Coding Guidelines

The National Correct Coding Initiative (NCCI) identifies national correct coding methodologies to control improper coding that would lead to inappropriate payment. The coding policies developed are based on coding conventions defined in the AMA’s CPT Manual, national and local policies and edits, coding guidelines developed by national societies, analysis of standard medical and surgical practice and review of current coding practices.

CPT/HCPCS Guidelines instructional text found in sections of the CPT and HCPCS coding books. These guidelines define items that are necessary to appropriately interpret and report on procedures and services.

An acronym for Evaluation and Management, this publication provides definitions and documentation guidelines for the three key components - history, examination, and medical decision making - of E/M services for visits which consist predominantly of counseling or coordination of care. These three key components appear in the descriptors for office and other outpatient services, hospital observation services, hospital inpatient services, consultations, emergency department services, nursing facility services, domiciliary care services, and home services.

This database houses guidelines for coding and reporting using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). They are a set of rules that have been developed to accompany and complement the official conventions and instructions provided with the ICD-9-CM itself to assist the healthcare provider and the coder in identifying those diagnoses and procedures that you can report on.

This database houses guidelines for coding using the International Classification of Diseases, 10th Revision, Procedure Coding System (PCS) which you can use to collect data and estimate payment for all inpatient procedures.

This is the official publication for ICD-9-CM coding guidelines and advice as designated by the four Cooperating Parties (AHA, AHIMA, CMS, and NCHS) and the Editorial Advisory Board. This quarterly newsletter should be an essential component of your coding education and compliance program.

The American Hospital Association Coding Clinic for HCPCS offers consistent and accurate advice for proper application of HCPCS. Regular features of AHA Coding Clinic for HCPCS include:

• An "Ask the Editor" section with actual examples drawn from our HCPCS coding advice service
• Correct code assignments for new technologies
• Articles and topics that offer practical information to improve data quality
• Bulletin of coding changes and/or corrections to health care providers

You can perform a keyword search in this database and view CMS frequently asked questions.

When you perform an advanced search in Knowledgebase for MSDRG-related criteria, you can view the MSDRG Definitions Manual as well as any subsequent Errata publications.

The AMA CPT Appendices are included in the coding manuals and provide additional coding information.