AMCA Medical Billing and
Coding Exam Study Guide(113
expert questions & answers )
Inclusion notes
Headed by the word "includes" and refine the content of the
category appearing above them
Sub-category
4 or 5 alphanumeric subdivision of a category
Brackets {}
enclose synonyms, alternative wording or explanatory
phrases. Brackets identify manifestation codes.
Eponym
Condition named for a person - such as Hodgkin's disease
NEC
Not Elsewhere Classifiable - no code is specific for that
condition
NOS
Not Otherwise Specified - used when a condition is not
completely described in the medical record
Category
Three character alphanumeric code that covers a single
disease or related condition
Exclusion notes
, Headed by the word "excludes" and indicates conditions that are
not classifiable to the preceding code
Parentheses ( )
used in both the index and tabular list to enclose supplementary
words - non-essential modifiers
Colons :
used in the Tabular List after an incomplete term which needs one
or more of the modifiers
Sequelae
Are conditions that remain after a patient's acute illness or injury
has ended - could be called residual effects or late effects
Providers
Physicians, hospitals and other suppliers that furnish care or
supplies to Medicare. Patients are called providers
Beneficiary Pays:
Deductible, premiums, co-insurance (20%) non-covered services
Medicare Pays:
Covered services (80%)
The correct procedure for assigning accurate diagnosis codes has
six steps
1. Review complete medical documentation
2. Abstract the medical conditions from the visit documentation
3. Identify the main term for each condition
4. Locate the main term in the alphabetic index
5. Verify the code in the tabular list
6. Check compliance with any applicable Official Guidelines and
list codes in appropriate order
Current Procedural Terminology (CPT)
Coding Exam Study Guide(113
expert questions & answers )
Inclusion notes
Headed by the word "includes" and refine the content of the
category appearing above them
Sub-category
4 or 5 alphanumeric subdivision of a category
Brackets {}
enclose synonyms, alternative wording or explanatory
phrases. Brackets identify manifestation codes.
Eponym
Condition named for a person - such as Hodgkin's disease
NEC
Not Elsewhere Classifiable - no code is specific for that
condition
NOS
Not Otherwise Specified - used when a condition is not
completely described in the medical record
Category
Three character alphanumeric code that covers a single
disease or related condition
Exclusion notes
, Headed by the word "excludes" and indicates conditions that are
not classifiable to the preceding code
Parentheses ( )
used in both the index and tabular list to enclose supplementary
words - non-essential modifiers
Colons :
used in the Tabular List after an incomplete term which needs one
or more of the modifiers
Sequelae
Are conditions that remain after a patient's acute illness or injury
has ended - could be called residual effects or late effects
Providers
Physicians, hospitals and other suppliers that furnish care or
supplies to Medicare. Patients are called providers
Beneficiary Pays:
Deductible, premiums, co-insurance (20%) non-covered services
Medicare Pays:
Covered services (80%)
The correct procedure for assigning accurate diagnosis codes has
six steps
1. Review complete medical documentation
2. Abstract the medical conditions from the visit documentation
3. Identify the main term for each condition
4. Locate the main term in the alphabetic index
5. Verify the code in the tabular list
6. Check compliance with any applicable Official Guidelines and
list codes in appropriate order
Current Procedural Terminology (CPT)
