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MEDI7414 Medical Specialties
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MEDI7414 Medical Specialties
0 Download4 Pages / 924 Words
Course Code: MEDI7414
University: The University Of Queensland
MyAssignmentHelp.com is not sponsored or endorsed by this college or university
Country: Australia
Questions:
Part 1
Explain the purpose and function of the ICD-10-PCS coding system, include reasons for the transition from ICD-9 Vol. 3.
Which of the four major goals used for the development of ICD-10-PCS do you think is the most valuable to inpatient coders? Explain your answer.
Do you think inpatient coders will need to have a more in-depth understanding of anatomy and medical terminology to use the ICD-10-PCS coding system? Why or why not.
Part 2
Explain the purpose for using the ICD-10-CM in the United States?
How is the ICD-10 coding system used differently in other countries?
Which designated purposes for use in the US do you think are the most valuable? Explain your answer.
Part 3
Why do you think the insurance company is denying your friend’s claim?
Explain the biller’s assigned diagnosis code of GERD and how it is different than the bleeding ulcer of the esophagus the physician treated. Include any symptoms that are similar between the two diagnoses.
What advice will you give your friend about how to get the paid ART
Explain the function of the ICD-10-CM coding guidelines and how they affect code assignment?
Describe two ways assigning incorrect codes can affect a patient.
Describe two ways assigning incorrect codes can affect society. (CDC)
Answers:
Part 1
Explain the purpose and function of the ICD-10-PCS coding system, include reasons for the transition from ICD-9 Vol. 3.
In essence, ICD-10 Procedure Coding System (ICD-10-PCS) is considered as an international system of medical classification often used for procedural coding system. This system was designed to replace Volume 3 of ICD-9-CM. Consequently, this system is meant to assign codes to procedures that are associated with hospital utilization in various countries such as the United State (Centers for Medicare and Medicaid Services (CMS), 2014). Additionally, ICD-10-PCS is used to support a collection of data, payment as well as an electronic health record. The main reason for the transitioning from ICD-9 Vol. 3 to ICD-10-PCS was the fact that the later could accommodate new diagnosis as well as procedure codes for future clinical protocols. Primarily, this could improve the overall quality measurements, patient’s safety as well as medical processes outcomes.
Which of the four major goals used for the development of ICD-10-PCS do you think is the most valuable to inpatient coders? Explain your answer.
Ideally, the main goals for the development of the ICD-10-PCS were to improve the overall accuracy as well as the efficiency of procedure coding, to replace the ICD-9-CM coding system with a rather more logical system. Additionally, it makes sure that communication with physicians is improved through developing a code system which is aligned more with the overall clinical aspects surrounding a variety of procedures, and give coders a chance to create accurate codes with little efforts involves (Centers for Medicare and Medicaid Services (CMS), 2014). However, the most valuable goals are to make sure that communication with physicians are improved through developing a code system which is aligned more with the overall clinical aspects surrounding a variety of procedures because it is ensured that patients are accorded quality health care system.
Do you think inpatient coders will need to have a more in-depth understanding of anatomy and medical terminology to use the ICD-10-PCS coding system? Why or why not.
Primarily, coders are not supposed to have a rather in-depth knowledge of anatomy as well as medical terminology because the ICD-10-PCS system is anatomically detailed regarding clinical data; therefore, reducing coder’s anxiety as it captures procedural description in detail (Subotin & Davis, 2014).
Part 2
Explain the purpose for using the ICD-10-CM in the United States?
The main purpose of the ICD-10-CM system is used by the healthcare providers as well as physicians to classify while coding all the necessary diagnoses, symptoms and procedures that are recorded in conjunction with hospital care system in the United States.
How is the ICD-10 coding system used differently in other countries?
While this system has been embraced in more than 100 countries around the world, the applicability of this system is different as other countries do not code further than the 5th character. Consequently, no other country can get close to the 69,000 codes that are currently used in the United States (Centers for Medicare and Medicaid Services (CMS), 2014).
Which designated purposes for use in the US do you think are the most valuable? Explain your answer.
One of the most valuable purposes of the ICD-10 in the US is to track virtually all epidemiological trends in the health care system. This is because the coders, physicians, and the healthcare profession can be on the toe with the required treatment procedure of an emerging illness.
Part 3
Why do you think the insurance company is denying your friend’s claim?
Some of the ways that an insurance company may deny a claim of a friend are by saying that the accident was a personal fault that contributed to the accident or even another party that is included in another policy was at fault (Subotin & Davis, 2014).
Explain the biller’s assigned diagnosis code of GERD and how it is different than the bleeding ulcer of the esophagus the physician treated. Include any symptoms that are similar between the two diagnoses.
GERD diagnosis code is a system used to diagnose a digestive disorder that is known to affect the lower esophageal sphincter. On the other hand, ulcers are treated by the use of acid-blocking drugs that are called proton pump inhibitors.
What advice will you give your friend about how to get the paid ART
To make a payment regarding the above mentioned, I would advise the friend to follow the guidelines that are provided by ICD-10-PCS (Centers for Medicare and Medicaid Services (CMS), 2014).
Explain the function of the ICD-10-CM coding guidelines and how they affect code assignment?
It provides a better data collection; therefore, improving the value-based reimbursement, outcome of the overall measures, and reporting new and existing medical terminologies (Subotin & Davis, 2014). In this light, they affect the code assignment by creating a more precision in the treatment process.
Describe two ways assigning incorrect codes can affect a patient.
Some effect of assigning a wrong code to a patient is that it may cause injuries and even death to patients.
Describe two ways assigning incorrect codes can affect society. (CDC)
Primarily, assigning a wrong code can result in a rather wrong diagnosis to people in society as well as improper treatment procedures.
References
Centers for Medicare and Medicaid Services (CMS). (2014). 2010 ICD-10-PCS Code Tables and Index. Webiste: www. cms. gov/Medicare/Coding/ICD10/2014-ICD-10-PCS. html. Accessed March, 20.
Subotin, M., & Davis, A. (2014). A system for predicting ICD-10-PCS codes from electronic health records. Proceedings of BioNLP 2014, 59-67.
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