Official Instructional Notations in the ICD-10-CM Flashcards Preview

Medical Billing, Insurance, and Coding - Smith Fall 2020 > Official Instructional Notations in the ICD-10-CM > Flashcards

Flashcards in Official Instructional Notations in the ICD-10-CM Deck (29)
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1

NEC

not elsewhere classified

2

NOS

not otherwise specified

3

NEC or NOS?
Used in both the Alphabetic Index and Tabular List

NEC

4

code may not fully describe the disease process or medical condition

NEC

5

directs the coder to other classifications

NEC

6

used when ICD-10-CM does not have any codes that provide greater specificity

NEC

7

NEC or NOC?
Equivalent of "unspecified". Used when the information at hand does not permit a more specific code assignment

NOC

8

encloses synonyms, alternative wording, or explanatory phrases.

brackets

9

symbol found in the Tabular list

brackets

10

brackets in the Alphabetic Index identify...

manifestation

11

where are the brackets on the claim form

listed second

12

enclose supplementary words that may be present or absent in the statement of a disease or procedure without affecting code assignment

parenthesis

13

words that may be used to clarify the diagnosis but do not affect code assignment

nonessential modifiers

14

located in the Tabular list after an incomplete term that needs on or more of the modifiers that follow in order to make the condition assignable to a given category

colon

15

means and/or

and

16

with/in and indicates that two conditions are included in the code and both conditions must be present to report the code

with

17

appears under certain categories to further define or give examples of the content of a category. Located in the Tabular list

Includes

18

"NOT CODED HERE" and indicates that the code excluded should not be assigned at the same time as the code above the Excludes1 note

Excludes1

19

"Not included here" and indicates the condition excluded is not part of the condition it is excluded from and a patient may have both conditions at the same time

Excludes2

20

"Use additional code" is paired with the _______ code

etiology

21

"Code first" is paired with the _____ code

manifestation

22

the code title ____ _____ _____ _____ indicates that it is a manifestation code

"in diseases classified elsewhere"

23

never first-listed codes

"in diseases classified elsewhere"

24

codes that must be used in conjunction with an underlying condition code and must follow the underlying condition code.

"in diseases classified elsewhere"

25

note instructs that two codes may be required to fully describe a condition but the sequencing of the two codes is discretionary, depending on the circumstances for the encounter

"Code also"

26

what is assigned for codes that are less than 6 characters that require a 7th character;

a placeholder X

27

three types of cross-references

1. "see"
2. "see" also
3. "see" category

28

cross-reference "see"

1. cross-reference which is an explicit direction to look elsewhere
2. used for anatomic sites and many modifiers not normally used in the Alphabetic Index
3. used to reference the appropriate main term under which all the information concerning a specific disease will be located

29

cross-reference "see" also

directs the coder to reference another main term if all the information being searched for cannot be located under the first main term entry