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					                   MC Strategies Revenue and Coding Curriculum
                                 Word Style Sheet


PUNCTUATION
Brackets: Square brackets are used in ICD-9-CM to enclose synonyms, alternative
wordings, abbreviations, and explanatory phrases. Please do not change to parentheses.
NUMBERS
Age: Use numerals (e.g., for patients age 50 and over; should not be given to children
 under 13)
Commas: No comma with four-digit numbers except dollar amounts (1200 patients,
 $1,200); comma with numbers that have five or more digits (52,000 vaccinations;
 100,121 deaths)
Days: Cap and follow with a number in the following construction: On Day 1 after
 surgery . . .
Discs: T10-11, L5-S1
Greater Than/Less Than: Spell out in text, but use symbols in tables and lists; includes
 variations such as "greater than or equal to."
Hyphens: No hyphens with units of measure except to avoid ambiguity or to indicate a
 range in a table. The following examples are correct:
      A 500 gram infant
      A 7 mm syringe
      1.1-2.0 cm [Use hyphen in a table]
       1.1 to 2.0 cm [Use "to" in lesson body]
      Ten 5-cm gauze pads [Hyphen used here for clarity]
Numerals: Spell out one through nine, and use numerals for 10 and above (e.g. seven
 characters long; 11 patients; 12 root operations).
Ordinal numbers: Spell out (e.g., fifth digit; fifteenth chapter; fourth month of
 chemotherapy; twenty-second injection [Exception: 7th character extension and similar
 forms in ICD-10-CM; no superscript or hyphenation in the ICD-10-CM construction];
 abbreviate in chapter titles, as in 2011 ICD-9 Coding Clinic, 2nd Quarter)
Percentages: Use the % sign, not the word "percent." In ranges, place the percentage
 sign at both ends of the range (e.g., 5%-10%, not 5-10%)
Quartiles and percentiles: Use numerals (e.g., HCPCS Applications, 2nd Quarter; 3rd
 quartile; 80th percentile)
Range of numbers: For numbers in a range, use "through" or "to" in the text and a
 hyphen in tables (see exception below):
Lessons 7 through 11
 Dosage     5-10 mg daily


                                                                           Updated 7-10-12
 Exception: Please use a hyphen in a range of codes ("Chapter 1 of ICD-10-CM consists
 of codes A00-B99"). If the code range is preceded by "from," either recast the sentence
 or use "to" ("Codes ranging from B95 to B97 are used to identify . . ."). Always
 hyphenate code ranges in screen titles, such as Parasitic Diseases (B95-B97).
Time: 9 A.M. [omit :00], 9:30 A.M.
Units of time: Use numerals for minutes, seconds, hours, days, weeks, months, years,
 etc. (e.g., 6 seconds;, 14 weeks’ gestation; every 3 months; endured for 100 years)
Years: No apostrophe in centuries or decades (e.g., 1900s, not 1900’s and in the '80s, not
 in the '80’s)

3-D code
“4 × 4 rule” (quotes only on first use)

A
AAPC (organization name; do not spell out, since the letters no longer stand for
anything)
A.M. (not a.m. or AM) (see "Time," above)
Activity Measure–Post-Acute Care (AM-PAC)
acute-care (adj., as in acute-care setting)
Addendum B (cap when referring to a specific addendum; lower case when preceded by
an article, as in "the addendum")
add-on (n. or adj.)
administrative simplification standard [HIPAA term]
adult-onset (adj.—Hyphenate before the noun; otherwise open)
Advance Beneficiary Notice (ABN)
AIDS-defining condition
airflow
alert and oriented to person, place, and time (A&O×3)
"All of the above" response [to a test question]; see also "None of the above"
alphabetic (not alphabetical)
alphanumeric (not alphanumerical)
also known as (not aka)
Alzheimer's disease
ambulatory care (n. or adj., no hyphen unless needed for clarification)
Ambulatory Payment Classification (APC) (not Ambulatory Payment Category)
ambulatory service center (ASC) [Be sure not to use ASC to mean two different things in
  the same lesson]
ambulatory surgery center (ASC)
A-mode
anancastic (not anankastic, the alternative spelling)
anatomical (not anatomic)
Ancillary Procedures sections (when referring to CPT or HCPCS)
antiinflammatory



                                                                            Updated 7-10-12
antineoplastic chemotherapy–induced anemia (use an en dash to indicate that the first two
  words work with the third to modify the fourth; in other words, they form a compound
  adjective modifying the noun “anemia”)
approximately (replace with about unless used to vary word choice)
aspiration (never plural)
assignment of benefits form
auto-authentication
average sales price (ASP)

B
back-date, back-dated (hyphenate all forms)
Balanced Budget Act (BBA) of 1997
Balanced Budget Refinement Act (BBRA) of 1999
Band-Aid
barcode (n. or v.)
bare-bones summary
behavorial therapy (not behavior therapy)
Berry’s ligament
best-case scenario
big-picture view
Bililite
bill hold (n.); bill-hold (adj.)
biological (not biologic unless referring to the drug category)
BiPAP
birth date (but use "date of birth" if possible)
Birthday Rule (Medicare)
birthmark
birth weight [see also low birth weight]
black and white (adj.)
blood-brain barrier
bloodflow
bloodstream
bloodwork
Bloom's taxonomy
bpm (abbreviation for "beats per minute")
brainstem
Braxton Hicks contractions
breach notification (adj., no hyphen, as in breach notification options)
breastbone
“build a code” approach (use quotation marks)
B-mode
B-scan
build-up (n.)
bull's-eye (adj., n.)
by-law
byproduct


                                                                           Updated 7-10-12
C
canceled (one "l")
cardioverter-defibrillator
caregiver
category (lower case, as in category A09)
Centers for Disease Control and Prevention (abbreviated CDC; takes a singular verb, as
  in The CDC recommends inoculating all children under age 13.)
Centers for Medicare and Medicaid Services (abbreviated CMS; takes a singular verb, as
  in When such confusion occurs, CMS is responsible for clarifying how the code should
  be applied.)
cesarean section (C-section)
charge description master (CDM)
chatroom
checklist
check-up (n.)
chickenpox
childbirth
childhood-onset (adj.—Hyphenate before the noun; otherwise open)
choice questions
claim form (not claims form)
Claims Manual (Cap when referring to the CMS Claims Manual, as in CMS recently
  deleted its Claims Manual guidance regarding the relationship of HCPCS codes to
  revenue codes.)
claims processing (adj.—not hyphenated, as in Medicare claims processing activities)
claims scrubber (not claim scrubber)
claims-filing (adj.—Hyphenated, as in Medicare claims-filing process)
clear-cut (adj., as in no clear-cut solution—Hyphenate before the noun; otherwise open)
clinic (set lower case when not a proper noun, e.g., the Mayo Fertility Clinic but the
  fertility clinic, even when “the fertility clinic” refers to the Mayo Fertility Clinic)
CMS Alphanumeric Editorial Panel
CMS-1450 claim form
CMS-1500 claim form
code (cap and no hyphen for V code, G code, E code, Q code, etc.)
Code Also note (but to code also when used as a verb, as in The coder is instructed to
  code also the incision site)
code book
code first
  Use quotation marks. No cap if preceded by "to"; otherwise cap, as in these examples:
      The instruction to "code first" any additional diagnoses
      X, Y, Z is denoted in the tabular list by the instruction “Code first."
coequal
coexist
cognitive-behavioral therapy
coinsurance
collarbone

                                                                            Updated 7-10-12
color-flow (adj., as in color-flow monitor)
colony-stimulating factor
column 1/column 2 correct coding edits or column 1/column 2 NCCI edits
Common Working File (CWF) [Medicare term]
community mental health centers (CMHCs)
comorbid
composite payment rate system
comprehensive [examination] (C) (CPT acronym)
comprise (The whole comprises the parts, not vice versa, as in The first-aid kit comprised
  a few Band-Aids, a tube of antibiotic ointment, and a bottle of iodine NOT A few Band-
  Aids, a tube of antibiotic ointment, and a bottle of iodine comprised the first-aid kit)
computer-generated (adj., as in computer-generated graphics; no hyphen when placed
  after the noun, as in The graphics were computer generated.)
condition code
Conditions of Participation (CoPs) [Medicare term]
consumer price index (CPI)
Cooperating Parties for ICD-9-CM
Cooperating Parties for the ICD-10-CM
co-payment
copyediting (one word)
core/quality measures (in CDI course only)
Correct Coding Initiative (CCI)
co-signature, co-sign
cost-conscious (adj., as in cost-conscious consumers; no hyphen when placed after the
  noun, as in Consumers are cost conscious.)
cost-effective (adj., as in a cost-effective solution; no hyphen when placed after the noun,
  as in The solution was cost effective.)
cost outlier threshold
cost-to-charge ratio (CCR)
co-surgeon
countersigner
covered entity (do not abbreviate)
co-worker
C-PAP
CPT category I
CR(E)ST syndrome
critical-access hospitals
cross- (Hyphenate all instances of all compounds beginning with cross-)
Current Procedural Terminology (CPT)
customer service (adj., no hyphen)
cut-off (n.), cut off (v.)
cutting-edge (adj., as in cutting-edge practices; no hyphen when placed after the noun, as
  in The hospital's facilities were cutting edge.)




                                                                              Updated 7-10-12
D
da Vinci Surgical System
data entry (adj., as in data entry errors)
date and time stamp (n. or v.)
debride (no accent mark)
decision-making (n. and adj.)
degree (hyphenate adjectival forms, as in first-degree relative, second-degree laceration,
  third-degree burn)
de-identified
Department of Health and Human Services (abbreviate DHS, not DHHS)
dependence (not dependency)
Det detailed [examination] (CPT abbreviation)
diabetes mellitus type 1 and type 2 (do not use roman numerals)
diagnosis-related group (DRG) (MWU when used in the following term: Medicare
  Severity Diagnosis-Related Groups)
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision
(DSM-IV-TR) [in text mentions]
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) [in text
mentions]
Diagnostic and statistical manual of mental disorders, ed 5 (DSM-5) [in references]
dilation (not dilatation)
direct-to-consumer (adj., as in direct-to-consumer laboratory services)
disc [not the alternative spelling, disk]
diseases—Set lower case even when commonly abbreviated, e.g., congestive heart failure
  (CHF), not Congestive Heart Failure (CHF) and benign prostatic hypertrophy (BPH),
  not Benign Prostatic Hypertrophy (BPH); Alzheimer’s disease, not Alzheimer’s
  Disease
disproportionate-share hospital (DSH)
"Do Not Resuscitate" order
doctors office, doctors offices (regardless of the number of doctors; here “doctors” is
  descriptive, not possessive)
doctor of osteopathy (DO)
done (replace with finished where possible)
Doppler
double-book (any form)
down side (n.)
Down syndrome
driver’s license, driver’s licenses (regardless of the number of drivers)
drop-down menu
drug interaction (n. and adj., as in drug interaction alerts)
DTaP (diphtheria, tetanus, and pertussis) vaccine/vaccination
dual eligible (n.)
dual-eligible beneficiary (adj.—Hyphenate before the noun; otherwise open)
dual-lead implantable cardioverter-defibrillator
due to (keep as is; this is coding language)
dumpster diver, dumpster diving

                                                                           Updated 7-10-12
E
1995 examination guidelines (no caps when preceded by any year)
E codes
eardrum
ECG (not EKG) but avoid abbreviating if electrocardiogram and echocardiogram are
  used in same lesson
echobeam
e.g. (change to "for example" or "such as" unless the SME has a strong preference for the
  Latin abbreviations)
elderly (replace with older adults; if age is given, no adjective is needed, as in adults age 65
  and older, not older adults age 65 and over)
e-learning
eligible professionals (EPs)
email, emailed, emailing
emergency department (lower case) (Use instead of emergency room); abbreviate as
  necessary
endoscopic video-assisted approach
endplate
end-stage (adj., as in end-stage kidney disease)
etc. (Avoid this construction when possible. Use only when it is clear what the other
  items in the list might be. If used, replace etc. with "and so on" or "and so forth.")
evaluation and management (E/M)
examination (Use in place of “exam” unless it becomes awkward to use repeatedly;
  alternate with “exam” to avoid an overly formal tone if necessary; do not change
  “exam” to “examination” within case studies or vignettes, which are meant to sound
  casual.)
excision-plication
Excludes Note (capped) but exclusion note (lower case)
Excludes1 Note, Excludes2 Note
expanded problem-focused (EPF) examination (CPT)
extended-care facility
external cause of injury codes (E codes)
External Cause Index, 2010 ["of Injuries" is omitted] [ICD-10-CM]
External Cause of Injuries Index, 2011 [ICD-10-CM]
external cause of morbidity

F
face mask (adj., no hyphen, as in face mask ventilation)
face-to-face (adj.)
fallopian tube (not capitalized)
Fast Tract insertion technique (Fast Tract is a registered trademark)
fee-based (adj., as in fee-based add-on)
female (change to woman, girl, or infant, as appropriate)
fiber optic (adj.)
fiberscopic (adj.)
Final Rule (Medicare OPPS term)

                                                                                  Updated 7-10-12
finger pointing (n.)
finished (use in place of done where possible)
first class mail
first-aid kit
first-degree relative, first-degree burn (see degree)
first-listed code
fiscal intermediary (FI) [old term; now called MAC]
fiscal year (FY) [not capped]
flare-up (n.)
flashcard
flat-rate (adj., as in flat-rate fee)
fluency-disorder stuttering
follow up (v.), follow-up (n., adj.)
following (change to after if not awkward to do so) Per SMEs' preference, please retain
  "following"
forced expiratory volume (FEV1)
foreign body (adj., no hyphen, as in foreign body lesion)
form locator (FL)
-free (adj., combining form; hyphenate preceding a noun, as in additive-free fomula;
     hyphenate after a linking verb, as in The formula is additive-free.)
front office (n.), front-office (adj.)
full term (no hyphen if placed after subject, as in “The pregnancy reached full term” and
“The delivery was coded as full term”)
full-term (adj., as in full-term delivery—Hyphenate before the noun; otherwise open)
full-thickness (adj., as in full-thickness burn—Hyphenate before the noun; otherwise
  open)

G
1997 General Multi-System Guidelines (hyphen and caps per CMS official title)
G codes
gallbladder
Gender Rule (Medicare)
general coding guidelines
General Equivalence Mappings (GEMs)
General Financial Responsibility form
general guideline for [X] (no caps)
genitourinary (GU)
geographic (adj.)
gestation (see weeks’ gestation)
giant cell arteritis
Glasgow Coma Scale
go live (v.)/go-live (adj., as in go-live date)
government agency
Gram stain (cap)
gram-positive (lower case the adj., as in gram-positive organism [but no hyphen in "the
  organism is gram positive"]; same goes for gram-negative)

                                                                            Updated 7-10-12
grayed out (as in The choices will be grayed out when all questions have been answered)
great toe

H
H2-receptor antagonist
H1N1 influenza (italicize H1N1)
hand-held (adj.)
handout (n.)
hard copy (n.), hard-copy (adj.—Hyphenate before the noun; otherwise open)
HCPCS Release and Code Set
head-to-toe (adj., as in head-to-toe examination; not hyphenated when placed after the
  noun, as in examined head to toe.)
health information management (HIM) (no caps on spelled-out term unless part of an
  organization's name)
healthcare (n. and adj.)
healthcare-associated infections (HAIs) (not hospital-associated infections)
Healthcare Common Procedure Coding System (HCPCS)
heart beat (n., adj.)
heart rate ( n. or adj., as in heart rate monitor)
heat stroke (n., adj.)
hemilaminectomy
herpes virus (two words)
hiatal hernia (not hiatus hernia)
high-risk (adj., as in high-risk behavior—Hyphenate before the noun; otherwise open)
him or her, his or hers (do not use “them” or “theirs”—e.g., “The patient does not have
  insurance and may be using coverage that does not belong to him or her” not “The
  patient does not have insurance and may be using coverage that does not belong to
  them”) NOTE: If this becomes awkward, switch back and forth, making the patient or
  physician a woman on one screen and a man on the next; continue alternating as nec.
HIPAA Notice of Privacy Policies
HIPAA Privacy Rule or Privacy Rule (cap) but “the rule”
HIPAA Security Rule (cap) but “the rule”
histological (not histologic)
history (can be abbreviated Hx; if the abbreviation is used once, the term must be
  abbreviated thereafter throughout the lesson; note that the "H" is always capitalized
  when abbreviated)
Health Information Technology for Economic and Clinical Health (HITECH) Act
HIV-positive, HIV-negative (always hyphenate)
home page
home-bound (adj.—Hyphenate all instances)
home-care (adj., as in home-care setting)
hospital-acquired conditions (HACs)
hospital-acquired infections (HAIs) [like HACs but more specific]
Hospital Compare (an HHS website—cap in refs and text)
hotlink, hotlinked
house calls

                                                                           Updated 7-10-12
hr (not hour)
http:// (Delete if followed by www)
human papillomavirus
human platelet alloantigen (HPA)
hydrodiscectomy, SpineJet HydroDiscectomy System (capitalize when full trade name
  given; no TM symbol; set lower case when referring to the procedure in a general sense
  as in The surgeon decompressed the spine using a hydrodiscectomy)

I
-ic, -ical [Use -ical endings in most circumstances. Check word style for your specific
term. Obviously, do not use -ical if it wouldn't make sense to do so, as in "psychiatrical"
and "lymphatical."]
ICD-10-CM/PCS to ICD-9-CM Reimbursement Mappings (but the reimbursement
   mappings)
ICD-10 Coordination and Maintenance Committee (but the coordination and
   maintenance committee)
ICD-10-CM Official Guidelines for Coding and Reporting
i.e. (change to "that is" unless the SME has a strong preference for the Latin)
impact, n. (change to effect unless "collision" or "force" is meant)
impact, v. (change to affect unless "strike" is meant)
implanted pulse generators
Index to Diseases and Injuries (but the alphabetic index or the index)
in situ (no italics)
in-box (n.)
“incident to” services [“incident to” always in quotes]
Includes Note (capped) but inclusion note (lower case)
induced (hyphenate to form compound adjectives such as drug-induced, as in drug-
   induced pancreatitis—Hyphenate before the noun; otherwise open, as in Her
   pancreatitis was drug induced.)
indwelling
informed consent (no caps)
inpatient
Inpatient Prospective Payment System (IPPS)
Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)
Integrated Outpatient Code Editor (I/OCE)
intensity-modulated (adj.)
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-
   CM)
internet-only manual (IOM)
intraabdominal
intraaneurysm
intraarterial
intraarticular
iron lung (no hyphen when preceding a noun, as in iron lung machine)

K


                                                                             Updated 7-10-12
Kaposi’s sarcoma
keychain
kneecap
knee-high (Hyphenate before the noun; otherwise open)

L
late-term (adj., as in late-term pregnancy)
lesson information page
Letter Pick [MC Strategies Knowledge Check]
leukopoor
level 1 E/M service (no cap on “level”)
Lewy body dementia
library card page
licensed school psychologists (LSPs)
life cycle (n.)
lifespan (n.)
life-sustaining (adj., as in life-sustaining treatments—Hyphenate before the noun;
   otherwise open)
life-threatening (adj., as in life-threatening event—Hyphenate before the noun; otherwise
   open)
-like (hyphenate if preceding word has three or more syllables [as in tsunami-like wave];
   otherwise, close up [as in ropelike tendon])
like-minded (Hyphenate all instances)
limited-access (adj., as in limited-access policy)
line item (adj., no hyphen)
lip-reading (n.)
live-image (adj.)
log in (v., set as two words), login (n., set as one word)
long-standing (adj., as in long-standing heart failure)
long-term (adj., as in long-term care—Hyphenate before the noun; otherwise open)
long-term care hospitals
low birth weight (no hyphens in any construction, as in extremely low birth weight
   newborn)
low cervical cesarean section
low transverse incision
lower respiratory (adj., as in lower respiratory infection, but acute lower-respiratory, as
   in acute lower-respiratory infection)
lower-extremity (adj.)
lub dub (heart sound)
Lund-Brower approach

M
mail-order (adj.—Hyphenate before the noun; otherwise open)
major complication and comorbidity (abbreviated MCC)
major diagnostic category (MDC)
makeup (n., as in genetic makeup)

                                                                             Updated 7-10-12
male (change to man, boy, or infant, as appropriate)
market basket (adj., no hyphen, as in market basket inflation rate)
mass-casualty (adj., as in mass-casualty event)
Master Patient Index, Master Person Index (MPI)
matrix (singular); matrixes (plural) [use matrices only if SME has a strong preference]
maximum (not maximal)
meaningful use initiative
medical assistant (MA)
medical doctor (MD)
medical decision making (MDM)
medically unlikely edits (MUE) (no caps)
Medicare administrative contractor (MAC)
Medicare Advantage Plans
Medicare as Secondary Payer (MSP) checklist
Medicare claims processing manual
Medicare Code Editor (caps), Medicare code edits
Medicare fee schedule (MFS)
Medicare Grouper
Medicare Learning Network (MLN)
Medicare Part A, or just Part A (same style for Parts B, C, and D)
Medicare participating provider (no caps; abbreviate MPP)
Medicare Physician Fee Schedule Data Base (MPFSDB)
Medicare pricer
Medicare Severity Diagnosis-Related Groups (set main words up)
Medicare supplement insurance
MedPAR
Merkel cell carcinoma
metered-dose inhaler
methicillin-resistant [or its opposite, methicillin-sensitive]Staphylococcus aureus
(MRSA)
microorganism
midrange
midyear
milliliter (mL)
millimeters of mercury (mm Hg)
mini-thoracotomy
minute (abbreviate "min" in tables and similar elements)
M-mode
mobility assistive equipment (MAE)
mobility-related activities of daily living (MRADL)
modified Seldinger technique
modifier -25 (hyphen, not en dash)
modifier not applicable
"More Information" tab
motor vehicle accident (do not abbreviate)
mouse click (n., two words)


                                                                            Updated 7-10-12
Müllerian
multidiscipline (adj., as in multidiscipline practice)
multidrug-resistant Staphylococcus aureus
multi-infarct dementia
multileaf collimator
multi-lobar pneumonia (hyphenated only because it's hyphenated by Coding Clinic)
multiphysician (adj.)
multisystem (no hyphen except in CMS title)
mutually exclusive code edits (MEC)

N
National Correct Coding Initiative
National Correct Coding Initiative Coding Policy Manual for Medicare Services
National Coverage Determination (NCD)
National Provider Identifier [number] (NPI)
negative-pressure ventilation
Table of Neoplasms
nerve sheath tumor
neurologic (per SMEs' request—please use -ic, not -ical).
Never Events
new issue review
new-patient (adj., as in new-patient visit)
next of kin
No. (abbreviate "number," using a capital "N," when referring to Coding Clinics, as in
  "2010 Coding Clinic for HCPCS, 1st Quarter, Vol. 10, No. 1"); otherwise, abbreviate
  but do not cap, as in "Document no. 1631."
no-map flag
nonbiological
"None of the above" response [to a test question]; see also "All of the above"
non-Hodgkin's lymphoma
nonionizing
non–face-to-face service
non–labor-related portion
non-Medicare patients
non–operating room procedure
non–pass-through drug
nonphysician provider
non-pressure ulcer (break from house style to match ICD-9 and ICD-10 style)
normal-tension glaucoma
not elsewhere classified (NEC)
not otherwise specified (NOS)
numeric (not numerical)
nursing facility (NF)

O
obsessive-compulsive disorder

                                                                          Updated 7-10-12
obstetrical (not obstetric)
Obstetrics section of the manual (not Obstetric section)
Office of Inspector General
off-road (adj., as in off-road vehicle but no hyphen when placed after verb, as in He took
  the Jeep off road.)
offsite (adj.)
on screen (as in "Learners will view the popup box on screen"); on-screen (as in "An on-
  screen popup box")
on-call (adj.—Hyphenate before the noun; otherwise open)
once-in-a-lifetime codes
one-up (v.)
on-site (adj.—Hyphenate before the noun; otherwise open)
open-heart
opt out (v.), opt-out (adj., as in opt-out notice)
out-box (n.)
Outpatient Code Editor (OCE)
Outpatient Prospective Payment System (OPPS)
Outpatient Prospective Payment System (OPPS) conversion factor
Outpatient Prospective Payment System (OPPS) Final Rule
overbooking
overtime
oxacillin-resistant Staphylococcus aureus (ORSA)

P
P.M. (not p.m. or PM)
PaCO2 (set the "2" in subscript)
page (abbreviate p. or pp. when giving a page number, as in On p. 8 of Coding Clinic . . .
  but spell out otherwise, as in An exclusion note at the bottom of the page . . .
palladium 103 (brachytherapy agent)
Pap smear or Pap test (cap "P"; not necessary to spell out "Papanicolaou")
part (use arabic numbers 1, 2, 3, etc., not roman numerals)
partial-thickness (adj., as in partial-thickness burn)
pass-through status
patient care (adj. or n.)
patient education (adj. —no hyphen)
patient-accessible (adj.—Hyphenate before the noun; otherwise open unless hyphen nec.
  for clarity)
patient-controlled (adj.—Hyphenate before the noun; otherwise open)
payment mapping [GEMs term—no caps]
physical examination (abbreviated P/E, not PE)
physician (do not change to "surgeon" even if that seems to be correct in context)
physician assistant
physician-controlled (adj.—Hyphenate before the noun; otherwise open)
physician fee schedule
physicians office (no apostrophe; see doctors office)
physician orders

                                                                             Updated 7-10-12
pilot test (n. or v.—no hyphen)
place of occurrence code
PN–2, PN–3b, etc.
pneumocystis carinii (Query SME whether to change to pneumocystis jirovecii. No ital.)
popup box
port access device
positive-pressure ventilation
post-discharge
post-payment review
postterm
posttreatment
power-operated vehicle (POV)
pre-admission (adj.)
preanesthesia
predominantly (not predominately)
preeclampsia
pre-existing (adj.)
pregnancy-induced (adj., as in pregnancy-induced hypertension—Hyphenate before the
  noun; otherwise open)
pregnancy-related (adj., as in pregnancy-related fatigue—Hyphenate before the noun;
  otherwise open)
preprinted
preregister
preregistrar
present on admission (POA)
pressure support ventilation
pressure ulcers, stage 3 and 4 (use arabic numbers)
pricer (Medicare pricer)
primary care exception
prior to (change to before)
privacy officer (HIPAA term)
problem-focused (PF) examination (CPT)
Prospective Payment System (PPS)
prostate-specific antigen (PSA)
protected health information (PHI)
proton-pump inhibitor (PPI)
provider transaction access number (PTAN)
pseudo-obstruction

R
radiofrequency neurostimulator
radiological (not radiologic)
rapid-screening test
real-time (adj., as in real-time information)
recovery audit
Recovery Audit Contractor (RAC)


                                                                         Updated 7-10-12
Red Flag Rule but a red flag (set lower case even when referring to an official red flag; e.g.,
  “You will learn about the Red Flags Rule and methods of detecting red flags” and “A bill
  for services never rendered is a red flag.”)
re-expand
References tab
reimbursement mapping [GEMs term]
reinfusion
relative weight (no caps)
release of information form
resource utilization group (RUG)
Resources section
Resources tab (cap, as in See the Resources tab.)
retinaculum (sing.); retinacula (plural)
Rett's syndrome
return to provider (RTP)
Rh-positive, Rh-negative (hyphenate in all instances)
rollout
room and board charge
Rule of Nines

S
1997 Specialty-Specific Guidelines (hyphen and caps per CMS official title)
S code, S block
section (use arabic numbers 1, 2, 3, etc., not roman numerals)
Security Officer (HIPAA term)
see AND see also
    For see AND see also references in ICD-10-CM/PCS, set lower case, italics, no
      comma after see, as in the example below:




self-[anything ] (Any word that begins with "self" should be hyphenated)
semiannual
seniors (REPLACE WITH older adults; if age is given, no adjective is needed, as in
  adults age 65 and older, not older adults age 65 and over)
sensory-integrative function
setup (n.)
sex change operation (no hyphen)
sexually transmitted infections (STIs), not sexually transmitted diseases (STDs) (per
  CDC terminology, not author preference)
sickle cell anemia
single organ system examination
single photon emission computed tomography (SPECT)
single-code APC assignment
                                                                                  Updated 7-10-12
single-plane (adj.)
skilled nursing facility (SNF)
slide show
Social Security number
soft tissue (adj., as in soft tissue disorders)
speech-reading (n.)
speedball (slang for meth and heroin)
speech-language therapy
spellcheck (v.)
spellchecker (n.)
split-thickness (adj.)
square centimeters (abbreviate sq cm after first mention)
stage (lower case; query author if roman and arabic numerals are used inconsistently)
  (use arabic numbers for kidney disease, e.g., stage 2 kidney disease)
stainless steel (no hyphen, as in stainless steel suture wire)
standalone
stand-by (n.)
startup (n.)
status indicator (no caps)
stereotactic body radiation therapy
Steri-Strips (proprietary name)
stress management (adj.)
strongarm (adj.)
student (replace with learner if referring to the person taking the lesson or test)
subject matter expert
superbill
surgical-site infection (SSI)
Surgicel (proprietary name)
Surviving Sepsis Campaign

T
T anchors
[the] two times rule
T3 (triiodothyronine)
T4 (thyroxine)
Table of Drugs and Chemicals [ICD-10-CM]
Tabular List of Diseases and Injuries (but the tabular list) [ICD-10-CM]
take-out (n.)
therapist notes
third-party payer
Three Choices (MC Strategies Knowledge Check)
three-ring binder
throughput
time frame (n.)
time-based (adj., as in time-based codes—Hyphenate before the noun; otherwise open)
Title I and Title II [HIPAA terms]

                                                                           Updated 7-10-12
toolbar
transaction and code sets standards
transfusion-associated circulatory overload (TACO)
trimester (hyphenate adjectival forms, such as first-trimester spontaneous abortion)
trisomy 21
true/false exercise
t-tubes
tubulo-interstitial disease
turnover
type (lower case for diabetes and use arabic numerals, e.g., type 2 diabetes, except when
   it is common practice to use roman numerals for a particular type of disease or injury,
   e.g., type II occipital condyle fracture)
type (lower case for other instances, as in type A and type B emergency departments)

U
U.S. mail
Unacceptable Principal Diagnosis edit
under-documented
Uniform Hospital Discharge Data Set (UHDDS)
un-oxygenated
upon (replace with on)
upper respiratory (adj., as in upper respiratory infection) but acute upper-respiratory
  (adj., as in acute upper-respiratory infection)
urgent-care (adj.)
Use additional code
username

V
V code
valent (use a hyphen, as in 13-valent or 7-valent, regardless of where the phrase falls in
  the sentence)
velocity flow mapping
ventilator-associated pneumonia (VAP)
version 5010
versus (spell out and capitalize in titles)
via (change to through or by means of)
video clip
voiding-pressure flow study
Volume (cap when referring to code sets, as in ICD-9-CM Volume 3; no comma)
Von Willebrand disease
V-plasty

W
wage adjustment factor (WAF)
wage index
web link
website
                                                                              Updated 7-10-12
weeks’ gestation (apostrophe after “weeks”) but weeks of gestation (no apostrophe)
weight-loss (adj.); weight loss (n.)
well-[anything] (Hyphenate before the noun; otherwise open)
West Nile virus
Western blot
wet lung syndrome (no hyphen)
while (retain even if the statement is not temporal; do not change to whereas)
whistle blower (n.)
whistle-blower (adj., as in whistle-blower protections)
Wi-Fi
with
   In ICD-10-CM/PCS, set lower case, no italics, as in the example below:




Word Hunt exercise [MC Strategies Knowledge Check]
word-completion exercises
Work Plan [in reference to the Office of Inspector General's annual auditing plan]
workaround (n.), work around (v.)
Workers' Compensation (apostrophe per official Department of Labor spelling)
workflow (n.)
worksheet (n.)
workstation (n.)
workup (n.)
worst-case scenario
W-plasty
write-up (n.)

X, Y, Z
X12N 837, version 4010A1
x-rays
Y-extension
Y-portion
Z-plasty




                                                                            Updated 7-10-12

				
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