CODING WITH E-BOOKS

1. CODING WITH E-BOOKS

2. What is an e-Book? • The term "e-book" stands for "electronic book." PMIC e-Books are supplied in Adobe Acrobat PDF format. • The PDF file is created during the process of preparing the book manuscript for printing. • e-Books are exact reproductions of the original book including pagination, color coding, indexing, tables and illustrations. Advantages of e-Books • e-Books reside on your PC or MAC, can be left “open” permanently and take up no physical space like print books. • e-Books are instinctively easy to use with mouse clicks, keyboard movement keys, or tabs within the PDF documents. • e-Books include Book Marks for easy navigation to chapters or sections. • e-books are fully searchable by code, key word, or phrase. • You can use zoom options to increase type size or page width. • You can selectively print high-quality pages of the e-Book. Press the [Esc] key to exit

3. What is a “PDF” file?” • PDF is an acronym for Portable Document format. • The PDF format is well established, extremely versatile and runs on both Windows and Mac operating systems. The Acrobat Reader software needed to read PDF books is available as a free download from Adobe. • If you do not have the Adobe Acrobat Reader on your PC, click http://get.adobe.com/reader/. Opening a PDF File • PDF files have the extension .pdf or .PDF. • To open a PDF file, position your mouse pointer on the desired file and click once or twice (depending on how your mouse is set up). • Alternately you may have a desktop icon that you click to open a specific PDF file. • Large PDF files, such as e-Books may take a few seconds to open fully, depending on the speed and available memory of your PC or document server. Press the [Esc] key to exit

4. First Page of an Open e-Book When an e-Book is opened, the Title Page will appear on the right side of the screen and the Book Marks will appear on the left. Press the [Esc] key to exit

5. Using The Pre-Formatted Book Marks • PMIC e-Books include Book Marks that make it easy to navigate to specific book sections. • The Book Marks correspond to the major sections or chapters of the e-Books. • Clicking on a Book Mark will open the first page of that section. • The Book Mark panel can be closed by clicking the x in the top right corner. Expanding and Collapsing Book Marks • Some Book Marks have sub-categories and are marked by a . • Clicking on the + sign expands the Book Mark. Press the [Esc] key to exit

6. What You Click is What You Get! Clicking a Book Mark results in the first page of that section appearing on the right side of your monitor. Press the [Esc] key to exit

7. How to Search an e-Book with Find You can search a PDF file using The Find or functions. The “find” option is activated by clicking View on your toolbar, then Toolbars, then checking the Find box. This will display the Find option on the Acrobat Reader. Press the [Esc] key to exit

8. How to Search an e-Book with Search The Search option Is activated by clicking . This opens a Search window on the right side of the screen. Key in the search word, phrase, or code then click the search button. The search will begin from the current position through the end of the document, the start at the beginning back to the current location. Press the [Esc] key to exit

9. Search Results The PDF search function will find all occurrences of the search term. Click on any line in the results to go to that location in the e-Book. Press the [Esc] key to exit

10. Navigating the e-Book In addition to getting to the desired Section of an e-Book, you also need to browse and turn pages and scroll within the page. Moving from Page to Page There are four ways to move from one page to another in an e-Book. • You can use the right and left buttons and/or wheel of your mouse. • You can use the movement keys on your keyboard. • You can use the movement symbols within the PDF document. • You can also use the vertical scroll bar of your browser window. Click the left button to page back Click the right button to page forward Click the left arrow to page back Click the right arrow to page forward Press the [Esc] key to exit

11. Navigating the e-Book (continued) Scrolling within a Page There are three ways to scroll within a page of an e-Book. • You can use the wheel of your mouse. • You can use the movement keys on your keyboard. • You can also use the vertical scroll bar of your browser window. Click the up button to scroll up Click the down button to scroll down Press the [Esc] key to exit

12. Printing Pages of an e-Book To print a page/pages of an e-Book, click File on the menu bar or the Print icon. On the print control page select Current page or enter a range of pages. Make sure the Print color as black box is unchecked. Click OK to print the page(s). Note: Color coding will print in black if you are not using a color printer. Press the [Esc] key to exit

13. General Contents of PMIC e-Books • PMIC e-Books include all official codes and descriptions current as of the release of the edition. • PMIC e-Books include comprehensive coding instructions. • PMIC CPT Plus! and ICD-9-CM e-Books include unique, full-color, full page anatomical illustrations with code section cross-references. • PMIC e-Books include a standardized color-coding system that helps the coder identify codes subject to special coding rules, coverage limitations, and payment restrictions. This unique color-coding system helps users code faster and more accurately, while decreasing audit liability, claims processing errors, as well as potentially increasing revenues. Press the [Esc] key to exit

14. CPT Plus! CPT® Plus! is an enhanced, value added CPT coding reference that includes features to help users code easier, better and faster. CPT Plus! includes: • All official CPT codes with full descriptions, coding and parenthetical notes. • Comprehensive introduction covering CPT Coding Fundamentals. • Discussion of common coding and billing issues. • List of additions, deletions and revisions in the current edition. • Full-color anatomical illustrations with coding cross-references. • Instructions and Guidelines for each section of CPT. • Evaluation & Management Documentation guidelines. • Unique symbol and color-coding system to identify special coding rules. • Comprehensive Alphabetical Index. CPT® is a registered trademark of the American Medical Association (AMA). Press the [Esc] key to exit

15. Key Points Regarding the CPT Coding System • CPT codes describe medical procedures, services and supplies. • All CPT codes are five digit codes. • CPT codes are mandated by HIPAA for government and private health plans. • CPT codes are self-definitive, i.e. with the exception of CPT codes for unlisted procedures and/or the few CPT codes which include the term specify in the description, each CPT code number represents the universal definition of the service or procedure. • CPT codes are revised and updated annually by the AMA and the revisions become effective each January 1st. • Accurate CPT coding provides an efficient method of communicating medical, surgical and diagnostic services and procedures among providers, facilities, and party payers. Press the [Esc] key to exit

16. CPT Plus! Symbols •A filled BLACK CIRCLE preceding a CPT code indicates that the code is new to the CPT coding system. ▲ A filled BLACK TRIANGLE preceding a CPT code indicates that there is a revision to the description. ( ) CPT codes enclosed within parenthesis have been deleted from the CPT coding system and should no longer be used. + A bold plus sign preceding a CPT code indicates that the code is an “add-on” code and must be listed in addition to the main CPT code.  This symbol preceding a CPT code indicates that the code is exempt from the use of modifier -51.  This symbol preceding a CPT code indicates that the procedure includes conscious sedation as a part of providing the procedure and that the conscious sedation codes, 99141 or 99142, should not be reported separately. Press the [Esc] key to exit

17. CPT Plus! Color Coding Press the [Esc] key to exit

18. ICD-9-CM Coder’s Choice ICD-9-CM Coder’s Choice is an enhanced, value added ICD-9-CM coding reference that includes features to help users code easier, better and faster. ICD-9-CM Coder’s Choice includes: • All official ICD-9-CM Volume 1 (diagnosis) and Volume 3 (procedure) codes with full descriptions, along with all official tables, appendices and indexes. • Comprehensive introduction covering ICD-9-CM coding fundamentals. • Official CMS Guidelines for coding and reporting. • Present on Admission (POA) Guidelines. • List of additions, deletions and revisions in the current edition. • Full-color anatomical illustrations with coding cross-references. • 4th and 5th digit symbol alerts. • Unique symbol and color-coding system to identify special coding rules; including 3-digit codes, unspecified codes, nonspecific codes, manifestation codes, MSP alerts, primary and secondary V-codes. Press the [Esc] key to exit

19. Key Points Regarding the ICD-9-CM Coding System • ICD-9-CM includes Volume 1 diagnosis codes and Volume 3 procedures codes. • ICD-9-CM Volume 1 codes are three to five digit numeric or alphanumeric codes. • ICD-9-CM Volume 3 codes are two to four digit numeric codes. • ICD-9-CM codes are mandated by HIPAA for government and private health plans. • ICD-9-CM codes must be reported to the highest level of specificity. • ICD-9-CM codes are self-definitive, i.e. with the exception of codes for unlisted diagnosis, each ICD-9-CM code number represents the universal definition of the diagnosis or procedure. • ICD-9-CM codes are revised and updated annually by CMS and NCHS and the revisions become effective each October1st. • Accurate ICD-9-CM coding provides an efficient method of communicating diagnostic and procedure information among providers, facilities, and party payers. Press the [Esc] key to exit

20. ICD-9-CM Conventions The ICD-9-CM Tabular List (Volume 1) makes use of abbreviations, punctuation, symbols, and other conventions that must be clearly understood. The purpose of these conventions is to provide special coding instructions and to conserve space. Abbreviations NOS Not Otherwise Specified. Equivalent to Unspecified. This abbreviation refers to a lack of sufficient detail in the statement of diagnosis to be able to assign it to a more specific sub division within the classification. NEC Not Elsewhere Classified. Used with ill-defined terms to alert the coder that a specified form of the condition is classified differently. The category number for the term including NEC is to be used only when the coder lacks the information necessary to code the term to a more specific category. Press the [Esc] key to exit

21. ICD-9-CM Coding Conventions (continued) Punctuation ( ) PARENTHESES are used to enclose supplementary words that may be present or absent in a statement of disease without affecting the code assignment. [ ] SQUARE BRACKETS are used to enclose synonyms, alternate wordings or explanatory phrases. : COLONS are used after an incomplete phrase or term that requires one or more of the modifiers indented under it to make it assignable to a given category. EXCEPTION to this rule pertains to the abbreviation NOS. Symbols • A filled BLACK CIRCLE preceding a code indicates that the code is new to this revision of ICD-9-CM. A symbol key appears on all left-hand pages of the Tabular List, Volume 1 and Volume 3. ▲ A filled BLACK TRIANGLE preceding a code indicates that there is a revision to the text of an existing code.  A circle containing the number 4 or 5 preceding a code indicates that a fourth or fifth digit is required for coding to the highest level of specificity. Press the [Esc] key to exit

22. ICD-9-CM Coding Conventions (continued) Other conventions Type Face: • BOLD: Bold type face is used for all codes and titles in the Tabular List. • Italics: Italicized type face is used for all exclusion notes and to identify those rubrics that are not to be used for primary tabulations of disease. Format: ICD-9-CM uses an indented format for ease in reference. Instructional Notations Instructional terms define what is, or what is not, included in a given subdivision. This is accomplished by using both inclusion and exclusion terms. • INCLUDES: Indicates separate terms, such as, modifying adjectives, sites and conditions, entered under a subdivision, such as a category, to further define or give examples of, the content of the category. • Excludes: Exclusion terms are enclosed in a box and are printed in italics to draw attention to their presence. The importance of this instructional term is its use as a guideline to direct the coder to the proper code assignment. In other words, all terms following the word EXCLUDES: are to be coded elsewhere as indicated in each instance. Press the [Esc] key to exit

23. ICD-9-CM Coding Conventions (continued) Instructional Notations (continued) • NOTES These are used to define terms and give coding instructions. Often used to list the fifth-digit subclassifications for certain categories. • SEE The “see” instruction following a main term in the index indicates that another term should be referenced. It is necessary to go to the main term referenced with the “see” note to locate the correct code. • SEE CATEGORY A variation of the instructional term SEE. This refers the coder to a specific category. You must always follow this instructional term. • SEE ALSO A “see also” instruction following a main term in the index instructs that there is another main term that may also be referenced that may provide additional index entries that may be useful. It is not necessary to follow the “see also” note when the original main term provides the necessary code. • CODE FIRST This instructional note is used for those codes not intended to be used as a principal diagnosis, or not to be sequenced before the underlying disease. The note requires that the underlying disease (etiology) be coded first with the code the note is applied to being coded second. This note appears only in the Tabular List (Vol. 1). Press the [Esc] key to exit

24. ICD-9-CM Coding Conventions (continued) • USE ADDITIONAL CODE This instruction is placed in the Tabular List in those categories where the coder may wish to add further information, by using an additional code, to give a more complete picture of the diagnosis or procedure. Related terms • AND The word “and” should be interpreted to mean either “and” or “or” when it appears in a title. • WITH The word “with” in the alphabetic index is sequenced immediately following the main term, not in alphabetical order. Press the [Esc] key to exit

25. ICD-9-CM Color Coding (Volume 1) Press the [Esc] key to exit

26. ICD-9-CM Color Coding (Volume 3) Press the [Esc] key to exit

27. HCPCS Coder’s Choice HCPCS Coder’s Choice is an enhanced, value added HCPCS coding reference that includes features to help users code easier, better and faster. HCPCS Coder’s Choice includes: • All official HCPCS codes with full descriptions, along with all official tables, appendices and indexes. • Comprehensive introduction covering HCPCS coding fundamentals. • List of additions, deletions and revisions in the current edition. • Unique symbol and color-coding system to identify special coding rules; including 3-digit codes, unspecified codes, nonspecific codes, manifestation codes, MSP alerts, primary and secondary V-codes. Press the [Esc] key to exit

28. Key Points Regarding the HCPCS Coding System • HCPCS codes describe supplies, materials, injections and procedures provided by medical professionals. • HCPCS codes are five-digit, alphanumeric codes. The first digit is a letter between A and Z, and the second through fifth digits are numbers. • The HCPCS coding system is a two-level system consisting of CPT Level I and HCPCS Level II national codes. HCPCS codes follow a specific hierarchy of selection and use. HCPCS National Level II takes precedence over HCPCS Level I (CPT). • HCPCS codes are mandated by HIPAA for government and private health plans. • HCPCS codes are self-definitive, i.e. each HCPCS code number represents the universal definition of the supply, injection or procedure. • HCPCS codes are revised and updated annually by CMS and the revisions become effective each January 1st. • Accurate HCPCS coding provides an efficient method of communicating supply, material, injection and procedure information among providers, facilities, and party payers. Press the [Esc] key to exit

29. HCPCS Color Coding Press the [Esc] key to exit

30. HCPCS Color Coding (Continued) Press the [Esc] key to exit

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