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Basic Coding for Oral and Maxillofacial Surgeons

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Basic Coding for Oral and Maxillofacial Surgeons Basic Coding for Oral and Maxillofacial Surgeons Online Course 2015 About the Speaker Dawn W. Jackson, DrPH, RHIA, CCS-P, FAHIMA Ms. Jackson is a Professor and the Program Director for the Health Services Administration program at Eastern Kentucky University. She obtained her bachelor’s degree from East Carolina University (Greenville, NC) in Health Information Management, her master’s degree from Eastern Kentucky University (Richmond, KY) in Allied Health Education, and her doctor of public health degree in Health Services Management from the University of Kentucky (Lexington, KY). Her areas of expertise include: healthcare reimbursement systems, coding and billing processes, medical law, and health care management. As a certified coding specialist, Ms. Jackson has trained physicians and their staff for over 20 years. Of particular significance, she has been presenting coding courses for the American Association of Oral and Maxillofacial Surgeons for over 18 years. Coding and billing decisions are personal choices to be made by individual oral and maxillofacial surgeons exercising their own professional judgment in each situation. The information provided to you in this course is intended for educational purposes only. In no event shall AAOMS be liable for any decision made or action taken or not taken by you or anyone else in reliance on the information contained in this course. For practice, financial, accounting, legal or other professional advice, you need to consult your own professional advisors. able of Contents T Background Information of ICD-9-CM ......................................................................................1 What is Coding? ...................................................................................................................1 History of ICD-9-CM ..........................................................................................................2 Purposes of ICD-9-CM ........................................................................................................4 Cooperating Parties ..............................................................................................................4 Updating ICD-9-CM ............................................................................................................5 Format and Structure of ICD-9-CM ............................................................................................7 Format ..................................................................................................................................7 Volume I - Tabular List Structure ...................................................................................................................7 Valid Codes ..............................................................................................................8 7th Characters ...........................................................................................................9 Placeholders .............................................................................................................9 Volume II – Alphabetic Index Structure .................................................................................................................11 Default Codes.........................................................................................................12 Additional Major Portions Table of Neoplasms ...................................................................................12 Table of Drugs and Chemicals ...................................................................12 Alphabetic Index to E Codes .....................................................................13 Five Easy Steps to Locating ICD-9-CM Codes .................................................................13 ICD-9-CM Conventions...............................................................................................................17 Nonessential Modifiers ......................................................................................................17 Abbreviations .....................................................................................................................17 Punctuation Marks .............................................................................................................18 Use of Terms “With” and “And” .......................................................................................18 Cross References ................................................................................................................19 Instructions Found in the Tabular List ...............................................................................20 Principles of ICD-9-CM ..............................................................................................................25 Signs and Symptoms ..........................................................................................................25 Suspected Conditions .........................................................................................................25 Acute and Chronic Conditions ...........................................................................................26 Nonspecific Conditions ......................................................................................................26 Laterality ............................................................................................................................27 Background of CDT .....................................................................................................................29 Overview History of CDT ......................................................................................................29 Code Maintenance Committee ...............................................................................29 Survey of CDT .......................................................................................................30 Updating CDT ........................................................................................................31 SNODENT .............................................................................................................31 Structure and Use of CDT Code on Dental Procedures and Nomenclature .....................................................31 Alphabetic Index ....................................................................................................32 Finding CDT Codes ...............................................................................................32 Understanding HCPCS ...............................................................................................................35 Organization .......................................................................................................................35 Guidelines for Proper Use of HCPCS ...............................................................................36 Background Information of CPT ...............................................................................................39 History of CPT ...................................................................................................................39 Purposes of CPT ................................................................................................................39 Cooperating Parties ............................................................................................................40 Updating CPT ....................................................................................................................40 Format of CPT .............................................................................................................................41 Sections of the Numeric List..............................................................................................41 Use of the Semicolon .........................................................................................................41 Guidelines ..........................................................................................................................42 CPT Icons...........................................................................................................................42 Resequencing Initiative ......................................................................................................43 Alphabetic Index ................................................................................................................44 Using the Alphabetic Index ...............................................................................................45 Miscellaneous Components of CPT ............................................................................................47 Unlisted Services ...............................................................................................................47 Modifiers ............................................................................................................................47 CPT Categories ..................................................................................................................50 Claims Submission .......................................................................................................................55 Data Needed for Claims Submission .................................................................................55 Coordination of Benefits ....................................................................................................56
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