What’s Your Idea of a Best Seller?
Every once in a while I page through a magazine taking keen interest in the best seller and “must read” book lists that everyone is talking about. I usually tear out the pages for books that are interesting so I can download them later. And then I rarely read them. Or it takes me literally months to finish a book. I love to read, but frankly, after a day of reading code books, and spending a lot of time writing, I just don’t have the eye or mental energy to crack a book for fun.
My idea of a best seller is a string of code books that I use every day. Don’t worry though, I find other ways to have fun that have nothing to do with coding!
The last time I moved, I had lots of friends helping me lug boxes and it didn’t take long for them to zone in on the heaviest ones: they were labeled “code books.” I have code books for various coding systems going back several years and yes, they are heavy. And it’s hard to explain to the layman why I need so many books in such an electronic age. I’ve found it can also be challenging to explain the different code sets to novice coders. But alas, I am going to give it a try in a series of blog posts because you may not be exposed to all coding systems in coding school, but depending on the setting you work in, you may find you have to become familiar with something new.
I Don’t Hate Encoders
Let’s get one thing out of the way first, though. I have no issues with computers or encoders. In fact, I use a computer for almost everything and, like so many people, I am pretty addicted to my iPhone and iPad. But as a coding trainer, I learned by the book and I teach by the book and will always default to the book when I have a question. Encoders are only useful when the user understands the logic behind the program and that logic is based on the book.
In healthcare, we deal with two major planets of coding systems: the International Classification of Diseases (ICD) and the Health Care Common Procedure Coding System (HCPCS). And as if that wasn’t enough, those coding systems are divided into further classifications with different uses. Coding for a physician practice? Then you’d better brush up on different parts of the coding spectrum than what you’d see in a hospital. Coding outpatient services for a hospital? Then you need to know something different than what you would need to know if you were coding hospital inpatient services. Want to know how to code everything? Then it’s time to become familiar with your new best seller list. This post will start with the basic coding system that everyone uses.
ICD-9-CM Volumes 1 and 2: Everyone Does it
You probably aren’t surprised to hear that the government determines which codes we use in the U.S. But you may be surprised to hear that the law that defines those coding systems is a little law called HIPAA. Yes, the same law that addresses privacy and security of medical information also tells us which codes we must use to report healthcare services. This is why some code books boldly state on the cover that they support HIPAA compliance. In order to make health information portable and comparable,the Healthcare Portability and Accountability Act of 1996 (HIPAA) makes sure we’re all speaking a common language, expressed in codes, before we exchange data electronically. The privacy and security provisions are simply byproducts of making sure health care data can be shared electronically.
ICD-9-CM has three volumes. The first two volumes include the diagnosis codes. This includes the tabular (Volume 1) and index (Volume 2). I’ll address volume 3 in part 2 of this series. Bottom line here: every HIPAA-covered entity, which includes hospitals and physicians (and excludes workers’ compensation and car insurers) utilizes ICD-9-CM codes to report diagnoses on a claim.
ICD-9-CM codes have 3-5 digits with a decimal point after the first three digits. All codes are numeric except for V codes, which start with a V and then have two numeric digits and may have up to two more digits after the decimal point; and E codes, which start with an E and have three numeric digits and may have an additional digit after a decimal point. E and V codes are actually “supplementary” codes that are not included in the main part of the ICD-9-CM volumes 1 and 2 code set.
Here are some examples of ICD-9-CM codes:
- 486, Pneumonia, organism unspecified
- 401.9, Essential hypertension, unspecified
- 250.00, Diabetes mellitus without mention of complication, Type II or unspecified type, not stated as uncontrolled
Examples of supplementary codes:
- V08, Asymptomatic HIV infection status
- V27.0, Outcome of delivery, single liveborn
- V76.51, Screening for malignant neoplasm of colon
- E961, Assault by corrosive or caustic substance, except poisoning
- E885.3, Fall from skis