[embeddoc url=”https://academicresourceshub.com/wp-content/uploads/2024/08/Green_3-2-1_2024_Ch01_SolutionsGuide.docx” download=”all” viewer=”microsoft”]Updated annually, Green’s bestselling 3-2-1 CODE IT! 2024 EDITION and MindTap digital learning solutions equip beginning coders with a comprehensive introduction to today’s medical coding. Revised annually to provide the most current information, this easy-to-use medical coding resource addresses the latest changes to ICD-10-CM, ICD-10-PCS, CPT® and HCPCS Level II code sets. Students begin with diagnosis coding and progress to coding procedures and services. Separate chapters review inpatient and outpatient coding and differentiate general and specific ICD-10-CM and ICD-10-PCS guidelines, HCPCS Level II coding and CPT coding and guidelines. Examples, defined terms and printed and digital practice opportunities reinforce concepts. Computer-assisted coding cases and professional encoder software help prepare students for professional coding credentials.
Part I. Coding Overview
Chapter 1. Overview of Coding
Introduction
Career as a Coder
Education and Training
Professional Credentials
Employment Opportunities
Other Professions Related to Coding
Professional Associations
Coding Systems and Coding Processes
Coding Systems
Medical Coding Process
Coding Manuals, Encoders, and Computer-Assisted Coding
Other Classification Systems, Databases, and Nomenclatures
Alternative Billing Codes
Clinical Care Classification System
Current Dental Terminology
Diagnostic and Statistical Manual of Mental Disorders
Health Insurance Prospective Payment System Rate Codes
International Classification of Diseases for Oncology, Third Edition
International Classification of Functioning, Disability and Health
Logical Observation Identifiers Names and Codes
National Drug Codes
RxNorm
Systematized Nomenclature of Medicine Clinical Terms
Unified Medical Language System
Documentation as the Basis for Coding
Medical Necessity
Patient Record Formats
Health Data Collection
Reporting Hospital Data
Reporting Physician Office Data
Summary
Internet Links
Review
Part II. ICD-10-CM Coding System
Chapter 2. Introduction to ICD-10-CM Coding and Conventions
Introduction
Overview of ICD-10-CM
Updating ICD-10-CM
Mandatory Reporting of ICD-10-CM Codes
ICD-10-CM Index to Diseases and Injuries
Main Terms, Subterms, and Qualifiers
Basic Steps for Using the ICD-10-CM Index and Tabular List
ICD-10-CM Tabular List of Diseases and Injuries
ICD-10-CM Official Guidelines for Coding and Reporting
ICD-9-CM Legacy Coding System
General Equivalence Mappings (GEMs)
ICD-10-CM Coding Conventions
The Alphabetic Index and Tabular List
Format and Structure
Use of Codes for Reporting Purposes
Placeholder Character
Seventh Characters
Abbreviations
Punctuation
Other and Unspecified Codes
Includes Note
Inclusion Terms
Excludes Notes
Etiology and Manifestation Convention
And
With
Cross References
Code Also Note
Default Codes
Code Assignment and Clinical Criteria
General ICD-10-CM Diagnosis Coding Guidelines
Locating a Code in ICD-10-CM—Use of Index and Tabular List
Level of Detail in Coding
Codes from A00.0–T88.9, Z00–Z99.8, U00–U85
Signs and Symptoms
Conditions That Are an Integral Part of a Disease Process
Conditions That Are Not an Integral Part of a Disease Process
Multiple Coding for a Single Condition
Acute and Chronic Conditions
Combination Code
Sequelae (Late Effects)
Impending or Threatened Condition
Reporting Same Diagnosis Code More Than Once
Laterality
Documentation by Clinicians Other Than the Patient’s Provider
Syndromes
Documentation of Complications of Care
Borderline Diagnosis
Use of Sign/Symptom/Unspecified Codes
Coding for Health Care Encounters in Hurricane Aftermath
ICD-10-CM Chapter 11: Diseases of the Digestive System (K00–K95)
ICD-10-CM Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00–L99)
ICD-10-CM Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00–M99)
ICD-10-CM Chapter 14: Diseases of the Genitourinary System (N00–N99)
ICD-10-CM Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00–O9A)
Obstetrical Discharges
ICD-10-CM Chapter 16: Certain Conditions Originating in the Perinatal Period (P00–P96)
ICD-10-CM Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q00–Q99)
ICD-10-CM Chapter 18: Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00–R99)
ICD-10-CM Chapter 19: Injury, Poisoning, and Certain Other Consequences of External Causes (S00–T88)
Fractures
Burns
Adverse Effects, Poisonings, Underdosings, and Toxic Effects
ICD-10-CM Chapter 20: External Causes of Morbidity (V00–Y99)
ICD-10-CM Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00–Z99)
Reporting Z Codes
ICD-10-CM Chapter 22: Codes for Special Purposes (U00–U85)
Summary
Internet Links
Review
Part III. ICD-10-CM Outpatient and Physician Office Coding
Chapter 5. ICD-10-CM Outpatient and Physician Office Coding
Introduction
Outpatient Care
Primary Care Services
Hospital Outpatient Services
Outpatient Diagnostic Coding and Reporting Guidelines
Selection of First-Listed Condition
Codes from A00.0–T88.9, Z00–Z99, U00–U85
Accurate Reporting of ICD-10-CM Diagnosis Codes
Codes That Describe Signs and Symptoms
Encounters for Circumstances Other Than a Disease or Injury
Level of Detail in Coding
ICD-10-CM Code for the Diagnosis, Condition, Problem, or Other Reason for Encounter/Visit
Uncertain Diagnoses
Chronic Diseases
Code All Documented Conditions That Coexist
Patients Receiving Diagnostic Services Only
Patients Receiving Therapeutic Services Only
Patients Receiving Preoperative Evaluations Only
Ambulatory Surgery (or Outpatient Surgery)
Routine Outpatient Prenatal Visits
Encounters for General Medical Examinations with Abnormal Findings
Encounters for Routine Health Screenings
Summary
Internet Links
Review
Part IV. ICD-10-PCS Coding System
Chapter 6. Introduction to ICD-10-PCS Coding, Conventions, and Guidelines
Introduction
Overview of ICD-10-PCS Coding
ICD-10-PCS Format and Structure
ICD-10-PCS Codes Contain Independent Values
Updating ICD-10-PCS
Reporting ICD-10-PCS Codes
ICD-10-PCS Index
Purpose of ICD-10-PCS Index
Main Terms and Subterms
Cross References
ICD-10-PCS Tables
Sections of ICD-10-PCS Tables
Build-a-Code Approach
Valid Characters
Step-by-Step Approach to Constructing a Valid ICD-10-PCS Code
ICD-10-PCS Official Guidelines for Coding and Reporting
ICD-10-PCS Coding Conventions
A1 – Structure of Codes
A2 – Unique Values
A3 – Expanding Values
A4 – Meaning of a Single Value
A5 – Increasing Detail in ICD-10-PCS Codes
A6 – Index and Tables
A7 – Coding Directly From Tables
A8 – Valid Codes: Seven Alphanumeric Characters
A9 – Valid Codes: Selecting Characters 4–7 in the Same Row of a Table
A10 – And
A11 – Definition of ICD-10-PCS Terms
ICD-10-PCS Sections and Coding Guidelines
Medical and Surgical Section Coding Guidelines
Obstetrics Section Coding Guidelines
Placement Section
Administration Section
Measurement and Monitoring Section
Extracorporeal or Systemic Assistance and Performance Section
Extracorporeal or Systemic Therapies Section
Osteopathic Section
Other Procedures Section
Chiropractic Section
Imaging Section
Nuclear Medicine Section
Radiation Therapy Section
Physical Rehabilitation and Diagnostic Audiology Section
Mental Health Section
Substance Abuse Treatment Section
New Technology Section
Summary
Internet Links
Review
Part V. ICD-10-CM and ICD-10-PCS Inpatient Hospital Coding
Chapter 7. ICD-10-CM and ICD-10-PCS Inpatient Hospital Coding
Introduction
Acute Care Facilities (Hospitals)
Inpatient Diagnosis Coding Guidelines
Admitting Diagnosis
Principal Diagnosis
Reporting Additional Diagnoses
Hospital-Acquired Conditions and Present on Admission Indicator Reporting
Inpatient Procedure Coding Guidelines
Principal Procedure
Significant Other Procedures (or Secondary Procedures)
Coding Inpatient Diagnoses and Procedures
Summary
Internet Links
Review
Part VI. Health Care Procedure Coding System (HCPCS) Level II Coding System
Chapter 8. HCPCS Level II Coding System
Introduction
Overview of HCPCS
HCPCS Level I
HCPCS Level II
HCPCS Level II Codes
Responsibility for HCPCS Level II Codes
Types of HCPCS Level II Codes
General Guidelines for Modifier Use
Laterality Modifiers
Reporting HCPCS Level II Modifiers on Claims
Assigning HCPCS Level II Codes
HCPCS Level II Index
HCPCS Level II Code Sections
Basic Steps for Using the HCPCS Level II Index and Sections
Determining Payer Responsibility
Patient Record Documentation
Summary
Internet Links
Review
Part VII. Current Procedural Terminology (CPT) Coding System
Chapter 9. Introduction to CPT Coding
Introduction
History of CPT
Overview of CPT
CPT Categories
Organization of CPT
CPT Category I Codes
CPT Category II Codes
CPT Category III Codes
CPT Code Format
CPT Index
Main Terms and Subterms
Boldfaced Type
Italicized Type
Cross-Reference Term
Single Codes and Code Ranges
Inferred Words
CPT Appendices
CPT Symbols
CPT Sections, Subsections, Categories, and Subcategories
CPT Guidelines
CPT Instructional Notes
CPT Descriptive Qualifiers
CPT Modifiers
Functional and Informational Modifiers
Reporting Modifiers on Claims
CPT Modifiers According to Reporting Similarities
National Correct Coding Initiative (NCCI)
Unbundling CPT Codes
Summary
Internet Links
Review
Chapter 10. CPT Evaluation and Management
Introduction
Overview of Evaluation and Management Section
Place of Service (POS)
Type of Service (TOS)
Evaluation and Management Section Guidelines
E/M Guidelines Overview
Classification of E/M Services
Split or Shared Visits
Multiple Evaluation and Management Services on the Same Date
Unlisted Service
Special Report
Evaluation and Management Categories and Subcategories
Office or Other Outpatient Services
Hospital Inpatient and Observation Care Services
Consultations
Emergency Department Services
Critical Care Services
Nursing Facility Services
Home or Residence Services
Prolonged Services
Case Management Services
Care Plan Oversight Services
Preventive Medicine Services
Non-Face-to-Face Services
Special Evaluation and Management Services
Newborn Care Services
Delivery/Birthing Room Attendance and Resuscitation Services
Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
Cognitive Assessment and Care Plan Services
Care Management Services
Psychiatric Collaborative Care Management Services
Transitional Care Management Services
Advance Care Planning
General Behavioral Health Integration Care Management
Other Evaluation and Management Services
Summary
Internet Links
Review
Chapter 11. CPT Anesthesia
Introduction
Anesthesia Terminology
Types of Anesthesia
Overview of Anesthesia Section
Monitored Anesthesia Care (MAC)
Anesthesia Section Guidelines
Reporting Codes for Unusual Monitoring and Other Services
Anesthesia Modifiers
Time Reporting
Anesthesia Services
Supplied Materials
Separate or Multiple Procedures
Unlisted Service or Procedure
Special Report
Qualifying Circumstances
Anesthesia Subsections
Head
Neck
Thorax (Chest Wall and Shoulder Girdle)
Intrathoracic
Spine and Spinal Cord
Upper Abdomen
Lower Abdomen
Perineum
Pelvis (Except Hip)
Upper Leg (Except Knee)
Knee and Popliteal Area
Lower Leg (Below Knee, Includes Ankle and Foot)
Shoulder and Axilla
Upper Arm and Elbow
Forearm, Wrist, and Hand
Radiological Procedures
Burn Excisions or Debridement
Obstetric
Other Procedures
Summary
Internet Links
Review
Chapter 12. CPT Surgery I
Introduction
Overview of Surgery Section
Organization of Surgery Section
Surgery Guidelines
Services
CPT Surgical Package Definition
Follow-Up Care for Diagnostic Procedures
Follow-Up Care for Therapeutic Surgical Procedures
Supplied Materials
Reporting More Than One Procedure/Service
Separate Procedure
Unlisted Service or Procedure
Special Report
Imaging Guidance
Surgical Destruction
Foreign Body/Implant Definition
General Subsection
Integumentary System Subsection
Skin, Subcutaneous and Accessory Structures
Nails
Pilonidal Cyst
Introduction
Repair (Closure)
Destruction
Breast
Summary
Internet Links
Review
Chapter 13. CPT Surgery II
Introduction
Musculoskeletal System Subsection
Musculoskeletal System Instructional Notes
General
Head
Neck (Soft Tissues) and Thorax
Back and Flank
Spine (Vertebral Column)
Abdomen
Shoulder
Humerus (Upper Arm) and Elbow
Forearm and Wrist
Hand and Fingers
Pelvis and Hip Joint
Femur (Thigh Region) and Knee Joint
Leg (Tibia and Fibula) and Ankle Joint
Foot and Toes
Application of Casts and Strapping
Endoscopy/Arthroscopy
Respiratory System Subsection
Nose
Accessory Sinuses
Larynx
Trachea and Bronchi
Lungs and Pleura
Summary
Internet Links
Review
Chapter 14. CPT Surgery III
Introduction
Cardiovascular System Subsection
Cardiovascular System Instructional Notes
Heart and Pericardium
Arteries and Veins
Hemic and Lymphatic Systems Subsection
Spleen
General
Transplantation and Post-Transplantation Cellular Infusions
Lymph Nodes and Lymphatic Channels
Summary
Internet Links
Review
Chapter 15. CPT Surgery IV
Introduction
Mediastinum and Diaphragm Subsection
Digestive System Subsection
Lips
Vestibule of Mouth
Tongue and Floor of Mouth
Dentoalveolar Structures
Palate and Uvula
Salivary Gland and Ducts
Pharynx, Adenoids, and Tonsils
Esophagus
Stomach
Intestines (Except Rectum)
Meckel’s Diverticulum and the Mesentery
Appendix
Colon and Rectum
Anus
Liver
Biliary Tract
Pancreas
Abdomen, Peritoneum, and Omentum
Urinary System Subsection
Kidney
Ureter
Bladder
Urethra
Summary
Internet Links
Review
Chapter 16. CPT Surgery V
Introduction
Male Genital System Subsection
Reproductive System Procedures Subsection
Intersex Surgery Subsection
Female Genital System Subsection
Maternity Care and Delivery Subsection
Antepartum Services
Delivery Services
Postpartum Care
Delivery After Previous Cesarean Delivery
Abortion
Endocrine System Subsection
Thyroid Gland
Parathyroid, Thymus, Adrenal Glands, Pancreas, and Carotid Body
Nervous System Subsection
Skull, Meninges, and Brain
Spine and Spinal Cord
Endoscopic Decompression of Neural Elements and/or Excision of Herniated Intervertebral Discs
Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System
Eye and Ocular Adnexa Subsection
Eyeball
Anterior Segment
Posterior Segment
Ocular Adnexa
Conjunctiva
Auditory System Subsection
External Ear
Middle Ear
Inner Ear
Temporal Bone, Middle Fossa Approach
Operating Microscope Subsection
Summary
Internet Links
Review
Chapter 17. CPT Radiology
Introduction
Radiology Terminology
Planes of View
Positioning and Radiographic Projection
Radiology Procedures
Overview of Radiology Section
Professional Versus Technical Components
Use of Modifiers with Radiology Codes
Complete Procedure
Evaluation and Management (E/M) Services
Radiology Section Guidelines
Subject Listings
Separate Procedures
Unlisted Service or Procedure
Special Report
Supervision and Interpretation, Imaging Guidance
Administration of Contrast Material(s)
Written Report(s)
Foreign Body/Implant Definition
Radiology Subsections
Diagnostic Radiology (Diagnostic Imaging)
Diagnostic Ultrasound
Radiologic Guidance
Breast, Mammography
Bone/Joint Studies
Radiation Oncology
Nuclear Medicine
Summary
Internet Links
Review
Chapter 18. CPT Pathology and Laboratory
Introduction
Overview of Pathology and Laboratory Section
Specimens and Specimen Collection
Professional and Technical Components
Pathology and Laboratory Section Tables
Pathology and Laboratory Section Guidelines
Services in Pathology and Laboratory
Separate or Multiple Procedures
Unlisted Service or Procedure
Special Report
Modifier 51, Modifier 90, and Modifier 91
Pathology and Laboratory Subsections
Organ or Disease-Oriented Panels
Drug Assay and Therapeutic Drug Assays
Evocative/Suppression Testing
Pathology Clinical Consultations
Urinalysis
Molecular Pathology
Genomic Sequencing Procedures and Other Molecular Multianalyte Assays
Multianalyte Assays with Algorithmic Analyses
Chemistry
Hematology and Coagulation
Immunology
Transfusion Medicine
Microbiology
Anatomic Pathology
Cytopathology
Cytogenetic Studies
Surgical Pathology
In Vivo (e.g., Transcutaneous) Laboratory Procedures
Other Procedures
Reproductive Medicine Procedures
Proprietary Laboratory Analyses
Summary
Internet Links
Review
Chapter 19. CPT Medicine
Introduction
Overview of Medicine Section
Medicine Section Guidelines
Add-On Codes
Separate Procedures
Unlisted Service or Procedure
Special Report
Imaging Guidance
Supplied Materials
Foreign Body/Implant Definition
Medicine Subsections
Immune Globulins, Serum or Recombinant Products
Immunization Administration for Vaccines/Toxoids
Vaccines, Toxoids
Psychiatry
Biofeedback
Dialysis
Gastroenterology
Ophthalmology
Special Otorhinolaryngologic Services
Cardiovascular
Noninvasive Vascular Diagnostic Studies
Pulmonary
Allergy and Clinical Immunology
Endocrinology
Neurology and Neuromuscular Procedures
Medical Genetics and Genetic Counseling Services
Adaptive Behavior Services
Central Nervous System Assessments/Tests (e.g., Neuro-Cognitive, Mental Status, Speech Testing)
Health Behavior Assessment and Intervention
Behavior Management Services
Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration
Photodynamic Therapy
Special Dermatological Procedures
Physical Medicine and Rehabilitation
Medical Nutrition Therapy
Acupuncture
Osteopathic Manipulative Treatment
Chiropractic Manipulative Treatment
Education and Training for Patient Self-Management
Non-Face-to-Face Nonphysician Services
Special Services, Procedures, and Reports
Qualifying Circumstances for Anesthesia
Moderate (Conscious) Sedation
Other Services and Procedures
Home Health Procedures/Services
Medication Therapy Management Services
Summary
Internet Links
Review
Part VIII. Insurance and Reimbursement Overview
Chapter 20. Insurance and Reimbursement
Introduction
Third-Party Payers
Health Insurance Marketplace
Types of Third-Party Payers
Health Care Reimbursement Systems
Prospective Payment Systems, Fee Schedules, and Exclusions
Case-Mix Analysis, Severity of Illness (SI), and Intensity of Services (IS) Systems
Medical Necessity of Medicare Part A Hospital Inpatient Admissions
There are no reviews yet.