CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example
The World Health Organization (WHO) developed the International Classification of Diseases to help in having a standardized diagnosis classification system across the entire world. As such, ICD-10-CM is the Clinical Modification that the Centers for Diseases Control and Prevention adopted by the National Center for Health Statistics for utilization in the US(Manchikanti et al., 2015). Healthcare providers, including psychiatric and mental health specialists, need to record diagnostic codes or codes on health insurance claims or other third-party reimbursements (Kuo & Manaker, 2019).(CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example)
As the provider attending to patient Liam, I had to consider the four levels of medical decision-making (MDM) during the patient encounter and appropriately establish how each condition diagnosed had to be addressed. The MDM levels are straightforward (99202 and 99212), Low (99203 and 99213), moderate (99204 and 99214), and (99205 and 99205). Liam is a new patient encounter, so he gets ICD-10 –CM diagnosis code Z01.89. The next step is to use Chapter 5 on Mental, Behavioral, and Neurodevelopmental Disorders, where each of the codes begins with F. The patient presented with significant symptoms classified as anxiety F41.1 for generalized anxiety disorder, whose confirmation arises from the prominent feelings of apprehension, worry, tension, and autonomic arousal symptoms like sweating and heart palpitations. Secondly, Depression was assigned F32. 9 unspecified types (Abubakar et al., 2021). I opted for this ICD -10 diagnostic code because the depressive symptoms, while causing the patient problems with school work and relationships with others, do not meet the full criteria of the other conditions in the depression spectrum. The provider uses the unspecified category when there is insufficient information to make another diagnosis because this was a new patient. Social anxiety F40.11 social phobia, generalized. The patient displays persistent and intense fear and anxiety in specific social situations, like meeting his college mates in groups. Other symptoms related to the patient’s brain and mind functioning are feeling depersonalized and fear of losing control. These symptoms presented as ruminations.(CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example)
Health insurance claims are paid based on the CPT code the provider submits to the payer. The three assigned diagnostic codes support the medical necessity of the services offered. The coding and subsequent medical reimbursement are significant in the healthcare delivery process because they entail transforming billable medical care offered to a client /patient into medical reimbursement codes that health insurance payers can pay each claim accurately.(CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example)
To sum up, the provider must record the diagnostic code on the health insurance claim on electronic and paper claims for services rendered from 2015 onwards. The provider must remember that the change to ICD-10-CM had no impact on procedure coding envisaged by Current Procedural Terminology for both office and outpatient services.(CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example)
References
Abubakar, A. R., Sani, I. H., Malami, S., Yaro, A. H., Jahan, I., Adnan, N., … & Haque, M. (2021). Anxiety Disorders: Recent Global Approach to Neuro-pathogenesis, Drug Treatment, Cognitive Behavioral Therapy, and Their Implications. Bangladesh Journal of Medical Science, 20(3), 487-503.(CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example)
Kuo, T. Y., & Manaker, S. (2019). Reimbursement Strategies and CPT Codes for Device Development. Academic Entrepreneurship for Medical and Health Scientists, 1(3), 9.(CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example)
Malykh, V. L., & Rudetskiy, S. V. (2018). Approaches to medical decision-making based on big clinical data. Journal of healthcare engineering, 2018.(CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example)
Manchikanti, L., Kaye, A. D., Singh, V., & Boswell, M. V. (2015). The tragedy of the implementation of ICD-10-CM as ICD-10: is the cart before the horse or is there a tragic paradox of misinformation and ignorance. Pain physician, 18(4), E485-E495.(CPT E and M Code and ICD-10 Diagnosis Code Comprehensive Nursing Essay Example)
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