About the Editor and Authors

v

Acknowledgments

ix

Note to Educators

xi

Foreword

xiii

Chapter 1

Introduction   Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA

1

PART I

TERMINOLOGIES AND CLASSIFICATIONS COMMONLY USED FOR ADMINISTRATIVE AND STATISTICAL REPORTING

11

Chapter 2

International Classification of Diseases (ICD) and the U.S. Modifications   Ann Zeisset, RHIT, CCS, CCS-P

13

Chapter 3

Current Procedural Terminology (CPT®)   Ann Zeisset, RHIT, CCS, CCS-P

49

Chapter 4

Healthcare Common Procedure Coding System (HCPCS)   Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA

67

Chapter 5

National Drug Codes (NDCs)   Danielle Przychodzin, PharmD, RPh

81

Chapter 6

Current Dental Terminology (CDT)   Karen Kostick, RHIT, CCS, CCS-P

91

PART II

OTHER VOCABULARY, TERMINOLOGY, AND CLASSIFICATION SYSTEMS

103

Chapter 7

Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®)   Margaret M. Foley, PhD, RHIA, CCS

105

Chapter 8

MEDCIN®   Margaret M. Foley, PhD, RHIA, CCS

127

Chapter 9

Diagnostic and Statistical Manual of Mental Disorders (DSM)   Karen Kostick, RHIT, CCS, CCS-P

137

Chapter 10

Logical Observation Identifiers, Names, and Codes (LOINC®)   Daniel Vreeman, PT, DPT, MSc

151

Chapter 11

Drug Terminology Systems   Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA

165

Chapter 12

Terminologies Used in Nursing Practice   Judith J. Warren, PhD, RN, BC, FAAN, FACMI

185

Chapter 13

Derived and Related International Classifications   Ann Zeisset, RHIT, CCS, CCS-P and Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA

201

Chapter 14

Other Vocabulary, Terminology, and Classification Systems   Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA and Ann Zeisset, RHIT, CCS, CCS-P

215

PART III

DATA STANDARDS FOR HEALTHCARE

249

Chapter 15

Data Set Standards   Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA and Judith J. Warren, PhD, RN, BC, FAAN, FACMI

251

Chapter 16

Data Interchange Standards   Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA and Judith J. Warren, PhD, RN, BC FAAN, FACMI

269

PART IV

APPLICATION OF VOCABULARY, TERMINOLOGY, AND CLASSIFICATION SYSTEMS IN HEALTHCARE

285

Chapter 17

Database of Vocabulary, Terminology, and Classification Systems   Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA

287

Chapter 18

Use of Vocabulary, Terminology, and Classification Systems   Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA

295

Appendix A

Answer Key for “Check Your Understanding” Exercises

305

Appendix B

Glossary

313

Index

325