What is a Medical or Non-Medical Code Set? A code set is
a shared list of codes that is used in place of longer names or explanations
. Using adopted code sets in standard transactions streamlines the administrative process by reducing time spent translating information into different formats.
What are standard code sets?
What is a code set? Under HIPAA, a “code set” is
any set of codes used for encoding data elements
, such as tables of terms, medical concepts, medical diagnosis codes, or medical procedure codes.
What are the standard code sets used by medical practices?
- ICD-10 – International Classification of Diseases, 10
th
edition. - Health Care Common Procedure Coding System (HCPCS)
- CPT-Current Procedure Terminology.
- CDT – Code on Dental Procedures and Nomenclature.
- NDC – National Drug Codes.
What are the three main types of medical coding?
- ICD. The first of these is the International Classification of Diseases, or ICD codes. …
- CPT. Current Procedure Terminology, or CPT, codes, are used to document the majority of the medical procedures performed in a physician’s office. …
- HCPCS.
What are medical code sets quizlet?
Code sets
used in a general business situation for
items, such as zip codes, rather than a medical condition or service. … Supplemental health information needed to support a particular health care claim.
What is a group number used to identify?
The group number in the periodic table represents
number of valence electrons of the elements
in a certain group.
What are HIPAA’s transaction and code sets?
The HIPAA transactions and code set standards are
rules to standardize the electronic exchange of patient-identifiable, health-related information
. They are based on electronic data interchange (EDI) standards, which allow the electronic exchange of information from computer to computer without human involvement.
What is the unique identifier rule?
Providers – NPI, or National Provider Identifier, is a
unique 10-digit number used to identify health care providers
. Health plans – There is no longer an adopted standard to identify health plans. Patients – There is no adopted standard to identify patients.
Why is it important to know the difference between code sets?
When the code set is part of a transaction you submit, such as the electronic claim, eligibility request or claim status, it is important that you
understand how the codes within the code set are used
, and you should also have a way of entering these codes into your practice management software.
What is the first listed diagnosis?
In today’s medical parlance,
Primary diagnosis
is now termed as first-listed diagnosis. Therapeutic services received only during an encounter/visit, the diagnosis should first be sequenced, followed by the condition. Problem or other reason should be assigned as secondary codes.
What is the most current code standard?
ICD
is the standard international system of classifying mortality and morbidity statistics, and it’s used by more than 100 countries. The system is used by health care facilities to define diseases and allocate resources to provide care.
What does Phi stand for?
PHI stands for
Protected Health Information
. The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information.
Are there ICD 10 procedure codes?
ICD-10-PCS will be the
official system of assigning codes to procedures associated with hospital utilization
in the United States. ICD-10-PCS codes will support data collection, payment and electronic health records. ICD-10-PCS is a medical classification coding system for procedural codes.
What are the types of medical coders?
- Certified Professional Coder (CPC)
- Certified Outpatient Coding (COC)
- Certified Inpatient Coder (CIC)
- Certified Coding Specialist (CCS)
- Certified Medical Coder (CMC)
What are two main coding systems?
In the U.S., there are two types of ICD-10 systems:
ICD-10-CM (Clinical Modification) is used for diagnosis
and ICD-10-PCS (Procedure Coding System) is used for inpatient hospital procedures.
How many types of medical coders are there?
Here are
three types
of codes that you will come across in medical coding. The most commonly known code is ICD codes or International Classification of Diseases code. The World Health Organization (WHO) established the ICD codes during the late 1940s.
