Spelling,Chapter 18

Spelling,Chapter 18 - Term Definition ABSTRACT An outline...

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Term: ABSTRACT Definition: An outline or summary of the diagnostic statement and/or procedures and services performed. Term: ALPHABETIC INDEX Definition: Volume 2 of the ICD-9-CD coding manual; it lists conditions, injuries, illnesses and diseases in alphabetical order by main terms, modifying terms and sub terms. Term: ANCILLARY DIAGNOSTIC SERVICES Definition: Services that support patient diagnosis (e.g., labs or radiology services) Term: AND Definition: In the context of the ICD-9-CM, "and" should be interpreted as and/or
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Term: ASSESSMENT Definition: The physicians determination of what is or may be wrong with the patient based on the findings from the H & P. The assessment includes a preliminary, interim, or final diagnoses. Term: CHIEF COMPLAINT (CC) Definition: The reason the patient has sought medical care. It is recorded in the history documentation in the medical record, preceded by the abbreviation CC. Term: CODE ALSO Definition: Used when more than one code is necessary to identify a given condition:code also or use additional code is used Term: CODING Definition: Converting verbal or written descriptions into numeric and alphanumeric designations
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Term: CONVENTIONS Definition: Abbreviations, punctuation, symbols, instructional notations, and related entities that provide guidance to the medical assistant or coder in the
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