2011 I ADvAnCeD An Atomy & Physiology for iCD-10-Cm/PCs An essential resource for diagnostic and procedural coding. Introduction The Advanced Anatomy and Physiology for ICD-10-CM/PCS Overview is designed to introduce medical coders to the new ICD-10- CM/PCS system, the differences between ICD-9-CM and Developing an understanding of anatomy and physiology from ICD-10-CM, and additionally to provide a more advanced a coding perspective is one challenge coders face. Most anatomy understanding of body systems, diseases/disease processes, and and physiology courses begin with general information on anatomy. structural organization and function beginning with an overview of the chemical level (atoms and molecules), cellular level, tissue Each chapter in this book contains a systemized approach to level, organ level, and proceed to the body system level. Even learning. Course objectives begin each chapter followed by an after taking introductory anatomy and physiology courses, overview of the given chapter topic. A thorough discussion many coders have difficulty identifying the correct diagnosis or provides the reader with the specifics of advanced coding in procedure code. This difficulty is due to a number of factors, ICD-10-CM and how it relates to the ICD-9-CM system. not the least of which is the organization of the coding systems Official Coding Guidelines for both coding systems are listed themselves. side-by-side to allow easy comparison of similarities and changes. Questions are provided to evoke thoughtful consideration of Diagnostic and procedural coding systems are not organized effective coding. Additionally, chapter-specific terminology in the same fashion as most anatomy and physiology texts. are defined to foster greater learning. A quiz ends each chapter Instead, diagnostic coding systems are organized by the disease allowing the reader to test their knowledge. Quiz answers can or disease process which may sometimes be found under a body be found on the following web site: www.contexodata.com/ system but may also be found under different designations API10/ such as neoplasms, infections, or signs and symptoms. CPT procedure codes are organized by type of service or procedure Refer to the end of this chapter for a detailed summary of the (e.g., evaluation and management, surgical, radiological, etc) organization of this book. and then depending on the section may be organized by body system (surgical section), physician specialty (medicine section), Course Objectives or more specific types of service (radiology section). ICD-9- CM Volume 3 was organized by the body system on which This course is designed to provide: the procedure was performed, but because the available code • A solid foundation in basic human anatomy and physiology numbers in some body systems were exhausted years ago, some • A review of each body system with in-depth information on new procedures on specific body systems are listed in the tabular cells, tissues, and organs that comprise each body system sections under Procedures and Interventions Not Elsewhere Classified or Miscellaneous Procedures. ICD-10- PCS is organized • In-depth information on the function of cells, tissues, in sections for the general type of procedure performed (e.g., organs, and body systems and the roles they play in Medical/Surgical, Obstetrics, Placement, Administration, etc.), maintaining homeostasis and health then by body system, root operation, body part, approach, • An overview of diseases and disease processes specific to device, and qualifier. each body system In this course, each body system will be covered in a separate • A discussion of the effects of diseases and disease processes chapter with the chapter objectives identified at the beginning. on multiple body systems The chapters will first discuss pertinent information starting at • Information on multi-system diseases and disease processes the chemical level and then progress through each level to the body system level. Both structure and function will be discussed. • Advanced medical terminology specific to each body system Within each chapter, the diseases, disease processes, conditions, • The relations between anatomy and physiology and code and symptoms related to the body system will be discussed. capture in diagnosis and procedure coding Specific medical terminology required to identify diagnosis and • New anatomical and physiological documentation procedure codes correctly will be reviewed. New documentation requirements for code capture in ICD-10-CM and ICD- requirements needed to capture codes in ICD-10-CM and 10-PCS ICD-10-PCS will also be covered. Each chapter will end with a © 2011 Contexo Media i Section I I Section Anatomy and Physiology for ICD-10-CM In order to use ICD-10-CM effectively, the ICD-10-CM A. Conventions for the ICD-9-CM A. Conventions for the ICD-10-CM Official Guidelines for Coding and Reporting must be reviewed and compared with the current ICD-9-CM Guidelines. The See Section I.C2. General guidelines. ICD-10-CM and ICD-9-CM Guidelines specific to each See Section I.C.19. Adverse body system are included in the chapter related to that body effects, poisoning, underdosing system. They are displayed side-by-side so that any changes to and toxic effects . the guidelines are readily apparent. Here in the introduction 1. Format: 2. Format and Structure: to Section I, two tables are provided with the conventions and The ICD-9-CM uses an indented The ICD-10-CM Tabular List contains general guidelines in ICD-9-CM and ICD-10-CM displayed format for ease in reference. categories, subcategories and side-by-side. See Appendix A for complete guidelines for both codes. Characters for categories, ICD-9-CM and ICD-10-CM. subcategories and codes may Coding conventions for ICD-10-CM contain many of the be either a letter or a number. conventions found in ICD-9-CM. However, because the format All categories are 3 characters. A and structure of the ICD-10-CM has undergone a number of three-character category that has changes, ICD-10-CM contains some additional information on no further subdivision is equivalent coding conventions and also some changes when compared to to a code. Subcategories are either ICD-9-CM. It is suggested that the Conventions Table below 4 or 5 characters. Codes may be 4, be carefully reviewed prior to doing the coding in each chapter. 5, 6 or 7 characters. That is, each level of subdivision after a category Table 1. Conventions Table is a subcategory. The final level of subdivision is a code. All codes A. Conventions for the ICD-9-CM A. Conventions for the ICD-10-CM in the Tabular List of the official The conventions for the ICD-9-CM The conventions for the ICD-10-CM version of the ICD-10-CM are in are the general rules for use of are the general rules for use of bold. Codes that have applicable the classification independent of the classification independent of 7th characters are still referred the guidelines. These conventions the guidelines. These conventions to as codes, not subcategories. A are incorporated within the are incorporated within the code that has an applicable 7th index and tabular of the ICD-9- Index and Tabular of the ICD- character is considered invalid CM as instructional notes. The 10-CM as instructional notes. without the 7th character. conventions are as follows: The ICD-10-CM uses an indented 1. The Alphabetic Index format for ease in reference. and Tabular List 3. Use of codes for The ICD-10-CM is divided into the reporting purposes Index, an alphabetical list of terms For reporting purposes only codes and their corresponding code, and are permissible, not categories or the Tabular List, a chronological list subcategories, and any applicable of codes divided into chapters based 7th character is required. on body system or condition. The Index is divided into two parts, the Index to Diseases and Injury, and the Index to External Causes of Injury. Within the Index of Diseases and Injury there is a Neoplasm Table and a Table of Drugs and Chemicals. © 2011 Contexo Media ix Blood, Blood Forming Organs, and Immune System Advanced Anatomy and Physiology for ICD-10-CM/PCS building blocks for all blood cell types. Each type of blood cell goes molecule of oxygen. The oxygen is then transported from the through a maturation process of two or more stages as follows: lungs to other tissues where the iron atoms release the oxygen Primitive reticular cell -> which is diffused into interstitial fluid. The globin portion of Hemocytoblast -> hemoglobin then combines with a molecule of carbon dioxide Rubriblast -> Prorubricyte -> Rubricyte -> Normoblast -> which is transported from the tissue and released in the lungs. Reticulocyte -> Erythrocyte Red blood cells have a short life span, becoming nonfunctional Myeloblast -> in about 120 days. This means that red blood cells must Basophil continually be produced. This process occurs in the bone Eosinophil marrow. Any disease of the bone marrow can affect the number Neutrophil of circulating red blood cells. Any time the number of functional Megakaryoblast -> Megakaryocyte -> Thrombocytes (platelets) red blood cells is reduced, or the hemoglobin content of the red blood cell is below normal, a condition called anemia results. Lymphoblast -> Lymphocytes Anemia has many causes including lack of iron intake in food, Monoblast -> Monocytes amino acid deficiencies, or vitamin B12 deficiencies. Blood cells Leukocytes Leukocytes, more commonly referred to as white blood cells, Immune System Immune Granular leukocytes