ICD-9 Volumes

• Coders must train and take certification testsat the office image by Pix by Marti from Fotolia.com
  
  There are three volumes of classifications. Volume One, the Tabular List of Diseases and Injuries; Volume Two, the Alphabetic Index of Diseases and Injuries; and Volume Three, the Tabular List and Alphabetic Index of Procedures, used for surgeries and inpatient procedures. Volumes One and Two are primarily used for outpatient facilities.
  
  

Classification System

• Basic codes are used to classify an injury or a disease. The codes consist of three digits and are referred to as categories. The categories are expanded by the addition of two more numbers for subcategories. A decimal separates the basic three-digit code from the subcategory. For example, a diabetic's condition that is uncontrolled (Type 3) would be coded as 250.03: insulin-dependent diabetes mellitus (250), uncontrolled (03).
  
  

Coding

• A coder first locates the primary condition in Volume Two, the Alphabetic Index of Diseases and Injuries. The coder then proceeds to look for sub-terms, which further describes the condition. Once the coder has located the code in Volume Two, the coder then must verify the code in Volume One, the Tabular List of Diseases and Injuries. The tabular list has 17 chapters, each with a range of codes. For example, neoplasms are from 140 through 239 and Mental Disorders consist of codes from 290 through 319.
  
  

Additional Codes

• Coders must sometimes read medical records to obtain the correct diagnosis.doctor visiting image by TEMISTOCLE LUCARELLI from Fotolia.com
  
  The coding process also includes V Codes (the main reason for the patient's visit), E Codes (the external causes of injuries or poisonings), and M Codes ( to identify the nature and behavior of neoplasm-cancer cells) to provide additional information related to the condition. In addition, braces, brackets and slanted squares are used to further assist the coder in choosing the appropriate code. There are also additional coding conventions and rules to assist the coder. For example, if the physician is unable to diagnose the patient, the coder may have to code the signs and symptoms. Coders must not code for a specific condition unless they have a confirmed diagnosis.
  
  

Considerations

• The ICD-9 is extremely specific in terms of coding to prevent billing errors. Physicians, hospitals, nursing homes and other medical facilities depend on the correct coding. In addition, if a coder codes incorrectly, such as coding HIV as a diagnosis when the condition is suspect but not verified, the code can possibly have an impact on the patient's insurance coverage, their job or the life.