Modifier – as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbursement. Modifiers may add information or change the description according to the physician documentation to give more specificity for the service or procedure rendered. Appending of an appropriate modifier will effectively respond to…
The clinical examples that are provided here are limited to Office or Other Outpatient Services, Hospital Inpatient Services, Consultation, Emergency and Critical Care services. These clinical examples do not encompass the entire scope of medical practice. Inclusion or exclusion of any particular specialty group does not infer any judgment of importance or lack thereof; nor…
CPC sample question # 1 CPT 26123, CPT 26125, ICD-9-CM 728.6 CPT 26123 is used for reporting the Fasciectomy, with release of 1 single digit and CPT 26125 is for the additional dight. Diagnosis code 728.6 is used to report the Dupuytren’s contraction CPC sample question # 2 CPT 33208, ICD-9-CM 426.12 CPT 33208 is…
Definition of Schizophrenia Or Other Primary Psychotic Disorders: Schizophrenia and other primary psychotic disorders are characterised by significant impairments in reality testing and alterations in behaviour manifest in positive symptoms such as persistent delusions, persistent hallucinations, disorganised thinking (typically manifest as disorganised speech), grossly disorganised behaviour, and experiences of passivity and control, negative symptoms such…
Definition of Neurodevelopmental Disorders: Neurodevelopmental disorders are behavioural and cognitive disorders that arise during the developmental period that involve significant difficulties in the acquisition and execution of specific intellectual, motor, language, or social functions. Although behavioural and cognitive deficits are present in many mental and behavioural disorders that can arise during the developmental period (e.g.,…
Definition of Postprocedural Endocrine Or Metabolic Disorders: Any endocrine or metabolic disorder caused by or subsequent to any medical procedure. Coded Elsewhere: Injury or harm arising from surgical or medical care, not elsewhere classified (NE80-NE8Z) Postprocedural hypothyroidism ICD 11 Code For Postprocedural hypothyroidism 5D40 Postprocedural hypothyroidism 5D40.0 Postirridation hypothyroidism 5D40.00 Hypothyroidism postradioactive iodine ablation 5D40.0Y…
Exclusions: histiocytosis X (chronic) (2B31.2) Coded Elsewhere: Tophaceous gout (FA25.20) Amyloidosis Definition of Amyloidosis: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clinical signs and biochemical type of amyloid protein involved. Most amyloidoses are…
Exclusions: Sphingolipidosis (5C56.0) Coded Elsewhere: Lipoid dermatoarthritis (FA38.Y) Multicentric reticulohistiocytosis (EE8Y) Lipoid proteinosis (LD27.Y) Hyperlipoproteinaemia Definition of Hyperlipoproteinaemia: Disorders of lipoprotein metabolism that result in high levels of lipoproteins in the circulating blood 5C80 Hyperlipoproteinaemia 5C80.0 Hypercholesterolaemia 5C80.00 Primary hypercholesterolaemia Definition of Primary hypercholesterolaemia: This is a genetic disorder characterised by high cholesterol levels, specifically…
Volume depletion ICD 11 Code For Volume depletion 5C70 Volume depletion Exclusions: Hypovolaemic shock (MG40.1) 5C70.0 Dehydration Definition of Dehydration: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water intake. Coded Elsewhere:…
Disorders of amino acid absorption or transport Definition of Disorders of amino acid absorption or transport: Any condition caused by deficiencies in amino acid absorption and transport. ICD 11 Code For Disorders of amino acid absorption or transport 5C60 Disorders of amino acid absorption or transport Exclusions: Disorders of tryptophan metabolism (5C50.3) Coded Elsewhere: Fanconi…
Definition of Inborn Errors Of Metabolism: Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversion of various substances (substrates) into others (products). Exclusions: Disorders of lipoprotein metabolism or certain specified lipidaemias (BlockL2‑5C8) Inborn…
Definition of Certain Specified Nutrient Excesses: Any disease caused by an excess of specific nutrients. Confirmation is by blood test. Vitamin excesses ICD 11 Code For Vitamin excesses 5B90 Vitamin excesses 5B90.0 Hypervitaminosis A Definition of Hypervitaminosis A: Because vitamin A is fat soluble and can be stored, primarily in the liver, routine consumption of…
Overweight or localised adiposity Definition of Overweight or localised adiposity: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). The BMI categories for defining overweight vary by age and gender in infants, children and adolescents….