4. Assign a CPT anesthesia code for total hip replacement, open procedure. Added 5/10/2022 12:43:23 PM The CPT coding system describes how to report procedures or services. , eyes, shoulder joints, breasts). Health Care Common Procedure Coding System (HCPCS) CPT-Current Procedure Terminology. Holly_Caldwell8. 11042—11047 Use these codes when the only procedure performed in wound debridement. CPT® Editorial Panel Ensures that CPT codes remain up to date and reflect the latest medical care provided to patients. The CPT coding system was developed by the AMA (American Medical Association), consists of five-digit codes, and may be numeric or alphanumeric. Quiz & Worksheet Goals. Weegy: TRICARE is a regionally managed healthcare program for active duty and returned members of the. 01952. A Healthcare Common Procedure Coding System/Current Procedural Terminology (HCPCS/CPT ) code shall be reported only if all services described by the code are performed. CPT coding system. The. The transition to ICD-10-CM/PCS code sets will take effect on October 1, 2015 and all users will transition to the new code sets on the same date. Correct: False Rationale. Recognize how and where CPT is used in the health care ecosystem. Appendix A. From: Genomic and Personalized Medicine (Second. combine sums from different depths. ”Inpatient Procedure Coding Inpatient Reimbursement ICD-10-PCS Description THERAPEUTIC PROCEDURES 0F7–––– Dilation, hepatobiliary system and pancreas (CPT 47538, 47539, and 47542) 0F9 –––– Drainage, hepatobiliary system and pancreas (CPT 47538, 47539, and 47542)If the code descriptor of a CPT code from the respiratory system (or any other system) includes a tissue transfer service (e. Healthcare Common Procedure Coding System (HCPCS) is used for: identifying products, supplies, and services not included in the CPT codes. 17 terms. , CPT code 40490 Biopsy of lip Footnote 7), and those procedures or services classified in the nervous system subsection will have a code assignment that begins with the number 6. Per CR 9749: Please use CPT G0498: Chemo extend IV infusion with pump: this is the single serviceI confidently assign required Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), Tenth Revision, International Classification of Diseases, Clinical Modification (ICD-10-CM), and American Society of Anesthesiologists (ASA) codes. HCPCS fna HCFA. Allowing physicians to choose the best patient care by permitting code level selection based on medical decision-making. WHO Member states began using the ICD-10 classification system from 1994 for both morbidity and mortality reporting. Study with Quizlet and memorize flashcards containing terms like A CPT modifier is a(n) ____ digit modifier appended to a CPT code to indicate that a service or procedure has been altered. In any healthcare. This change does not impact CPT coding for physician and hospital outpatient services. HCPCS codes are alphanumeric and are divided into two levels primary levels and a third locally used level: Level I: These are also known as CPT-4 and are used for reporting services and procedures performed by physicians. This symbol means the code identifies the code as being an add-on code. In the year 2000, the CPT system was officially named the coding standard for all United States health care . A. The ultimate responsibility for correct coding lies with the provider of services. The CPT coding system is used by all of the following EXCEPT ___________? a) doctors offices and clinics. Introduction to Billing Code Systems. Added 106 days ago|7/8/2022 12:47:54 AM CPT code is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, [ health insurance companies and accreditation organizations. Delete codes 49652–49657, which describe laparoscopic repair of anterior abdominal hernias. Appendix B. Physician Coding and Payment Tables 2A -E describe applicable coding guidance for procedures when performed with the Axonics System. 0. 2 workload reporting functionality. When setting fees for an unlisted procedure or service, compare the procedure or service performed with a “listed” procedure/service that requires similar provider work, resources, patient risk, etc. Code range 70010- 79999. Radical vaginal hysterectomy. CPT code information is copyright by the AMA. 00834-P1. Instructions: Assign ICD and CPT codes for this case. Unit K Meds. 26. An established patient is seen in the clinic office complaining of severe headaches. (99217–99220) Hospital observation services. the ICD-10 codes become the standard for the U. Diagnosis based d. What procedure is used to decompress the renal system by means of inserting a catheter into the kidney while leaving the other end of the catheter outside the. federal government since. The technology has been billed as everything from the savior of coding-based bottom lines due to ICD-10-CM/PCS (ICD-10) to the automated destroyer of human coding jobs. Chapter 17 medical office codes. (Hint, they start with the letter U and the letter F. Review procedure or service listed on source document. 1. Preview. urinary elimination (funds exam 4). They are divided into six sections: Evaluation and Management, Anesthesia, Surgery, Radiology, Pathology and Laboratory, and Medicine. Place of Service Codes are two-digit codes placed on health care professional claims to indicate the setting in which a service was provided. In which of the following sentences is a semicolon used correctly? A. revised during 2021 but do not appear in the AMA's CPT code book until 2023 are identified in appendix B as “Web. Score 1 User: A summary of all payments, charges, and adjustments Original conversation. com - Coding Forum Q&A CPT Codes DRGs & APCs DRG Grouper E/M Guidelines HCPCS Codes HCC Coding, Risk Adjustment ICD-10-CM Diagnosis Codes ICD-10-PCS Procedure Codes Medicare Guidelines NCCI Edits. Help with File Formats and Plug-Ins. 1136/neurintsurg-2014-011156 Abstract In 1966, The American Medical Association (AMA) working with multiple major medical specialty societies. Added 342 days ago|3/20/2022 8:18:47 PM Healthcare Common Procedure Coding System (HCPCS) is used for: identifying products, supplies, and services not included in the CPT codes. ICD-10-CM Official Guidelines for Coding and Reporting FY 2020 (October 1, 2019 - September 30, 2020) Narrative changes appear in bold text . Read the introduction of the CPT manual. 99040 C. The output of the healthcare coding software workflow is coded records, including the CPT codes and ICD-10 codes needed to file a complete claim, such as code linkage, patient demographics, modifiers and units. R10. As the technology moves from “up-and-coming” to “must-have” in the industry, many are looking for hard answers on how CAC will help, or hurt, their facility. The Current Procedural Terminology (CPT) code range for Radiology Procedures 70010-79999 is a medical code set maintained by the American Medical Association. lists all modifiers that are used to alter or modify codes. Preview. ICD-10-CM/PCS D As of October 1, 2015, the coding system used to code diagnoses in any healthcare setting is: rev: 02_27_2015_QC_CS-9167 A. clinical examples of many of the Evaluation and Management (E/M). ICD-10-PCS codes are recorded in FL 74a-e to describe significant procedures performed during an inpatient stay. Modifier -59 is added to the 12002 code because it is a distinct procedural service. CPT codes were developed as a uniform coding system to help providers, such as. The CPT coding system is: a. The codes identify: procedures performed. Each APC comprises services similar in clinical intensity, resource utilization and cost. 82 payment for APC 5051 for year 2016 (for the "average US hospital)". For URIs specified here for code systems defined as part of FHIR, they SHALL be used in preference to any other identifying mechanisms. 728= $117. Log in for more information. 64 RVUs. 3. For more than 5 decades, physicians and other health care professionals have relied on CPT to communicate with colleagues, patients, hospitals and insurers about the procedures. Log in for more information. Log in for more information. Procedures may vary based on the patient condition and documentation. All diagnosis and procedure codes must be supported by clear documentation within the medical record. This answer has been confirmed as correct and helpful. This provides easy access to the data you need — without the need to sift through irrelevant data. CPT is considered level I of the Healthcare Common Procedure Coding System (HCPCS). The coding system used in illustrating the tangible items such as supplies is: A. CPT D. the patient develops an itchy rash with pinkish, raised lesions. Acute cystitis with hematuria . Diagnosis based d. Added 364 days ago|5/10/2022 12:43:23 PM The CPT coding system was developed by the AMA (American Medical Association), consists of five-digit codes, and may be numeric or alphanumeric. Merit-based Incentive Payment System. Modifier 59 is typically used to override National Correct Coding Initiative (NCCI) Edits. CPT ® codes. The CPT coding system is: a. services related to office visits and hospital observation codes are coded from what section. Chief complaint based b. Surgery. Slide 1. 2. Several general guidelines are repeated in this Chapter. Effective July 1, 2023, CMS implemented NCCI PTP edits between Column One codes 80305, 80306, and 80307 for presumptive test (s), and Column Two codes G0480 – G0483, and G0659 for definitive test (s). CPT CODE(S): (1) 78452-26, (2) 93016 (3) 93018 14. g. CMS Manual System Department of Health & Human Services (DHHS) Pub. 00702. ”. In the 2020 CPT ® book, CPT deleted code 99444, which was defined as an online E/M service by a physician or other qualified health care professional. 0 Answers/Comments. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the health care industry. CPT codes are used for billing, data analysis, and insurance coverage and payment. CPT. WINDOWPANE is the live-streaming app for sharing your life as it happens, without filters, editing, or anything fake. WINDOWPANE is the live-streaming app for sharing your life as it happens,. Added 7/4/2020 7:38:17 PM Transcript. )Anesthesia (00100-01999, 99100-99150)Used to report the administration of anesthetic usually during surgery by an anesthesiologist, anesthetist, or other physician. 19. They are divided into six sections: Evaluation and Management, Anesthesia, Surgery, Radiology, Pathology and Laboratory, and Medicine. This symbol is used to indicate a reinstated or recycled category 111 code. Joe watered the garden; however, the plants did not grow. Within each guide, you’ll find easy-to-follow explanations, examples, coding tips, and exercises designed to reinforce. Hollow circle ⭕️. The CPT coding system CPT codes are used to describe tests, surgeries, evaluations, and any other medical procedure performed by a healthcare provider on a patient. exp: 22210 Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical. Healthcare Common Procedure Coding System (HCPCS) is used for Weegy: Healthcare Common Procedure Coding System (HCPCS) is used for facilitating the processing of health insurance claims by. 20 terms. •For example, in the course of performing fiberoptic colonoscopy (code 45378), a physician performs a biopsy (code 45380) and removes a polyp by snare (45385). The first CPT was published in this year. CPT Codes for Evaluation and Management: 99201–99499. Diagnosis Coding For diagnosis coding, use ICD-10-CM code range of O00-O9A with sequencing priority over codes from other categories. ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 – UPDATED January 1, 2021 (October 1, 2020 - September 30, 2021) Narrative changes appear in bold textAmerican Medical Association. For instance, “Congenital cataract” is listed under “Cataract. Expert Help. M. Diagnosis based d. The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. As the full description implies through its location in the CPT manual and the description, the removal of internally indwelling stent reported with this code would require the use of a snare or capture to directly grasp and remove the stent without the use of a. Chief complaint based b. Biventricular (heart) failure NOS. Score 1 User: A summary of all payments, charges, and adjustmentsThe CPT coding system consists of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. In 1966, The American Medical Association (AMA) working with multiple major medical specialty societies developed an iterative coding system for describing medical procedures and services using uniform language, the Current Procedural Terminology (CPT) system. Study with Quizlet and memorize flashcards containing terms like CPT/ HCPCS, American Medical Association (AMA), HIPAA and more. classifies dental procedures and services. This answer has been confirmed as correct and helpful. Current Procedural Terminology. 09/06/2023 04:51 PM. HCPCS level II is an alpha-numeric standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician’s office. ICD: 427. Access quick references from CMS and medical and trade associations View in-depth webcasts for and by medical professionals. Locate main term in the CPT index. Preview. A)was developed by the AAMA B)consists of five-digit codes C)consists of three- to five-digit codes D)consists of alphanumeric codes. CPT codes are issued and maintained by the American Medical Association (AMA) *** “ICD-10 is the 10th revision of the World Health Organization’s International Classification of Diseases (ICD) coding system. Preview. What does this symbol mean? Add on code. 3. The Current Procedural Terminology (CPT ®) code 27280 as maintained by American Medical Association, is a medical procedural code under the range - Arthrodesis Procedures. CPT Codes. Name 3 of the 7 components that make up E and M codes. 4-) trigonitis (N30. History of Current Procedural Terminology coding development. and the base endoscopy (the parent code). 25 terms. ICD-10-CM. 5 The AMA continues to recognize the importance of maintaining an updated and relevant CPT coding system and does so through resolutions in its House of Delegates, active physician involvement in systematic review of existing codes,. Preview. 3-) N30. Modifiers may only be submitted with anesthesia procedure codes (i. Study with Quizlet and memorize flashcards containing terms like True or false? CPT is a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. User: A summary of all payments, charges, and adjustments. Standards Status: Trial Use. User: The CPT code for posting Mr. Four levels of medical decision. The code requires and includes performing a complete cystoscopy. CPT Codes: 99213 (physician), 70460-26 (radiologist) 36. Bowden’s medical records utilizes EMR system. g. The CPT coding system consists of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. Score 1 User: Ultrasound would be coded from where The CPT coding system was developed by the AMA (American Medical Association), consists of five-digit codes, and may be numeric or alphanumeric. federal. f. The software enhancement provides the ability to transmit CPT codes and modifiers to the Patient Care Encounter (PCE) workload reporting. PMID: 24589819 DOI: 10. Shunt, Spinal CSF Procedures. There are three columns in the guidelines. For example, HCPCS provides codes. Log in for more information. 9/6/2023 11:16:03 PM| 5 Answers. 8. Use the actual value of the code 45385 plus the difference between 45380. docx - SIM Chart 70 Quiz 1. 9 CPT Evaluation and Management. Cost based c. Radiology 70010-79999. With Codify by AAPC cross-reference tools, you can check common code pairings. Bowden's payment is : A. Current Procedural Terminology Coding Quiz. a) revise technologic advances. Identify the key CPT components. Think time first. Healthcare Common Procedure Coding System (HCPCS) is used for: identifying products, supplies, and services not included in the CPT codes. Fetal contraction stress tests, antepartum. Today, each CPT code is five digits long and corresponds to nearly any healthcare service that can be billed for [5,8]. Study with Quizlet and memorize flashcards containing terms like 1. diagnosis or diagnoses. 8 Tabular List. Category I CPT Codes. 19 Step-By-Step A&P Digestive System. The initial purpose of the system was to help standardize terminology among physicians. Log in for more information. services related to office visits. 2. To diagnose and treat the patient, the physician needs to identify a cause for these headaches. Log in for more information. Chapter 19 Digestive System CPT Coding. Expert answered| Janet17 |Points 51030|. Log in for more information. To increase efficiencies with intake. 7. The principles of correct coding discussed in Chapter I apply to the Current Procedural Terminology (CPT) codes in the range 40000-49999. 6. See Tables 9-1, 9-2, and 9-3 for the specific CPT codes for small intestine pouch endoscopy, proctosigmoidoscopy, sigmoidoscopy (rigid, flexible) and colonoscopy. This modifier indicates that a procedure had been performed by another physician on the same day and was repeated by a different physician. As defined by the American Medical Association Current Procedural Terminology (American Medical Association, Chicago, IL), Mohs Micrographic Surgery (MMS) is a technique for the removal of complex or ill-defined skin. The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) was developed by the National Center for Health Statistics (NCHS) to classify inpatient procedures and services, and it was implemented on October 1, 2015 (replacing Volume 3 of ICD-9-CM). 211. The CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and. Weegy: The Dutch settle in New Netherlands because: They wanted to get rich from the fur trade. This module is the first in a series of reimbursement-related topics. Surgery 10021-69990. Current Procedural Terminology (CPT ®) is a listing of descriptive terms and identifying codes for reporting medical, surgical and diagnostic services and procedures. Sammy, a 5-year-old male, tumbled down the stairs at daycare, striking and fracturing his coccygeal bone. l. Codes include local, regional, and general anesthesia. , and reference this procedure/service in your special report (above). A CPT code cannot represent an experimental or investigational procedure and the procedure. 3. For 2023–2026, the co-insurance is 15%. 3. A code of 12034 is used for the intermediate repair of lacerations to the leg and arm totaling 8. on Sally Jones and did not. HCPCS LEVEL II. G codes are used to identify: A. Weegy: The CPT coding system consists of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. 41 terms. The current code set, CPT IV, forms the basis of reporting most of the. Added 158 days ago|6/10/2023 9:50:00 PM weeks after delivery. Myth or fact? The number of vital signs recorded affects billing. TTT Set 1 (1/2) 14 terms. G codes are used to identify D. LOINC. The CPT coding system classifies more than 8000 medical services and procedures. 28445. Using the right workload system leads to employee success. None of the above D. . Weegy: TRICARE is a regionally managed healthcare program for active duty and returned members of the armed forces, their families, and survivors. Weegy. C. CPT. 4. 6. Example: Tabular List. the CPT 4 coding system consist of 3-5 digit codes or 5 digit codes. Code Systems. You can also assign Ambulatory Payment Classifications (APC) or. Two Healthcare Common Procedural Coding System (HCPCS) codes (G0105 and G0121) were developed by the Centers for Medicare and Medicaid Services (CMS) to differentiate. Log in for more information. Study with Quizlet and memorize flashcards containing terms like Diagnosis: Acute bronchial asthma A child was brought to the emergency department (ED) in distress, having significant difficulty breathing. is used to code and classify procedure data from hospital inpatient records only. Study with Quizlet and memorize flashcards containing terms like CPT/ HCPCS, American Medical. Score 1 User: A summary of all payments, charges, and adjustments The CPT coding system consists of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. Comparing ICD-9-CM and ICD-10-PCS: Repair Laparoscopic repair of right direct inguinal hernia. 40720. CPT: 33215-58. Weegy: If a number is a whole number, then it cannot be an irrational number. weegy. 598 X $73. This operation would be reported as: 15734, 15734-59, 49565 (hernia repair), 49568 (insertion of mesh). When reporting CPT codes, some services are considered integral to the standard of. The following names (URIs) may be used in the system element of the Coding datatype. 1983. The CPT coding system CPT codes are used to describe tests, surgeries, evaluations, and any other medical procedure performed by a healthcare provider on a patient. The way the ICD. Medicare Regulation Excerpts: PUB. g. Surgical Procedures on the Cardiovascular System. HCPCS Code Range V5120-V5267. , Whenever a permanent code is established by the HCPCS National Panel to replace a temporary code, the temporary. The Healthcare Common Procedure Coding System (HCPCS) is a standardized coding system used to identify particular items and services on claims submitted to Medicare, Medicaid, and other health insurance programs in a consistent and orderly manner under the Health Insurance Portability and Accountability Act and implementing regulations. This symbol designated CPT codes that cannot be assigned a -51 modifier (multiple procedures) Lightning bolt ⚡️. HCPCS. Added 287 days ago|7/8/2022 12:47:54 AMThe CPT coding system was developed by the AMA (American Medical Association), consists of five-digit codes, and may be numeric or alphanumeric. Weegy: Joint Information System (JIS) develops, recommends, and executes public. 2 (routine postpartum follow-up). Log in for more information. Log in for more information. 00000-09999 – Anesthesia Services 10000-19999 – Integumentary System 20000-29999 – Musculoskeletal System 30000-39999 – Respiratory, Cardiovascular, Hemic, and Lymphatic System 40000. Added 3/20/2022 8:18:47 PM Healthcare Common Procedure Coding System (HCPCS) is used for: identifying products, supplies, and services not included in the CPT codes. Study with Quizlet and memorize flashcards containing terms like acquires working knowledge of coding systems (CPT, HCPCS level II, ICD-9CM, ICD-10-CM, ICD-10-PCS), coding conventions and guidelines, government regulations, and third party payer requirements to ensure that all diagnoses (conditions), services (office visits), and. Question. The COC exam contains 100 multiple-choice questions (proctored). 15 terms. II. $1. *Of note, within the CPT definition of a Comprehensive history is the description: "chief complaint; extended history of present illness; review of systems which is directly related to the problem(s) identified in the history of the present illness plus a review of all additional. The far right. Dr. Preview. , for upgrade to dual chamber system) (List separately in addition to code for primary procedure) Pacemaker to ICD/CRT-D upgrade procedures CPT®¹ Code DescriptionCPT codes implementation schedule. This answer has been confirmed as correct and helpful. The changes to CPT codes ranging from 99201-99215 are proposed for adoption by the Centers for Medicare and Medicaid Services on Jan. Weegy: You need to include explanation of this evidence to show readers your line of thinking. , semicolon, the indent, “separate procedure,” cross-references, etc. Code change instructions. A coder is required to have a working knowledge of the CPT, HCPCS Level II, ICD-10-CM, and _____ coding systems. c) convert medical descriptions into 5 digit codes. Users can select a previous quarter going back six years and the application will display only the code set data for that period. com for Chiropractors CMS 1500 Claim Form Code-A-Note - Computer Assisted Coding Codapedia. Updated 7/4/2020 7:38:17 PM. CPT ® Code Set. Anesthesiology 00100-01999, 99100-99140. 4. Correct Coding: 93000-77. The modifier that should be reported is ____________________. 12. ADVERTISEMENT. Surgical CPT Coding, Part 1. b) simplify the CMS-1500 form. Its a 5 digit numeric code,Surgical modifier 50 Bilateral procedure describes procedures/services that occur on identical, opposing structures (e. UnitedHealthcare will reimburse for critical care add-on services (code +99292) in the following situations:CPT Code: _____ Click the card to flip 👆. mallory_pitt0829. Healthcare Common Procedure Coding System. The CPT code 51700 (Bladder irrigation, simple, lavage and/or. The CPT® Editorial Panel is responsible for maintaining the CPT code set. Log in for more information. 2021 CPT Coding - Chapter 16. classifies services not included in the CPT manual to describe the alternative medical service, supply, or therapy provided. User: The cpt coding system Weegy: CPT codes are used to describe tests, surgeries, evaluations, and any other medical procedure performed by a healthcare provider on a patient. The AMA has several resources to help you accurately bill procedures and services with the Current Procedural Terminology (CPT) code set and Healthcare Common Procedure Coding System (HCPCS. Added 123 days ago|9/25/2022 1:59:42 AM The CPT coding system was developed by the AMA (American Medical Association), consists of five-digit codes, and may be numeric or alphanumeric. com The CPT coding system? A)was developed by the AAMA B)consists of five-digit codes C)consists of three- to five-digit codes D)consists of alphanumeric codes The CPT coding system was developed by the AMA (American Medical Association), consists of five-digit codes, and may be numeric or alphanumeric. The 1994 CPT code set added only two codes for laparoscopic hernia repair (49650 and 49651). Use CPT II code 0503F (postpartum care visit) and ICD-10 diagnosis code Z39. The American Medical Association (AMA) developed a coding system in 1966 to standardize identification of medical services. CPT ® and added three new time-based codes for online evaluation and treatment, for use by clinicians who have E/M in their scope of practice, and three codes for use by clinicians who do not. . (99241–99255) Consultations. Indicate the simple subjects and simple predicates of the following sentences. For example, some payers may choose to use CPT 97150 (therapeutic procedure[s], group, 2 or more individuals), and others may opt for CPT code 92508 (treatment of speech, language, voice,. With 10,969 codes that describe the medical procedures and services available to patients, the CPT code set continues to grow and evolve with the rapid pace of innovation in medical science and. However, those general guidelines from Chapter I not. yaneli799. 2. code is eligible for payment, but the Column Two code is denied unless a clinically appropriate NCCI PTP-associated modifier is also reported. When reporting these codes, rupture is defined in the CPT manual as “clinical and/or radiographic evidence of acute hemorrhage. CMS maintains Healthcare Common Procedure Coding System (HCPCS) Level II codes to identify products, supplies, and services not in the CPT code set maintained by the American Medical Association. ICD 10 CM and ICD 10 PCS Chapter 13 Test Yourself. 63710. I CPT Category I CPT Description 0319T 33270Terms in this set (61) CDT. Use CPT II code 0503F (postpartum care visit) and ICD-10 diagnosis code Z39.