Coding Guidelines
ICD 10 Coding Guidelines
International Classification of Diseases, Tenth Revision (ICD-10) is a system used by physicians to classify and code all diagnoses, symptoms and procedures for claims processing. It was chiefly designed by the World Health Organization, with the U.S. version being created by the Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) to better align with the country’s health care infrastructure.
ICD-10-CM diagnosis codes tell the story of each patient encounter, describe etiologies of the disease process, explain the complications of care, provide a basis for medical necessity, support coverage for payment purposes, identify incidence of disease, and support statistical tracking for healthcare practices, as well as provide disease state information on medical practices across the continuum of care. This plays an important role in determining the severity of the patient’s condition and contributes to research on treatment outcomes.
Evaluation and Management Services
Evaluation and management (E/M) services are cognitive (as opposed to procedural) services in which a physician or other qualified healthcare professional diagnoses and treats illness or injury. Nearly all physicians provide E/M services, however most services that infectious diseases physicians provide are of the E/M type. Appropriate documentation and coding of E/M services are vital to capturing the medical services provided to infectious diseases patients and therefore are also vital for appropriate reimbursement and compensation. IDSA has curated resources for ID physicians and their staff to assist in a better understanding of E/M coding.
