ICD-9-CM guidelines have been issued to bring about standardization and uniformity in the use of medical codes. Adherence to this guideline is a requirement under Health Insurance Portability and Accountability Act (HIPAA).
The International Classification of Diseases, 9th Revision, Clinical Modification, more popularly known as ICD-9-CM, is a set of guidelines issued by two departments within the Department of Health and Human Services (DHHS): The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS).
The ICD-9-CM guidelines provide healthcare professionals with the knowledge of how to code and report diseases, which has to be in accordance with this instrument. The ICD-9-CM guidelines are meant for accompanying and supplementing the extant official conventions and instructions that the ICD-9-CM has already provided.
Facts about the ICD-9-CM guidelines
- These ICD-9-CM guidelines are to be used by healthcare coders when allocating ICD-9-CM diagnosis and procedure codes
- Adherence to these guidelines is a requirement under HIPAA
- These, however, are guidelines, and hence are subservient to the more clear-cut conventions and instructions that the classification has
- Although ICD-9-CM guidelines provide additional instruction; instructions on how to code and sequence diseases, as set out in Volumes I, II and III of ICD-9-CM, are the guiding document
ICD-9-CM guidelines on general inpatient coding
ICD-9-CM guidelines have full details of how medical coders have to go about general inpatient coding. These are some of the general areas in which ICD-9-CM guidelines have to be adhered to:
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- Use of both alphabetic index and tabular list
- Level of specificity in coding
- Not Elsewhere Classified (NEC) or Not Otherwise Specified (NOS) code titles
- Conditions that are classified as being both acute and chronic
- Code relating to combinations
- Tabular list
- Multiple coding of diagnoses
- Late effect, meaning residual effect or condition produced
- ICD-9-CM guidelines when diagnosis is uncertain
- o ICD-9-CM guidelines on impending or threatened condition