ICD-9-CM Procedure Codes. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates that Volume 3 of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) be used to code inpatient services on medical claims.
The majority of Volume 3 of ICD-9-CM is arranged by anatomical location. After the codes that start with 00, which cover procedures and interventions not classified elsewhere in Volume 3, the codes run in progression to describe procedures and interventions at different sites and through different constitutional systems.
CMS states that hospitals can use Volume 3 codes for internal tracking purposes, but the HIPAA standard is to use Healthcare Common Procedure Coding System (HCPCS) codes in every other setting when financial transactions take place with third-party payers. Not all procedures that are performed in a hospital are inpatient services.
ICD-9-CM codes are used in medical billing and coding to describe diseases, injuries, symptoms and conditions. ICD-9-CM 304.00 is one of thousands of ICD-9-CM codes used in healthcare. Although ICD-9-CM and CPT codes are largely numeric, they differ in that CPT codes describe medical procedures and services.
CMS states that hospitals can use Volume 3 codes for internal tracking purposes, but the HIPAA standard is to use Healthcare Common Procedure Coding System (HCPCS) codes in every other setting when financial transactions take place with third-party payers.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates that Volume 3 of the International Classification of Diseases, 9th Revision, Clinical Modification ( ICD-9-CM) be used to code inpatient services on medical claims.
Any services these patients receive are described by the use of HCPCS codes because they do are not in an inpatient treatment status. All procedure codes are attached to specific charges that a hospital has determined represents its reasonable cost to perform the service.
The codes begin with 00.01, to describe a therapeutic ultrasound of vessels in the head and neck, and they end with 99.99, which describes other miscellaneous procedures. ICD-9-CM indicates that leech therapy falls under 99.99. Being able to read and understand the code manual is an asset for hospitals to submit accurate claims for accurate reimbursement.
Medical billers and medical coders who do not use these code sets regularly have still been trained in their use. A solid, well-rounded education is what professional medical coders and billers bring to their jobs, applying a consistent philosophy to coding that governs every medical claim for payment.
The International Statistical Classification of Diseases and Related Health Problems (commonly known as the ICD) provides alpha-numeric codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. Nearly every health condition can be assigned ...
The handbook is authored by Nelly Leon-Chisen, RHIA , Director of Coding and Classification at the AHA.