Medical Coding and Classification Flashcards
6 cards from real AHIMA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Medical Coding and Classification flashcards as text
What is ICD-10-CM?
Answer: The International Classification of Diseases, 10th Revision, Clinical Modification — used for diagnostic coding
ICD-10-CM provides standardized codes for diagnoses and conditions, used for billing, research, and health statistics in the United States.
What is CPT coding?
Answer: Current Procedural Terminology — standardized codes for medical procedures and services
CPT codes, maintained by the AMA, describe medical, surgical, and diagnostic procedures for billing and reporting purposes.
What is the purpose of medical coding?
Answer: To translate diagnoses, procedures, and services into universal alphanumeric codes for billing and data analysis
Medical coding converts clinical documentation into standardized codes that support billing, research, public health monitoring, and quality measurement.
What is a DRG (Diagnosis-Related Group)?
Answer: A patient classification system that groups similar clinical conditions for hospital payment purposes
DRGs classify hospital inpatients into groups based on diagnosis, procedures, age, and complications, determining the hospital's Medicare payment for each case.
What is HCPCS?
Answer: Healthcare Common Procedure Coding System — codes for services, equipment, and supplies not in CPT
HCPCS codes cover items and services not included in CPT, such as durable medical equipment, prosthetics, ambulance services, and certain drugs.
What is the role of a clinical documentation improvement (CDI) specialist?
Answer: To work with physicians to improve documentation accuracy and completeness for proper coding
CDI specialists review medical records and collaborate with providers to ensure documentation accurately reflects patient acuity, supporting appropriate coding and reimbursement.