for the name of anatomical site.
Ex. If the word Chest pain is to be search, we should search for the word pain then in the word pain we should search chest. Similarly if we need to search pulmonary tuberculosis, then don’t search pulmonary because it is anatomical site i.e. lungs so search tuberculosis & in the list of various tuberculosis search for pulmonary.