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Disclaimer, This course was current when it was published Every reasonable effort has been made to assure the accuracy of the. information within these pages The ultimate responsibility lies with readers to ensure they are using the codes and. following applicable guidelines correctly AAPC employees agents and staff make no representation warranty or. guarantee that this compilation of information is error free and will bear no responsibility or liability for the results. or consequences of the use of this course This guide is a general summary that explains guidelines and principles in. profitable efficient health care organizations,US Government Rights. This product includes CPT which is commercial technical data and or computer data bases and or commercial. computer software and or commercial computer software documentation as applicable which was developed exclu. sively at private expense by the American Medical Association 515 North State Street Chicago Illinois 60610. U S Government rights to use modify reproduce release perform display or disclose these technical data and or. computer data bases and or computer software and or computer software documentation are subject to the limited. rights restrictions of DFARS 252 227 7015 b 2 November 1995 as applicable for U S Depart ment of Defense. procurements and the limited rights restrictions of FAR 52 227 14 June 1987 and or subject to the restricted rights. provision of FAR 52 227 14 June 1987 and FAR 52 227 19 June 1987 as applicable and any applicable agency FAR. Supplements for non Department of Defense Federal procurements. AMA Disclaimer, CPT copyright 2010 American Medical Association All rights reserved. Fee schedules relative value units conversion factors and or related components are not assigned by the AMA are. not part of CPT and the AMA is not recommendation their use The AMA does not directly or indirectly practice. medicine or dispense medical services The AMA assumes no liability for data contained or not contained herein. CPT is a registered trademark of the American Medical Association. 2480 South 3850 West Suite B Salt Lake City Utah 84120. 800 626 CODE 2633 Fax 801 236 2258 www aapc com,All rights reserved. ISBN 978 1 935809 77 7, CPC CPC H CPC P CIRCC and CPMATM are trademarks of AAPC.
ii 2011 Medical Coding Training CPC Instructor Resources CPT copyright 2010 American Medical Association All rights reserved. Acknowledgements,Authors Katherine Abel CPC CPMA CPC I CRMS. Debra A Apfel RN BA CPC CPMA,Carrie Bosela CPC CPC I. Rhonda Buckholtz CPC CPC I CPMA CGSC CPEDC COBGC CENTC. Marcella Bucknam CPC CPC H CPC P CPC I CCC COBGC,Shelly Cronin CPC CPMA CANPC CGIC CGSC. Kelly Dennis CPC CPC I CANPC,Mary Divine CPC CPC H CPC I CUC. Brad Ericson MPC CPC COSC, Deborah Grider CPC CPC I CPC H CPC P COBGC CPMA CPCD CCS P.
Raemarie Jimenez CPC CPMA CPC I CANPC CRHC,Betty Johnson CPC CPC H CPC I CPCD. Dolly Perrine CPC CPMA CPC I CUC,Jean Pryor CPC CPMA CPC I CIMC. Dorothy Steed CPC H CPMA CPC I CEMC CFPC,Kate Tierney CPC CPC P CEDC CEMC CGSC COBGC. G John Verhovshek MA CPC,Susan Ward CPC CPC H CPC I CEMC CPCD CPRC. Reviewers Lynn Anderanin CPC CPC I COSC,Nicole Benjamin CPC CPC I CEDC.
Jennifer Hume CPC CPMA CEMC,Lindsay Anne Jenkins CPC CPC H CIRCC CPC I. Vandna Kejariwal CPC CPC H CPC I CEDC,Barbara Pross CPC CPMA CPC I CEDC CEMC COBGC. Carrie Lynn Rawlings CPC CPMA CPC I CCVTC CEMC,Alice Reybitz RN BA CPC CPC H CPC I CHI. Carrie Severson CPC CPC H CPC P CPMA CPC I,Kathy Skolnick CPC CPC I. Charleen Yamasato CPC CPC I, Production Dianne Allred Designer Desktop Publishing.
Michelle Dick AAPC Medical Artist,Tina M Smith Cover Designer Desktop Publishing. CPT copyright 2010 American Medical Association All rights reserved www aapc com iii. The Business of Medicine 1, The Difference Between Hospital and Physician Services 2. How a Physician Office Works and How the Coder Fits into It 2. Understanding the Hierarchy of Providers 3,The Different Types of Payers 3. Understanding RBRVS 4,Medical Necessity 7,The Advanced Beneficiary Notice 9. The Health Insurance Portability and Accountability Act of 1996 HIPAA 13. The Need for Compliance Rules and Audits 16,The OIG Work Plan 17.
What AAPC Will Do for You 20,Glossary 21,Sources 22. Medical Terminology and Anatomy Review,Introduction 23. Objectives 23,Medical Terminology 23,Introduction to Anatomy 31. Integumentary System 33,Musculoskeletal System 37,Cardiovascular System 40. Lymphatic System 43,Respiratory System Pulmonary System 45.
Digestive System 47,Urinary System 50,Reproductive Systems 50. Nervous System 53,Organs of Sense Eye 54,Organs of Sense Ear 55. Endocrine System 56,Hematologic Hemic System 59,Immune System 59. Sources 61, CPT copyright 2010 American Medical Association All rights reserved www aapc com v. Introduction to ICD 9 CM 63,Introduction 63,Overview of ICD 9 CM Layout 63.
Steps to Look Up a Diagnosis Code 70, ICD 9 CM Official Guidelines for Coding and Reporting 72. Glossary 83,ICD 9 CM Coding Chapters 1 9 85,Introduction 85. Objectives 85, Chapter 1 Infectious and Parasitic Diseases Codes 001 139 85. Chapter 2 Neoplasms Codes 140 239 90, Chapter 3 Endocrine Nutritional and Metabolic Diseases and Immunity Disorders 240 279 95. Chapter 4 Diseases of Blood and Blood Forming Organs 280 289 99. Chapter 5 Mental Disorders 290 319 101, Chapter 6 Diseases of Nervous System and Sense Organs 320 389 103.
Chapter 7 Diseases of Circulatory System 390 459 105. Chapter 8 Diseases of Respiratory System 460 519 110. Chapter 9 Diseases of Digestive System 520 579 113. Glossary 117,ICD 9 CM Coding Chapters 10 19 119,Introduction 119. Objectives 119, Chapter 10 Diseases of Genitourinary System 580 629 119. Chapter 11 Complications of Pregnancy Childbirth and the Puerperium 630 679 124. Chapter 12 Diseases Skin Subcutaneous Tissue 680 709 128. Chapter 13 Diseases of Musculoskeletal and Connective Tissue 710 739 130. Chapter 14 Congenital Anomalies 740 759 132, Chapter 15 Newborn Perinatal Guidelines 760 779 134. Chapter 16 Symptoms Signs and Ill defined Conditions 780 799 135. Chapter 17 Injury and Poisoning 800 999 137, Chapter 18 Classification of Factors Influencing Health Status and. Contact with Health Service Supplemental V01 V91 142. Chapter 19 Supplemental Classification of External. Causes of Injury and Poisoning E Codes E800 E999 145. Glossary 149, vi 2011 Medical Coding Training CPC Instructor Resources CPT copyright 2010 American Medical Association All rights reserved.
Introduction to CPT Surgery Guidelines HCPCS and Modifiers 151. Introduction to CPT 151,National Correct Coding Initiative CCI 156. Sequencing CPT Codes 157,Resource Based Relative Value Scale RBRVS 157. CPT Assistant 162, Category II Codes and a Brief Overview of the Physician Quality Reporting Initiative 163. CPT Category III Codes 163,Appendices 164,Surgery Guidelines 167. HCPCS Level II 172,HCPCS Level II Modifiers 175,Modifiers 183.
Glossary 193,Integumentary System,Introduction 195. Objectives 195,Anatomy and Medical Terminology 196. ICD 9 CM Coding 196,HCPCS Level II Codes 226,Modifiers 226. Glossary 231,Musculoskeletal System 233,Introduction 233. Objectives 233,Anatomy and Medical Terminology 233.
ICD 9 CM Coding 236,CPT Coding 241,HCPCS Level II 254. Modifiers 254,Glossary 261, CPT copyright 2010 American Medical Association All rights reserved www aapc com vii. Respiratory Hemic Lymphatic Mediastinum and Diaphragm 263. Introduction 263,Objectives 263,Anatomy and Medical Terminology 263. ICD 9 CM 269,Current Procedural Terminology 274,HCPCS Level II 285. Modifiers 285,Glossary 290,Chapter 10,Cardiovascular Systems 293.
Introduction 293,Objectives 293,Anatomy and Medical Terminology 293. ICD 9 CM 297,Modifiers 322,HCPCS Level II 324,Documentation Dissection 325. Glossary 330,Chapter 11,Digestive System 333,Introduction 333. Objectives 333,Anatomy and Medical Terminology 333. ICD 9 CM 338,CPT Digestive System 40490 49999 342,Glossary 360.
Chapter 12,Urinary System and Male Genital System 363. Introduction 363,Objectives 363,Anatomy and Medical Terminology 363. ICD 9 CM Coding 367,CPT Coding 375,Modifiers 393,Glossary 399. Sources 403, viii 2011 Medical Coding Training CPC Instructor Resources CPT copyright 2010 American Medical Association All rights reserved. Chapter 13,Female Reproductive System 405,Objectives 405.
Anatomy 405,ICD 9 CM 408,CPT Coding 411,HCPCS Level II 414. Modifiers 414,Glossary 418,Sources 418,Chapter 14,Endocrine and Nervous System 419. Introduction 419,Objectives 419,Anatomy 419,ICD 9 CM 428. CPT Coding 435,HCPCS Level II 454,Modifiers 454,Glossary 464. Chapter 15,Eye and Ocular Adnexa Auditory Systems 465.
Introduction 465,Objectives 465,Anatomy and Medical Terminology 465. ICD 9 CM 470,Symptoms and V Codes 473,Medicine Codes 484. The Medicine Section Special Otorhinolaryngologic Services 92502 92700 490. HCPCS Level II 495,Glossary 499,Chapter 16,Anesthesia 501. Introduction 501,Anatomy and Medical Terminology 501. ICD 9 CM Coding 508,CPT Coding 510,Modifiers 515,Anesthesia Related Teaching Rules 519.
Glossary 528, CPT copyright 2010 American Medical Association All rights reserved www aapc com ix. Chapter 17,Radiology 531,Introduction 531,Objectives 531. Anatomy and Medical Terminology 531,ICD 9 CM Coding 534. Types of Radiological Services 538,Diagnostic Ultrasound 543. Radiologic Guidance 544,Breast Mammography 545,Bone Joint Studies 547.
Radiation Oncology 547,Nuclear Medicine 549,HCPCS Level II 551. Modifiers 551,Glossary 555,Sources 557,Chapter 18,Pathology and Laboratory 559. Introduction 559,Objectives 559,Terminology 559,ICD 9 CM 561. CPT Coding 566,HCPCS Level II 581,Modifiers 581,Glossary 587. Chapter 19,Evaluation and Management 589,Introduction 589.
Objectives 589,Anatomy and Medical Terminology 589. ICD 9 CM Coding 590,CPT Coding 590,Determine the Level of Services 601. HCPCS Level II Codes 632,Modifiers 632,Glossary 640. x 2011 Medical Coding Training CPC Instructor Resources CPT copyright 2010 American Medical Association All rights reserved. Chapter 20,Medicine 641,Introduction 641,Anti infective Immunizations 641. Vaccines and Toxoids 642,Psychiatry 644,Biofeedback 647.
Dialysis and End Stage Renal Disease Services 648,Gastroenterology 651. Ophthalmological Services 651,Special Otorhinolaryngologic Services 651. Cardiovascular Services 652,Noninvasive Vascular Diagnostic Studies 652. Pulmonary Studies 653,Allergy and Immunology 653,Endocrinology 656. Neurology and Neuromuscular Procedures 656, Medical Genetics and Genetic Counseling Services 656.
Hydration Therapeutic Prophylactic Diagnostic Injections Infusions and. Chemotherapy Highly Complex Drugs or Highly Complex Biologic Agent Administration 659. Photodynamic Therapy 661,Special Dermatological Procedures 661. Physical Medicine and Rehabilitation 661,Acupuncture 664. Osteopathic Manipulative Treatment 664,Chiropractic Manipulative Treatment 665. Education and Training for Patient Self Management 666. Non Face to Face Nonphysician Services 667,Special Services Procedures and Reports 668. Qualifying Circumstances for Anesthesia 671,Home Health Procedures and Services 672.
Medication Therapy Management Services 675,Glossary 679. Chapter 21,What Lies Ahead 681, Prepare Now for Significant Health Care Changes 681. ICD 10 CM 681,The 5010 Electronic Transaction Standard 683. The Focus on Prevention and Physicians Changing Roles 685. Patient Care Moves Beyond the Physician Office 687. The Electronic Health Record 688,Focus on Fraud and Abuse 689. CPT copyright 2010 American Medical Association All rights reserved www aapc com xi. Appendix A,Answers and Rationales 691,Chapter 1 691.
Chapter 2 695,Chapter 3 703,Chapter 4 707,Chapter 5 713. Chapter 6 719,Chapter 7 723,Chapter 8 727,Chapter 9 731. Chapter 10 735,Chapter 11 739,Chapter 12 743,Chapter 13 749. Chapter 14 751,Chapter 15 757,Chapter 16 763,Chapter 17 767. Chapter 18 771,Chapter 19 775,Chapter 20 785, xii 2011 Medical Coding Training CPC Instructor Resources CPT copyright 2010 American Medical Association All rights reserved.
1 The Business of Medicine, Coding as a Profession Technicians who specialize in coding are called medical. coders or coding specialists Medical coders assign a. Each time you receive health care a record is maintained code to each diagnosis service procedure and when. of the resulting observations medical or surgical inter applicable supply using classification systems The clas. ventions and treatment outcomes This record includes sification system determines the amount that health care. information concerning your symptoms and medical providers will be reimbursed if the patient is covered by. history the results of examinations reports of X rays and Medicare Medicaid or other insurance programs using. Fee schedules relative value units conversion factors and or related components are not assigned by the AMA are not part of CPT and the AMA is not recommendation their use The AMA does not directly or indirectly practice medicine or dispense medical services The AMA assumes no liability for data contained or not contained herein

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