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Medical Coding and Billing ICD 10

Course Description

1 Hrs 8 Min

26 Videos

Description

ICD-10-CM is a clinical modification of the World Health Organization’s ICD-10, which consists of a diagnostics classification system. ICD-10-CM includes the level of detail needed for morbidity classification and diagnostics specificity in the United States. It also provides code titles and language that compliment accepted clinical practice in the US. The system consists of more than 68,000 diagnosis codes. This course provides the training necessary for medical administrative professionals to comply with the updated standards. The transition to ICD-10 is necessary for many reasons. Payors cannot pay claims fairly using ICD-9-CM since the classification system does not accurately reflect current technology and medical treatment.
Significantly different procedures are assigned to a single ICD-9-CM procedure code. Limitations in the coding system translate directly into limitations in the diagnosis-related groups (DRG). The healthcare industry cannot accurately measure the quality of care using ICD-9-CM. It is difficult to evaluate the outcome of new procedures and emerging health care conditions when there are not precise codes. Most importantly, we have a mission to improve our ability to measure health care services provided to our patients, enhance clinical decision-making, track public health issues, conduct medical research, identify fraud and abuse and design our payment systems to ensure services are appropriately paid.

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Course Syllabus

Course Outline

  1. Module 1: Certain Infectious and Parasitic Diseases
  2. Module 2: Neoplasm
  3. Module 3: Diseases of the Blood and Blood Forming Organs
  4. Module 4: Endocrine, Nutritional and Metabolic Diseases
  5. Module 5: Mental Disorders
  6. Module 6: Diseases of the Nervous System
  7. Module 7: Diseases of the Eye and Adnexa
  8. Module 8: Diseases of the Ear and Mastoid Process
  9. Module 9: Diseases of the Circulatory System
  10. Module 10: Diseases of the Respiratory System
  11. Module 11: Diseases of the Digestive System
  12. Module 12: Diseases of the Skin and Subcutaneous Tissue
  13. Module 13: Diseases of the Musculoskeletal System and Connective Tissue
  14. Module 14: Diseases of the Genitourinary System
  15. Module 15: Pregnancy, Childbirth, and the Puerperium
  16. Module 16: Newborn (Perinatal) Guidelines
  17. Module 17: Congenital Malformations, Deformations and Chromosomal Abnormalities
  18. Module 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings
  19. Module 19: Injury, Poisoning and Certain Other Consequences of the External Causes
  20. Module 20: External Causes of Morbidity
  21. Module 21: Factors Influencing Health Status

The ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) is a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care in the United States. It provides a level of detail that is necessary for diagnostic specificity and morbidity classification in the U.S.

Like its predecessor ICD-9-CM, ICD-10-CM is based on the International Classification of Diseases, which is published by the World Health Organization (WHO) and which uses unique alphanumeric codes to identify known diseases and other health problems. According to WHO, physicians, coders, health information managers, nurses and other healthcare professionals also use ICD-10-CM to assist them in the storage and retrieval of diagnostic information. ICD records are also used in the compilation of national mortality and morbidity statistics.

ICD-10-CM is a seven-character, alphanumeric code. Each code begins with a letter, and that letter is followed by two numbers. The first three characters of ICD-10-CM are the “category.” The category describes the general type of the injury or disease. The category is followed by a decimal point and the subcategory. This is followed by up to two sub-classifications, which further explain the cause, manifestation, location, severity, and type of injury or disease. The last character is the extension.

The extension describes the type of encounter this is. That is, if this is the first time a healthcare provider has seen the patient for this condition/injury/disease, it’s listed as the “initial encounter.” Every encounter after the first is listed as a “subsequent encounter.” Patient visits related to the effects of a previous injury or disease are listed with the term “sequela.”

Medical coders keep patient records accurate for both healthcare providers and insurance companies. To do so, they rely on the World Health Organization’s International Classification for Diseases (ICD), a system that classifies and codes all diagnoses, symptoms and procedures. The previous industry standard – the ICD-9 code sets – has recently been updated with a more detailed version, the ICD-10.

While the complexities of the new system may seem daunting, medical coders should see their efforts to understand how to use it pay off with increased efficiency and better health outcomes. HHS requires everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) report ICD-10 codes for diagnoses and inpatient hospital procedures. HIPAA requires providers and health plans use standard content, formats, and coding for health care transactions.

Find code sets in the Resources section. ICD-10-CM diagnosis codes provide the reason for seeking health care; ICD-10-PCS procedure codes tell what inpatient treatment and services the patient got; CPT (HCPCS Level I) codes describe outpatient services and procedures; and providers generally use HCPCS (Level II) codes for equipment, drugs, and supplies for services and treatment.

Who this course is for:

  1. Medical coders who are preparing for the transition from ICD-9 CM to ICD-10 CM
  2. Beginners who want to learn how to code medical diagnoses
  3. People who want to break into the field of medical coding
  4. Job seekers interested in a career in medical coding
  5. Anyone interested in medical coding
  6. Anyone who wants to better understand their own health records or medical condition

What you’ll learn:

  1. Learn what ICD-10-CM medical diagnosis codes are, and how to assign them
  2. Determine appropriate code sequencing in ICD-10 CM
  3. Articulate coding principles and conventions in ICD-10 CM
  4. Identify the appropriate ICD-10 code to assign for any given condition

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