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![unpleasant to him. At first he refused to sell spirits to any person
partly inebriated; then he reasoned himself into a total abandonment
of the death-dealing traffic. With no other business prospect before
him, prevented by his long difficulty from working at his trade, with
a young wife and child dependent on him, he suddenly locked up his
spirit-cellar and never more sold rum!
In 1828 or 1829, through the influence of his kinsman, James
Oswald, Esq., of Sheildhall, Mr. Murray was appointed surveyor on a
part of the Forth and Clyde canal, an office requiring much labor for
little pay. His prospects of promotion depended on Mr. Oswald and
other members of the Kirk of Scotland. Mr. Murray was a full
member of the Tron Church, Glasgow, when, according to law, a
minister was appointed there regardless of the choice, and contrary
to the wishes of the great majority of its members. In consequence
of this appointment, and again unmindful of personal advancement,
John Murray shook the dust from his sandals and quit at once and
forever the Tron Church and the Kirk of Scotland.
About the same time the Glasgow Emancipation Society was formed
or re-organized, on the doctrine of immediate emancipation so
splendidly announced by a secession minister of Edinburgh. The
secretaries of this association were John Murray the surveyor, and
William Smead, of the Gallowgate, grocer; the last a Friend. These
two were the head and front, the thinking and the locomotive power
of this well known association which did notable fight, if not the
principal labor, in effecting emancipation in the British West Indies,
and in assaulting American slavery.
And, twenty odd years ago, it was no trifling matter to do anti-
slavery work in Glasgow, the very names of whose stateliest streets
proclaimed that they were built by money wrung out of the blood
and sweat of the negroes of Jamaica, St. Vincents, etc. The whole of
the retired wealth, nearly all the active business influence, the
weight of the Established Church, the rank and fashion of Glasgow,
and though last not least, the keen wit of the poet Motherwell,[N]
and the great statistical learning and industry of M’Queen were](https://image.slidesharecdn.com/50595-250615140426-a573a94a/85/Let-s-Code-It-2022-2023-Code-Edition-Shelley-Safian-35-320.jpg)
![Over your bed, so low,
Heard ye not, long ago,
A voice of power[O]
Proclaim to earth and sea,
That, where ye sleep, should be
A home for Liberty,
Till Time’s last hour?
Hear ye the chains of slaves,
Now clanking round your graves?
Hear ye the sound
Of that same voice, that calls
From out our Senate halls,[P]
“Hunt down those fleeing thralls,
With horse and hound!”
That voice your sons hath swayed!
’Tis heard, and is obeyed!
This gloomy day
Tells you of ermine stained,
Of Justice’ name profaned,
Of a poor bondman, chained
And borne away!
Over Virginia’s Springs,
Her eagles spread their wings,
Her Blue Ridge towers:—
That voice,[Q]—once heard with awe,—
Now asks,—“Who ever saw,
Up there, a higher law
Than this of ours?”
Must we obey that voice?
When God, or man’s the choice,
Must we postpone
H h f Si i k ?](https://image.slidesharecdn.com/50595-250615140426-a573a94a/85/Let-s-Code-It-2022-2023-Code-Edition-Shelley-Safian-51-320.jpg)
Let's Code It! 2022-2023 Code Edition Shelley Safian
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- 6. Let’s Code It! 2022–2023CODE EDITION ISTUDY
- 7.
- 8. Let’s Code It! 2022–2023CODE EDITION Shelley C. Safian, PhD, RHIA MAOM/HSM/HI, CCS-P, COC, CPC-I, HCISPP, AHIMA-Approved ICD-10-CM/PCS Trainer Mary A. Johnson, MBA-HM-HI, CPC Central Carolina Technical College ISTUDY
- 9. Rev. Confirming Pages ConfirmingPages Revised Pages First Pages saf5080X_fm_ise.indd i 02/15/22 11:21 AM mheducation.com/highered LET’S CODE IT! Published by McGraw Hill LLC, 1325 Avenue of the Americas, New York, NY 10019. Copyright ©2023 by McGraw Hill LLC. All rights reserved. Printed in the United States of America. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of McGraw Hill LLC, including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning. Some ancillaries, including electronic and print components, may not be available to customers outside the United States. This book is printed on acid-free paper. 1 2 3 4 5 6 7 8 9 LMN 26 25 24 23 22 ISBN 978-1-265-15080-8 MHID 1-265-15080-X Cover Image: Shutterstock/Juliy Koval All credits appearing on page are considered to be an extension of the copyright page. The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a website does not indicate an endorsement by the authors or McGraw Hill LLC, and McGraw Hill LLC does not guarantee the accuracy of the information presented at these sites. ISTUDY
- 10. Shelley C. Safian ShelleySafian has been teaching medical coding and health information management for more than 20 years, at both on-ground and online campuses. In addition to her regu- lar teaching responsibilities at University of Maryland Global Campus and Colorado State University-Global, she regularly presents webinars/seminars and writes about cod- ing for the Just Coding newsletter. Safian is the course author for multiple distance edu- cation courses on various coding topics, including ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II coding. Safian is a Registered Health Information Administrator (RHIA) and a Certified Coding Specialist–Physician-based (CCS-P) from the American Health Information Management Association and a Certified Outpatient Coder (COC) and a Certified Professional Coding Instructor (CPC-I) from the American Academy of Professional Coders. She is also a Health Care Information Security and Privacy Practitioner (HCISPP) and a Certified HIPAA Administrator (CHA) and has earned the designa- tion of AHIMA-Approved ICD-10-CM/PCS Trainer. Safian completed her Graduate Certificate in Health Care Management at Keller Graduate School of Management. The University of Phoenix awarded her the Master of Arts/Organizational Management degree and a Graduate Certificate in Health Infor- matics. She earned her Ph.D. in Health Care Administration with a focus in Health Information Management. Mary A. Johnson Mary Johnson is the Medical Record Coding Program Director at Central Carolina Technical College in Sumter, South Carolina. She is also an adjunct faculty member for Southern New Hampshire University and Bryan University. Her background includes corporate training using both on-campus and online platforms. Johnson has over a dec- ade of teaching experience in medical coding and Health Information Management and specializes in the design and implementation of customized coding curricula. Johnson received her Bachelor of Arts dual degree in Business Administration and Marketing from Columbia College, and earned a Masters of Business Administration with a dual focus in Healthcare Management and Health Informatics from New England College. Johnson is a Certified Professional Coder (CPC) credentialed through the American Academy of Professional Coders (AAPC). Dedications —This book is dedicated to all of those who have come into my life sharing encourage- ment and opportunity to pursue work that I love; for the benefit of all of my students: past, present, and future. —Shelley —Thisbookisdedicatedinlovingmemoryofmyparents,Dr.andMrs.ClarenceJ.JohnsonSr., for their love and support. Also, to those students with whom I have had the privilege to work and to those students who are beginning their journey into the world of medical coding. —Mary ABOUT THE AUTHORS Courtesy of Shelley C. Safian Courtesy of Jimmy Wood and Mary A. Johnson ISTUDY
- 11.
- 12. Guided Tour xvi Prefacexxi PART I: Medical Coding Fundamentals 1 1 Introduction to the Languages of Coding 2 2 Abstracting Clinical Documentation 22 3 The Coding Process 39 PART II: Reporting Diagnoses 53 4 Introduction to ICD-10-CM 54 5 Coding Infectious Diseases 101 6 Coding Neoplasms 147 7 Coding Conditions of the Blood and Immunological Systems 175 8 Coding Endocrine Conditions 200 9 Coding Mental, Behavioral, and Neurologic Disorders 230 10 Coding Dysfunction of the Optical and Auditory Systems 265 11 Coding Cardiovascular Conditions 296 12 Coding Respiratory Conditions 332 13 Coding Digestive System Conditions 359 14 Coding Integumentary Conditions 386 15 Coding Muscular and Skeletal Conditions 410 16 Coding Injury, Poisoning, and External Causes 433 17 Coding Genitourinary, Gynecology, Obstetrics, Congenital, and Pediatrics Conditions 474 18 Factors Influencing Health Status (Z Codes) 523 19 Inpatient (Hospital) Diagnosis Coding 545 20 Diagnostic Coding Capstone 572 PART III: Reporting Physician Services and Outpatient Procedures 581 21 Introduction to CPT 582 22 CPT and HCPCS Level II Modifiers 606 23 CPT Evaluation and Management Coding 645 24 CPT Anesthesia Section 695 BRIEF CONTENTS ISTUDY
- 13. viii BRIEF CONTENTS 25CPT Surgery Section 721 26 CPT Radiology Section 801 27 CPT Pathology Lab Section 832 28 CPT Medicine Section 862 29 Physicians’ Services Capstone 900 PART IV: DMEPOS Transportation 909 30 HCPCS Level II 910 31 DMEPOS and Transportation Capstone 946 PART V: Inpatient (Hospital) Reporting 953 32 Introduction to ICD-10-PCS 954 33 ICD-10-PCS Medical and Surgical Section 979 34 Obstetrics Section 1019 35 Placement through Chiropractic Sections 1044 36 Imaging, Nuclear Medicine, and Radiation Therapy Sections 1091 37 Physical Rehabilitation and Diagnostic Audiology through New Technology Sections 1115 38 Inpatient Coding Capstone 1146 PART VI: Reimbursement, Legal, and Ethical Issues 1161 39 Reimbursement 1162 40 Introduction to Health Care Law and Ethics 1191 Appendix A-1 Glossary G-1 Index I-1 ISTUDY
- 14. CONTENTS Guided Tour xvi Prefacexxi PART I: Medical Coding Fundamentals 1 1 INTRODUCTION TO THE LANGUAGES OF CODING 2 1.1 The Purpose of Coding 2 1.2 Diagnosis Coding 3 1.3 Procedure Coding 9 1.4 Equipment and Supplies 16 Chapter Summary and Review 19 2 ABSTRACTING CLINICAL DOCUMENTATION 22 2.1 For Whom You Are Reporting 22 2.2 The Process of Abstracting 23 2.3 Deconstructing Diagnostic Statements 25 2.4 Identifying Manifestations, Co-morbidities, and Sequelae 28 2.5 Reporting External Causes 30 2.6 Deconstructing Procedural Statements 31 2.7 How to Query 34 Chapter Summary and Review 35 3 THE CODING PROCESS 39 3.1 The Coding Process Overview 39 3.2 The Alphabetic Indexes 40 3.3 The Tabular List, Main Section, Tables, and Alphanumeric Section 43 3.4 The Official Guidelines 45 3.5 Confirming Medical Necessity 47 Chapter Summary and Review 49 PART II: Reporting Diagnoses 53 4 INTRODUCTION TO ICD-10-CM 54 4.1 Introduction and Official Conventions 54 4.2 ICD-10-CM Official Guidelines for Coding and Reporting 63 4.3 The Alphabetic Index and Ancillaries 72 4.4 The Tabular List 78 4.5 Which Conditions to Code 84 4.6 Putting It All Together: ICD-10-CM Basics 88 Chapter Summary and Review 91 5 CODING INFECTIOUS DISEASES 101 5.1 Infectious and Communicable Diseases 101 5.2 Bacterial Infections 104 5.3 Viral Infections 109 5.4 Parasitic and Fungal Infections 117 5.5 Infections Caused by Several Pathogens 120 5.6 Immunodeficiency Conditions 123 5.7 Septicemia and Other Blood Infections 129 5.8 Antimicrobial Resistance 135 Chapter Summary and Review 139 6 CODING NEOPLASMS 147 6.1 Screening and Diagnosis 147 6.2 Abstracting the Details about Neoplasms 151 6.3 Reporting the Neoplastic Diagnosis 153 6.4 Neoplasm Chapter Notes 158 6.5 Admissions Related to Neoplastic Treatments 162 Chapter Summary and Review 166 ISTUDY
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- 16. x CONTENTS 7 CODINGCONDITIONS OF THE BLOOD AND IMMUNOLOGICAL SYSTEMS 175 7.1 Reporting Blood Conditions 175 7.2 Coagulation Defects and Other Hemorrhagic Conditions 180 7.3 Conditions Related to Blood Types and the Rh Factor 184 7.4 Disorders of White Blood Cells and Blood-Forming Organs 187 7.5 Disorders Involving the Immune System 190 Chapter Summary and Review 192 8 CODING ENDOCRINE CONDITIONS 200 8.1 Disorders of the Thyroid Gland 200 8.2 Diabetes Mellitus 205 8.3 Diabetes-Related Conditions 210 8.4 Other Endocrine Gland Disorders 212 8.5 Nutritional Deficiencies and Weight Factors 214 8.6 Metabolic Disorders 218 Chapter Summary and Review 220 9 CODING MENTAL, BEHAVIORAL, AND NEUROLOGIC DISORDERS 230 9.1 Conditions That Affect Mental Health 230 9.2 Mood (Affective) and Nonmood (Psychotic) Disorders 238 9.3 Anxiety, Dissociative, Stress-Related, Somatoform, and Other Nonpsychotic Mental Disorders 243 9.4 Physiological Conditions Affecting the Central Nervous System 246 9.5 Physiological Conditions Affecting the Peripheral Nervous System 251 9.6 Pain Management 253 Chapter Summary and Review 257 10 CODING DYSFUNCTION OF THE OPTICAL AND AUDITORY SYSTEMS 265 10.1 Diseases of the External Optical System 265 10.2 Diseases of the Internal Optical System 269 10.3 Other Conditions Affecting the Eyes 275 10.4 Dysfunctions of the Auditory System 280 10.5 Causes, Signs, and Symptoms of Hearing Loss 282 Chapter Summary and Review 286 11 CODING CARDIOVASCULAR CONDITIONS 296 11.1 Heart Conditions 296 11.2 Cardiovascular Conditions 303 11.3 Hypertension 307 11.4 Manifestations of Hypertension 313 11.5 CVA and Cerebral Infarction 318 11.6 Sequelae of Cerebrovascular Disease 322 Chapter Summary and Review 323 12 CODING RESPIRATORY CONDITIONS 332 12.1 Underlying Causes of Respiratory Disease 332 12.2 Disorders of the Respiratory System 336 12.3 Pneumonia and Influenza 339 12.4 Chronic Respiratory Disorders 343 12.5 Reporting Tobacco Involvement 346 12.6 Respiratory Conditions Requiring External Cause Codes 348 Chapter Summary and Review 350 ISTUDY
- 17. 13 CODING DIGESTIVESYSTEM CONDITIONS 359 13.1 Diseases of Oral Cavity and Salivary Glands 359 13.2 Conditions of the Esophagus and Stomach 363 13.3 Conditions Affecting the Intestines 367 13.4 Dysfunction of the Digestive Accessory Organs and Malabsorption 373 13.5 Reporting the Involvement of Alcohol in Digestive Disorders 377 Chapter Summary and Review 378 14 CODING INTEGUMENTARY CONDITIONS 386 14.1 Disorders of the Skin 386 14.2 Disorders of the Nails, Hair, Glands, and Sensory Nerves 391 14.3 Lesions 397 14.4 Prevention and Screenings 400 Chapter Summary and Review 401 15 CODING MUSCULAR AND SKELETAL CONDITIONS 410 15.1 Arthropathies 410 15.2 Dorsopathies and Spondylopathies (Conditions Affecting the Joints of the Spine) 415 15.3 Soft Tissue Disorders 419 15.4 Musculoskeletal Disorders from Other Body Systems 422 15.5 Pathological Fractures 423 Chapter Summary and Review 425 16 CODING INJURY, POISONING, AND EXTERNAL CAUSES 433 16.1 Reporting External Causes of Injuries 433 16.2 Traumatic Injuries 436 16.3 Using Seventh Characters to Report Status of Care 443 16.4 Using the Table of Drugs and Chemicals 444 16.5 Adverse Effects, Poisoning, Underdosing, and Toxic Effects 448 16.6 Reporting Burns 454 16.7 Abuse, Neglect, and Maltreatment 461 16.8 Complications of Care 462 Chapter Summary and Review 464 17 CODING GENITOURINARY, GYNECOLOGY, OBSTETRICS, CONGENITAL, AND PEDIATRICS CONDITIONS 474 17.1 Renal and Urologic Malfunctions 474 17.2 Diseases of the Male Genital Organs 483 17.3 Sexually Transmitted Diseases 486 17.4 Gynecologic Care 489 17.5 Routine Obstetrics Care 492 17.6 Pregnancies with Complications 499 17.7 Neonates and Congenital Anomalies 503 Chapter Summary and Review 512 18 FACTORS INFLUENCING HEALTH STATUS (Z CODES) 523 18.1 Preventive Care 523 18.2 Early Detection 525 18.3 Genetic Susceptibility 527 18.4 Observation 528 ISTUDY
- 18. xii CONTENTS 18.5 ContinuingCare and Aftercare 529 18.6 Organ Donation 531 18.7 Resistance to Antimicrobial Drugs 532 18.8 Z Codes as First-Listed/Principal Diagnosis 535 18.9 Social Determinants of Health 536 Chapter Summary and Review 537 19 INPATIENT (HOSPITAL) DIAGNOSIS CODING 545 19.1 Concurrent and Discharge Coding 545 19.2 Official Coding Guidelines 548 19.3 Present-On-Admission Indicators 549 19.4 Diagnosis-Related Groups 554 19.5 Uniform Hospital Discharge Data Set 556 Chapter Summary and Review 557 20 DIAGNOSTIC CODING CAPSTONE 572 PART III: Reporting Physician Services and Outpatient Procedures 581 21 INTRODUCTION TO CPT 582 21.1 Abstracting for Procedure Coding 582 21.2 CPT Code Book 583 21.3 Understanding Code Descriptions 585 21.4 Notations and Symbols 587 21.5 Official Guidelines 591 21.6 Category II and Category III Coding 594 Chapter Summary and Review 597 22 CPT AND HCPCS LEVEL II MODIFIERS 606 22.1 Modifiers Overview 606 22.2 Personnel Modifiers 610 22.3 Anesthesia Physical Status Modifiers 613 22.4 Ambulatory Surgery Center Hospital Outpatient Use Modifiers 615 22.5 Anatomical Site Modifiers 617 22.6 Service-Related Modifiers 619 22.7 Sequencing Multiple Modifiers 632 22.8 Supplemental Reports 635 Chapter Summary and Review 636 23 CPT EVALUATION AND MANAGEMENT CODING 645 23.1 What Are E/M Codes? 645 23.2 Location Where the E/M Services Were Provided 646 23.3 Relationship Between Provider and Patient 648 23.4 Types of E/M Services 651 23.5 Preventive Medicine Services 671 23.6 Abstracting the Physician’s Notes 673 23.7 E/M in the Global Surgical Package 675 23.8 E/M Modifiers and Add-On Codes 676 23.9 Special Evaluation Services 680 23.10 Coordination and Management Services 681 Chapter Summary and Review 684 24 CPT ANESTHESIA SECTION 695 24.1 Types of Anesthesia 695 24.2 Coding Anesthesia Services 698 24.3 Anesthesia Guidelines 702 24.4 Time Reporting 705 24.5 Qualifying Circumstances 706 24.6 Special Circumstances 707 24.7 HCPCS Level II Modifiers 709 Chapter Summary and Review 711 ISTUDY
- 19. 25 CPT SURGERYSECTION 721 25.1 Types of Surgical Procedures 722 25.2 The Surgical Package 724 25.3 Global Period Time Frames 728 25.4 Unusual Services and Treatments 729 25.5 Integumentary System 732 25.6 Musculoskeletal System 743 25.7 Respiratory System 751 25.8 Cardiovascular System 753 25.9 Digestive System 763 25.10 Urinary System 766 25.11 The Genital Systems: Male and Female 768 25.12 Nervous System 772 25.13 The Optical and Auditory Systems 777 25.14 Organ Transplantation 783 25.15 Operating Microscope 788 Chapter Summary and Review 790 26 CPT RADIOLOGY SECTION 801 26.1 Types of Imaging 801 26.2 Purposes for Imaging 805 26.3 Technical vs. Professional 807 26.4 Number of Views 809 26.5 Procedures With or Without Contrast 811 26.6 Diagnostic Radiology 813 26.7 Mammography 817 26.8 Bone and Joint Studies 818 26.9 Radiation Oncology 819 26.10 Nuclear Medicine 822 Chapter Summary and Review 823 27 CPT PATHOLOGY LAB SECTION 832 27.1 Specimen Collection and Testing 832 27.2 Testing Methodology and Desired Results 834 27.3 Panels 837 27.4 Blood Test Documentation 839 27.5 Clinical Chemistry 842 27.6 Molecular Diagnostics 843 27.7 Immunology, Microbiology, and Cytopathology 844 27.8 Surgical Pathology 847 27.9 Modifiers for Laboratory Coding 851 27.10 Pathology and Lab Abbreviations 852 Chapter Summary and Review 854 28 CPT MEDICINE SECTION 862 28.1 Immunizations 862 28.2 Injections and Infusions 866 28.3 Psychiatry, Psychotherapy, and Biofeedback 869 28.4 Dialysis and Gastroenterology Services 871 28.5 Ophthalmology and Otorhinolaryngologic Services 874 28.6 Cardiovascular Services 876 28.7 Pulmonary 881 28.8 Allergy and Clinical Immunology 882 28.9 Neurology and Neuromuscular Procedures 884 28.10 Physical Medicine and Rehabilitation 885 28.11 Acupuncture, Osteopathic, and Chiropractic Treatments 887 28.12 Other Services Provided 889 Chapter Summary and Review 891 29 PHYSICIANS’ SERVICES CAPSTONE 900 ISTUDY
- 20. xiv CONTENTS PART IV:DMEPOS Transportation 909 30 HCPCS LEVEL II 910 30.1 HCPCS Level II Categories 910 30.2 The Alphabetic Index 912 30.3 The Alphanumeric Listing Overview 914 30.4 Symbols and Notations 928 30.5 Appendices 936 Chapter Summary and Review 937 31 DMEPOS AND TRANSPORTATION CAPSTONE 946 PART V: Inpatient (Hospital) Reporting 953 32 INTRODUCTION TO ICD-10-PCS 954 32.1 The Purpose of ICD-10-PCS 954 32.2 The Structure of ICD-10-PCS Codes 954 32.3 The ICD-10-PCS Book 962 32.4 ICD-10-PCS General Conventions 968 32.5 Selection of Principal Procedure 971 Chapter Summary and Review 972 33 ICD-10-PCS MEDICAL AND SURGICAL SECTION 979 33.1 Medical/Surgical Section/Body Systems: Characters 1 and 2 979 33.2 Medical/Surgical Root Operations: Character 3 982 33.3 Medical/Surgical Body Parts: Character 4 991 33.4 Medical/Surgical Approaches: Character 5 993 33.5 Medical/Surgical Devices: Character 6 997 33.6 Medical/Surgical Qualifiers: Character 7 999 33.7 Multiple and Discontinued Procedures in Medical and Surgical Cases 1000 33.8 Medical/Surgical Coding: Putting It All Together 1003 Chapter Summary and Review 1007 34 OBSTETRICS SECTION 1019 34.1 Obstetrics Section/Body System: Characters 1 and 2 1019 34.2 Obstetrics Root Operations: Character 3 1020 34.3 Obstetrics Body Parts: Character 4 1025 34.4 Obstetrics Approaches: Character 5 1026 34.5 Obstetrics Devices: Character 6 1028 34.6 Obstetrics Qualifiers: Character 7 1028 34.7 Obstetrics Coding: Putting It All Together 1032 Chapter Summary and Review 1034 35 PLACEMENT THROUGH CHIROPRACTIC SECTIONS 1044 35.1 Reporting Services from the Placement Section 1044 35.2 Reporting Services from the Administration Section 1050 35.3 Reporting Services from the Measurement and Monitoring Section 1054 35.4 Reporting Services from the Extracorporeal or Systemic Assistance and Performance Section 1058 35.5 Reporting Services from the Extracorporeal or Systemic Therapies Section 1062 35.6 Reporting Osteopathic Services 1067 ISTUDY
- 21. 35.7 Reporting fromthe Other Procedures Section 1070 35.8 Reporting Inpatient Chiropractic Services 1074 35.9 Sections 2–9: Putting It All Together 1078 Chapter Summary and Review 1080 36 IMAGING, NUCLEAR MEDICINE, AND RADIATION THERAPY SECTIONS 1091 36.1 Reporting from the Imaging Section 1091 36.2 Reporting from the Nuclear Medicine Section 1096 36.3 Reporting from the Radiation Therapy Section 1100 36.4 Sections B, C, and D: Putting It All Together 1105 Chapter Summary and Review 1108 37 PHYSICAL REHABILITATION AND DIAGNOSTIC AUDIOLOGY THROUGH NEW TECHNOLOGY SECTIONS 1115 37.1 Reporting Services from the Physical Rehabilitation and Diagnostic Audiology Section 1115 37.2 Reporting Services from the Mental Health Section 1119 37.3 Reporting from the Substance Abuse Treatment Section 1123 37.4 Reporting from the New Technology Section 1126 37.5 Sections F–X: Putting It All Together 1134 Chapter Summary and Review 1138 38 INPATIENT CODING CAPSTONE 1146 PART VI: Reimbursement, Legal, and Ethical Issues 1161 39 REIMBURSEMENT 1162 39.1 The Role of Insurance in Health Care 1162 39.2 Types of Insurance Plans 1164 39.3 Methods of Compensation 1169 39.4 NCCI Edits and NCD/LCD 1171 39.5 Place-of-Service and Type-of-Service Codes 1173 39.6 Organizing Claims: Resubmission, Denials, and Appeals 1178 Chapter Summary and Review 1186 40 INTRODUCTION TO HEALTH CARE LAW AND ETHICS 1191 40.1 Sources for Legal Guidance 1191 40.2 Rules for Ethical and Legal Coding 1196 40.3 False Claims Act 1199 40.4 Health Insurance Portability and Accountability Act (HIPAA) 1201 40.5 Health Care Fraud and Abuse Control Program 1211 40.6 Codes of Ethics 1212 40.7 Compliance Programs 1213 Chapter Summary and Review 1214 Appendix A-1 Glossary G-1 Index I-1 ISTUDY
- 22. xvi Let’s Code It!was developed with student success in mind: success in college, success taking the certifica- tion exam, and success in their future health care career. GUIDED TOUR Chapter Openers Each chapter begins by clearly identifying the Learning Outcomes students need to master along with the Key Terms that they need to learn. Coding Bites These appear throughout the text to highlight key concepts and tips to further support understanding and learning. or diagnostic statement, in the seen and treated. The physician’s notes explai The notes may document a spec unnamed problem, or another As a coding specialist, it is your (or codes) so that everyone inv patient at a particular time. The International Classifica tion (ICD-10-CM) code book c report the reason why the healt cific encounter. Overview of the Interna Revision – Clinical Mod Book Sections The ICD-10-CM code book (w tions. Here is an overview of its sections to determine the most encounter occurred. Index to Diseases and In The Alphabetic Index [Index t terms used by the physician to from a health care professional. The Alphabetic Index lists al their basic description alphabet tions are listed by • Condition (e.g., infection, fra • Eponym (e.g., Epstein-Barr s • Other descriptors (e.g., perso So, whichever type of words you them in the Alphabetic Index in The Alphabetic Index can on sis, and you will use this suggest CODING BITES This is just an overview to help you orient your- self to the structure of the code book. You will learn, in depth, how to use the ICD-10-CM code set to report any and all of the reasons why a patient needs the care of a health care professional in Part II: Reporting Diagnoses. Condition The state of abnormality or dysfunction. Eponym A disease or condition named for a person. Abnormal, abnormality, abno - acid-base balance (mixed) E - albumin R77.0 - alphafetoprotein R77.2 - alveolar ridge K08.9 Confirming Pages 2 saf6657X_ch01_001-021.indd 2 04/19/19 04:37 PM Introduction to the Languages of Coding 1 Key Terms Classification Systems Condition Diagnosis Eponym External Cause Inpatient Medical Necessity Nonessential Modifiers Outpatient Procedure Reimbursement Services Treatments Learning Outcomes After completing this chapter, the student should be able to: LO 1.1 Explain the four purposes of medical coding. LO 1.2 Identify the structure of the ICD-10-CM diagnosis coding manual. LO 1.3 Differentiate between the types of procedures and the various procedure coding manuals. LO 1.4 Examine the HCPCS Level II coding manual used to report the provision of equipment and supplies. 1.1 The Purpose of Coding Around the world, languages exist to enable clear and accurate communication between individuals in similar groups or working together in similar functions. The purpose of using health care coding languages is to enable the sharing of information, in a specific and efficient way, between all those involved in health care. Coding languages are constructed of individual codes that are more precise than words. (You will discover this as you venture through this textbook.) By communi- cating using codes rather than words, you can successfully convey to others involved (1) exactly what happened during a provider-patient encounter and (2) why it occurred. You, as the professional coding specialist, have the responsibility to accurately interpret health care terms and definitions (medical terminology) into numbers or number-letter combinations (alphanumeric codes) that specifically convey diagnoses and procedures. Why is it so critical to code diagnoses and procedures accurately? The coding lan- guages, known as classification systems, communicate information that is key to various aspects of the health care system, including • Medical necessity • Statistical analyses • Reimbursement • Resource allocation Medical Necessity The diagnosis codes that you report explain the justification for the procedure, service, or treatment provided to a patient during his or her encounter. Every time a health care professional provides care to a patient, there must be a valid medical reason. Patients certainly want to know that health care professionals performed procedures or provided care for a specific, justified purpose, and so do third-party payers! This is referred to as medical necessity. Requiring medical necessity ensures that health care providers are not performing tests or giving injections without a good medical reason. Diagnosis codes explain why the individual came to see the physician and support the physician’s decision about what procedures to provide. Medical necessity is one of the reasons why it is so very important to code the diag- nosis accurately and with all the detail possible. If you are one number off in your code CODING BITES We use the concept of “languages” to help you relate medical coding—and its code sets—to an idea you already understand. In the health care industry, however, the various code sets, such as ICD- 10-CM or HCPCS Level II, are referred to as Classification Systems. Classification Systems The term used in health care to identify ICD-10-CM, CPT, ICD-10-PCS, and HCPCS Level II code sets. CODING BITES A diagnosis explains WHY the patient requires the attention of a health care provider and a procedure explains WHAT the physician or health care provider did for the patient. ISTUDY
- 23. 150 PART II| REPORTING DIAGNOSES saf6657X_ch06_145-172.indd 150 04/26/19 to be malignant or benign. Often, when you look up one of these specific neoplasm terms in the Alph Index, it will provide you with some specific information about the tumor. Let’s look in the ICD-10-CM Alphabetic Index under the term written by the physicia Fibroxanthoma (see also Neoplasm, connective tissue, benign) atypical — see Neoplasm, connective tissue, uncertain behavior malignant — see Neoplasm, connective tissue, malignant Fibroxanthosarcoma — see Neoplasm, connective tissue, malignant You can see that while you might not know if a fibroxanthoma is malignant or b the Alphabetic Index will tell you. the suffix -oma means tumor. Let’s Code It! Dr. Branson has diagnosed Abby with an alpha cell adenoma of the pancreas. You have been working wi Dr. Branson as his coder for a while, so you know that an adenoma is a neoplasm, but what kind of neoplasm it—benign or malignant? To help you determine this, instead of going to neoplasm, let’s see if there is a listing the Alphabetic Index under adenoma. When you find adenoma, the book refers you to Adenoma (see also Neoplasm, benign, by site) This tells you an adenoma is a benign tumor. Or you can continue down this list to the indented term, and find Adenoma alpha-cell pancreas D13.7 Turn to the Tabular List and read the complete description of code category D13: D13 Benign neoplasm of other and ill-defined parts of digestive system The note does not relate to this patient’s diagnosis for this encounter, so continue reading down the column to review all of the choices for the required fourth character. D13.7 Benign neoplasm of endocrine pancreas That matches Dr. Branson’s diagnosis. Check the top of this subsection and the head of this chapter in ICD-10-CM. There are several NOTES. Rea carefully. Do any relate to Dr. Branson’s diagnosis of Abby? No. Turn to the Official Guidelines and read Sectio I.C.2. There is nothing specifically applicable here, either. Good job! LET’S CODE IT! SCENARIO Abby Shantner, a 41-year-old female, comes to see Dr. Branson to get the results of her biopsy. Dr. Branson expl that Abby has an alpha cell adenoma of the pancreas. Dr. Branson spends 30 minutes discussing treatment opti ICD-10-CM Malignant Primary The term primary indicates the anatomical site (the place in the body) where the nant neoplasm was first seen and identified. If the physician’s notes do not s primary or secondary, then the site mentioned is primary. CHAPTER 6 | CODING NEOPLA saf6657X_ch06_145-172.indd 147 Pathology reports also may provide information on the grading and/or staging of the tumor. Grading a tumor is the microscopic analysis of the tumor cells and tissue to describe how abnormal they appear. Staging, however, evaluates the size and location of the tumor, as well as determination of any signs or evidence of metastasis. In some cases, you will need to know the grade of a patient’s tumor so you can determine the correct code. EXAMPLES C82.07 Follicular lymphoma grade I, spleen C82.16 Follicular lymphoma grade II, intrapelvic lymph nodes These two codes are examples of those with code descriptions that require you to check the physician’s documentation and pathology reports to identify the grade of the tumor. Confirm 104 PART II | REPORTING DIAGNOSES saf6657X_ch05_101-144.indd 104 04 5.2 Bacterial Infections Types of Bacteria Bacteria are single-celled organisms named by their shape (see Figure 5-1). R bacteria, called bacilli, are responsible for the development of diphtheria, te tuberculosis, among others. Spirilla, bacterial organisms shaped like a sp Bacteria Single-celled microorganisms that cause disease. EXAMPLE N30 Cystitis Use additional code to identify infectious agent (B95–B97) Very often, the ICD-10-CM will tell you that you will need this second code identify the specific pathogen. (c) (a) (d) (b) FIGuRE 5-1 Types of bacteria: (a) coccus, (b) bacillus, (c) spirillum, and (d) vibrio (a) Source: Janice Carr/CDC; (b) Source: Janice Carr/CDC; (c) ©Melba Photo Agency/Alamy; (d) Source: Janice Carr/CDC YOu INTERPRET IT! What is the mode of transmission for each condition? 1. Hepatitis B ___________ 2. Measles ___________ 3. Cholera ___________ 4. Insect bites ___________ 5. Influenza ___________ Guidance Connections Each of these boxes connects the concepts students are learning in the chapter to the related, specific Official Guidelines in order to further students’ knowledge and understanding of coding resources. Examples, Let’s Code It! Scenarios, and You Code It! Case Studies Examples are included throughout each chapter to help students make the connection between theoretical and practical coding. Let’s Code It! Scenarios walk students through abstracting and the coding process, step-by-step, to determine the correct code. And You Code It! Case Studies provide students with hands-on practice coding scenarios and case studies throughout each chapter. In addition, You Interpret It! questions present opportuni- ties for students to use critical-thinking skills to identify details needed for accurate coding. 146 PART II | REPORTING DIAGNOSES saf6657X_ch06_145-172.indd 146 Also, read the next notation carefully: Use additional code to identify any fam ICD-10-CM reminds you that an additional factor for the screening is not age but family in the patient’s past bloodline had been diag and it is known that this places the patient a EXAMPLE You would report code: Z80.42 Family history of malignan in addition to code Z12.5 for an encoun a screening prostate exam because his f with prostate cancer, dramatically increa EXAMPLE You would report code: Z85.3 Personal history of malign in addition to code Z12.31 Encounter f nant neoplasm of breast for an encount for a screening mammogram every 6 mo because the fact that she had a malignan dramatically increases her risk for a recu EXAMPLE You would report code: N63.- Unspecified lump in breas for an encounter when a 62-year-old fem she felt a lump in her breast during her m confirmed it was suspicious. A personal history code (Z85.-) shoul receive screening tests more frequently tha tory of breast cancer may get mammogram personal history of breast cancer code will in the frequency of testing. GUIDANCE CONNECTION Read the ICD-10-CM Official Guidelines for Coding and Reporting, section I. Conventions, General Coding Guide- lines and Chapter- Specific Guidelines, subsection C. Chapter- Specific Coding Guidelines, chapter 21. Factors influencing health status and con- tact with health services (Z00–Z99), subsection c.4) History (of). The Z12 code category also carries an ference between a diagnostic test, which is or symptoms, and a screening test, which is tion of disease without signs or symptoms. encounter for diagnostic Confirming a Diagnosis Once the patient exhibits signs, such as a or an abnormality identified during a scree essence of the neoplasm. This is the only w cells and malignant cells. ISTUDY
- 24. xviii Gain real-world experienceby using actual patient records (with names and other identifying information changed) to practice ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II coding for both inpatients and outpatients. You Code It! Practice exercises give students the chance to practice coding with short coding scenarios. You Code It! Application exercises give students the chance to review and abstract physicians’ notes documenting real patient encounters in order to code those scenarios. Both of these types of exercises can be found at the end of most chapters. Capstone Chapters come at the end of Parts II–V and include 15 additional real-life outpatient and inpatient case studies to help students synthesize and apply what they have learned through hands-on coding practice with each code set. Real Abstracting Practice with You Code It! Practice, You Code It! Application, and Capstone Case Studies Chapters End-of-Chapter Reviews Most chapters end with the following assess- ment types to reinforce the chapter learning outcomes: Let’s Check It! Terminology; Let’s Check It! Concepts; Let’s Check It! Guide- lines; Let’s Check It! Rules and Regulations; and You Code It! Basics. First Pages saf6657X_ch39_1157-1186.indd 1183 06/27/19 06:18 PM CHAPTER 39 | REIMBURSEMEnT 1183 CHAPTER 39 REVIEW CHAPTER 39 REVIEW Reimbursement Let’s Check It! Terminology Match each term to the appropriate definition. Part I Enhance your learning by completing these exercises and more at mcgrawhillconnect.com! ® 1. LO 39.2 A physician, typically a family practitioner or an internist, who serves as the primary care physician for an individual. This physician is responsible for evaluating and determining the course of treatment or services, as well as for deciding whether or not a specialist should be involved in care. 2. LO 39.1 A type of health insurance coverage that controls the care of each sub- scriber (or insured person) by using a primary care provider as a central health care supervisor. 3. LO 39.2 A type of health insurance that uses a primary care physician, also known as a gatekeeper, to manage all health care services for an individual. 4. LO 39.2 A policy that covers loss or injury to a third party caused by the insured or something belonging to the insured. 5. LO 39.1 The total management of an individual’s well-being by a health care professional. 6. LO 39.3 An insurance company pays a provider one flat fee to cover the entire course of treatment for an individual’s condition. 7. LO 39.2 The agency under the Department of Health and Human Services (DHHS) in charge of regulation and control over services for those cov- ered by Medicare and Medicaid. 8. LO 39.3 Payment agreements that outline, in a written fee schedule, exactly how much money the insurance carrier will pay the physician for each treat- ment and/or service provided. 9. LO 39.3 An extra reduction in the rate charged to an insurer for services pro- vided by the physician to the plan’s members. 10. LO 39.1 The amount of money, often paid monthly, by a policyholder or insured, to an insurance company to obtain coverage. 11. LO 39.2 Auto accident liability coverage will pay for medical bills, lost wages, and compensation for pain and suffering for any person injured by the insured in an auto accident. 12. LO 39.3 Agreements between a physician and a managed care organization that pay the physician a predetermined amount of money each month for each member of the plan who identifies that provider as his or her pri- mary care physician. 13. LO 39.2 A plan that reimburses a covered individual a portion of his or her income that is lost as a result of being unable to work due to illness or injury. 14. LO 39.2 Individuals who are supported, either financially or with regard to insur- ance coverage, by others. A. Automobile Insurance B. Capitation Plans C. Centers for Medicare Medicaid Services (CMS) D. Dependents E. Disability Compensation F. Discounted FFS G. Episodic Care H. Fee-for-Service (FFS) Plans I. Gatekeeper J. Health Care K. Health Maintenance Organization (HMO) L. Insurance Premium M. Liability Insurance N. Managed Care Confirming Pages saf6657X_ch06_145-172.indd 168 CHAPTER 6 REVIEW 168 PART II | REPORTING DIAGNOSES 7. Follicular grade III lymphoma, lymph nodes of inguinal region and lower limbs: a. main term: _____ b. diagnosis: _____ 8. Acral lentiginous, right heel melanoma: a. main term: _____ b. diagnosis: _____ 9. Lipoma of the kidney: a. main term: _____ b. diagnosis: _____ 10. Primary malignant neoplasm of right male breast, upper-outer quadrant: a. main term: _____ b. diagnosis: _____ 11. Malignant odontogenic tumor, upper jaw bone: a. main term: _____ b. diagnosis: _____ 12. Secondary malignant neoplasm of vallecula: a. main term: _____ b. diagnosis: _____ 13. Carcinoma in situ neoplasm of left eyeball: a. main term: _____ b. diagnosis: _____ 14. Benign neoplasm of cerebrum peduncle: a. main term: _____ b. diagnosis: _____ 15. Myelofibrosis with myeloid metaplasia: a. main term: _____ b. diagnosis: _____ YOU CODE IT! Practice Using the techniques described in this chapter, carefully read through the case studies and determine the most accurate ICD-10-CM code(s) and external cause code(s), if appropriate, for each case study. 1. George Donmoyer, a 58-year-old male, presents today with a sore throat, persistent cough, and earache. Dr. Selph completes an examination and appropriate tests. The blood-clotting parameters, the thyroid function studies, as well as the tissue biopsy confirm a diagnosis of malignant neoplasm of the extrinsic larynx. 2. Monica Pressley, a 37-year-old female, comes to see Dr. Wheaten today because she has been having diarrhea and abdominal cramping and states her heart feels like it’s quivering. The MRI scan confirms a diagnosis of benign pancreatic islet cell adenoma. 3. Suber Wilson, a 57-year-old male, was diagnosed with a malignant neoplasm of the liver metastasized from the prostate; both sites are being addressed in today’s encounter. 4. William Amerson, a 41-year-old male, comes in for his annual eye examination. Dr. Leviner notes a benign right conjunctiva nevus. 5. Edward Bakersfield, a 43-year-old male, presents with shortness of breath, chest pain, and coughing up blood. After a thorough examination, Dr. Benson notes stridor and orders an MRI scan. The results of the MRI con- firm the diagnosis of bronchial adenoma. 6. Elizabeth Conyers, a 56-year-old female, presents with unexplained weakness, weight loss, and dizziness. Dr. Amos completes a thorough examination and does a workup. The protein electrophoresis (SPEP) and quantitative immunoglobulin results confirm the diagnosis of Waldenström’s macroglobulinemia. 7. James Buckholtz, a 3-year-old male, is brought in by his parents. Jimmy has lost his appetite and is losing weight. Mrs. Buckholtz tells Dr. Ferguson that Jimmy’s gums bleed and he seems short of breath. Dr. Ferguson notes splenomegaly and admits Jimmy to Weston Hospital. After reviewing the blood tests, MRI scan, and bone marrow aspiration results, Jimmy is diagnosed with acute lymphoblastic leukemia. 8. Kelley Young, a 39-year-old female, presents to Dr. Clerk with the complaints of sudden blurred vision, dizzi- ness, and numbness in her face. Kelley states she feels very weak and has headaches. Dr. Clerk admits Kelley to the hospital. After reviewing the MRI scan, her hormone levels from the blood workup, and urine tests, Kel- ley is diagnosed with a primary malignant neoplasm of the pituitary gland. 9. Ralph Bradley, a 36-year-old male, comes to see Dr. Harper because he is weak, losing weight, and vomiting and has diarrhea with some blood showing. Ralph was diagnosed with HIV 3 years ago. Dr. Harper completes an examination noting paleness, tachycardia, and tachypnea. Ralph is admitted to the hospital. The biopsied tissue from an endoscopy confirms a diagnosis of Kaposi’s sarcoma of gastrointestinal organ. ICD-10-CM ISTUDY
- 25. In addition, allof the exercises in the Chapter Review can be assigned through Connect. Of particular note are the You Code It! Practice exercises, which offer our unique CodePath option. In Connect, students are presented with a series of questions to guide them through the critical thinking process to determine the correct code. Confirming Pages saf34625_ch04_053-100.indd 97 11/17/21 05:45 PM CHAPTER 4 REVIEW CHAPTER 4 | INTRODUCTION TO ICD-10-CM 97 YOU CODE IT! Application The following exercises provide practice in abstracting physician documentation from our health care facility, Prader, Bracker, Associates. These case studies are modeled on real patient encounters. Using the techniques described in this chapter, carefully read through the case studies and determine the most accurate ICD-10-CM code(s) for each case study. Remember to include external cause codes, if appropriate. ICD-10-CM PRADER, BRACKER, ASSOCIATES A Complete Health Care Facility 159 Healthcare Way • SOMEWHERE, FL 32811 • 407-555-6789 PATIENT: Kassandra, Kelly ACCOUNT/EHR #: KASSKE001 DATE: 09/16/22 Attending Physician: Oscar R. Prader, MD S: Pt is a 19-year-old female who has had a sore throat and cough for the past week. She states that she had a temperature of 101.5 F last night. She also admits that it is painful to swallow. No OTC medi- cation has provided any significant relief. O: Ht 5′5″ Wt. 148 lb. R 20. T 101 F. BP 125/82. Pharynx is inspected, tonsils enlarged. There is pus noted in the posterior pharynx. Neck: supple, no nodes. Chest: clear. Heart: regular rate and rhythm without murmur. A: Acute pharyngitis P: 1. Send pt for Strep test 2. Recommend patient gargle with warm salt water and use OTC lozenges to keep throat moist 3. Rx if needed once results of Strep test come back 4. Return in 2 weeks for follow-up Determine the most accurate ICD-10-CM code(s). WESTON HOSPITAL 629 Healthcare Way • SOMEWHERE, FL 32811 • 407-555-6541 PATIENT: DAVIS, HELEN ACCOUNT/EHR #: DAVIHE001 DATE: 10/21/22 Attending Physician: Renee O. Bracker, MD Patient, an 82-year-old that presents today to see Dr. Newson. Dr. Newson saw this patient 10 days ago in office, where she was diagnosed with a UTI and prescribed nitrofurantoin PO. Today she presents with the complaints of dysuria, low back pain, abdominal pain, nausea, and diarrhea. After a positive UA she was admitted to Weston Hospital. (continued) ISTUDY
- 26. Visit https://ebookmass.com todayto explore a vast collection of ebooks across various genres, available in popular formats like PDF, EPUB, and MOBI, fully compatible with all devices. Enjoy a seamless reading experience and effortlessly download high- quality materials in just a few simple steps. Plus, don’t miss out on exciting offers that let you access a wealth of knowledge at the best prices!
- 27. Exploring the Varietyof Random Documents with Different Content
- 28. to make oneman the property of another? Has God poured the tide of life through the African’s breast, and animated it with a portion of his own Divine spirit, and at the same time deprived him of all natural affections, that he alone is to be struck off the list of rational beings, and placed on a level with the brute? Is his flesh marble, and his sinews iron, or his immortal spirit of a class condemned, without hope, to penal suffering, that he is called upon to endure incessant toil, and to be subjected to degradation, bodily and mental, such as no other portion of the family of Adam have ever been destined to endure, without the vengeance of Heaven being signally displayed upon the oppressors? Does the African mother feel less love to her offspring than the white woman? or the African husband regard with less tenderness the wife of his bosom? Is his heart dead to the ties of kindred,—his nature so brutalized, that the sacred associations of home and country awaken no emotions in his breast? History unanswerably demonstrates that the negro does feel, keenly feel, the wrongs inflicted upon him by his unrighteous enslavers, and that his mind, barren as it has been rendered by hard usage, and desolated with misery, is not unwatered by the pure and gentle streams of natural affection. Yet the lordly oppressors remain unmoved by the sad condition of the negro, contemplate with indifference his bodily and mental sufferings, and still dare to postpone to an indefinite period the termination of his oppression and of their own guilt. But thanks be to God! there is some counteracting influence to this feeling, and that it is on the advance. The night has been long and dark,—already the horizon brightens; the day of freedom dawns. Go on, then, my friend; I say, go on! in the good cause thou hast espoused. Labor, and faint not. “Whatsoever thy hand findeth to do, do it with all thy might.” My kind regards to Frederick Douglass; may he, and all others also, be strengthened and encouraged to labor in the great work of human freedom; that so, by gradual increase, like the mighty surge, they may become strong enough to overpower and drown the oppressor, and be enabled to devise and execute
- 29. Wilson Armistead measures ofmercy and justice, which may avert the judgments of the Almighty from their guilty land. For surely some signal display of Divine displeasure must await America, unless she repent, and undo the heavy burdens of her THREE MILLION SLAVES. Are not the signs of the times calculated to remind us forcibly of this language of Isaiah, “Behold, the Lord cometh out of his place to punish the inhabitants of the earth for their iniquity; the earth also shall disclose her blood, and no more cover her slain.” Do we not hear already “——the wheels of an avenging God, Groan heavily along the distant road?” Assuredly, he comes to judge the earth. “Who shall abide the day of his coming; who shall stand when he appeareth?” Thy Friend, very truly,
- 30. IMPROMPTU STANZAS, SUGGESTED BYTHE WORKING OF THE FUGITIVE SLAVE ACT, AS ILLUSTRATED IN THE CASE OF REV. DOCTOR PENNINGTON. BY THE WORK-SHOP BARD.
- 31. Bring out thehandcuffs, clank the rusted gyves; Rain down your curses on the doomed race; Hang out a terror that shall haunt their lives, In every place. Unloose the bloodhounds from oppression’s den; Arm every brigand in the name of law, And triple shield of pulpit, press, and pen, Around them draw. Ho! politicians, orators, divines! Ho! cotton-mongers of the North and South! Strike now for slavery, or our Union’s shrines Are gone forsooth! Down from their glory into chaos hurled, Your thirty States in shivered fragments go, Like the seared leaves by autumn tempests whirled To depths below. Closed be each ear, let every tongue be dumb; Nor one sad pitying tear o’er man be shed, Though fainting at your threshold he should come, And ask for bread. Though woman, fleeing from the cruel grip Of foul oppression, scarred and stained with blood, Where from the severed veins the driver’s whip Hath drank its flood. Though helpless childhood ask—O pitying Heaven!— The merest crumb which falls upon the floor, Tho’ faint and famished, bread must not be given, Bolt fast the door. And must it be, thou just and holy God! Th t i id t th l d d t i k
- 32. J. M. Eells. Thatin our midst thy peeled and stricken poor Shall kneel and plead amid their tears and blood, For evermore? Shall those whom thou hast sent baptized from heaven, To preach the Gospel the wide world around, To teach the erring they may be forgiven, Be seized and bound? Placed on the auction-block, with chattels sold, Driven like beasts of burden day by day, The flock be scattered from the shepherd’s fold, The spoiler’s prey? How long—thy people cry—O Lord, how long! Shall not thine arm “shake down the bolted fire!” Can deeds like these of God-defying wrongs, Escape His ire? Must judgments,—such as swept with fearful tread O’er Egypt when she made thy people slaves, Where thy hand strewed with their unburied dead The Red Sea waves? Must fire and hail from heaven upon us fall, Our first-born perish ’neath the Avenger’s brand, And sevenfold darkness, like a funeral pall O’erspread the land? We kneel before thy footstool, gracious God, Spare thou our nation, in thy mercy spare; We perish quickly ’neath thy lifted rod And arm made bare.
- 33. West Troy, March,1851.
- 34. JOHN MURRAY (OFGLASGOW). About a year ago, the newspapers announced the death of Mr. John Murray, for many years the secretary of the Glasgow Emancipation Society, and I would do violence to truth and humanity whose servant and soldier he was, should I neglect to pen a few recollections of that most earnest and efficient man. He was related to the ancient and honorable family of the Oswalds of Sheildhall, and received that excellent educational and religious training which is given to the children of the middle and higher classes in Scotland. At the age of twenty-two or three, in consequence of an attack of pulmonary hemorrhage, he sailed for the West Indies and found employment at his trade, house-building, in St. Kitts. Very soon, however, he found other matters to engage, and almost engross his attention and labors; in conjunction with an uncle of George Stephen of London, and a Dr. Hamilton, resident in St. Kitts, he did manly and successful fight in behalf of the wronged and bleeding slave. After a residence in that island of some years, during which he obtained a thorough knowledge of the workings of slavery, he returned to Glasgow, poor in pocket, but rich in abolitionism. Soon after his return, he was united in marriage to Miss Anna ——, a lady whose perfect harmony in sentiment, softened by feminine delicacy, made a happy anti-slavery home for the zealous and ardent abolitionism of John Murray. It was a union of hearts attached in early youth, and which had remained “leal” during a long separation. Shortly after marriage, he commenced business as a spirit-dealer, then and now a most reputable calling in the opinion of the good citizens of Glasgow. Temperate himself, his calling gradually became
- 35. unpleasant to him.At first he refused to sell spirits to any person partly inebriated; then he reasoned himself into a total abandonment of the death-dealing traffic. With no other business prospect before him, prevented by his long difficulty from working at his trade, with a young wife and child dependent on him, he suddenly locked up his spirit-cellar and never more sold rum! In 1828 or 1829, through the influence of his kinsman, James Oswald, Esq., of Sheildhall, Mr. Murray was appointed surveyor on a part of the Forth and Clyde canal, an office requiring much labor for little pay. His prospects of promotion depended on Mr. Oswald and other members of the Kirk of Scotland. Mr. Murray was a full member of the Tron Church, Glasgow, when, according to law, a minister was appointed there regardless of the choice, and contrary to the wishes of the great majority of its members. In consequence of this appointment, and again unmindful of personal advancement, John Murray shook the dust from his sandals and quit at once and forever the Tron Church and the Kirk of Scotland. About the same time the Glasgow Emancipation Society was formed or re-organized, on the doctrine of immediate emancipation so splendidly announced by a secession minister of Edinburgh. The secretaries of this association were John Murray the surveyor, and William Smead, of the Gallowgate, grocer; the last a Friend. These two were the head and front, the thinking and the locomotive power of this well known association which did notable fight, if not the principal labor, in effecting emancipation in the British West Indies, and in assaulting American slavery. And, twenty odd years ago, it was no trifling matter to do anti- slavery work in Glasgow, the very names of whose stateliest streets proclaimed that they were built by money wrung out of the blood and sweat of the negroes of Jamaica, St. Vincents, etc. The whole of the retired wealth, nearly all the active business influence, the weight of the Established Church, the rank and fashion of Glasgow, and though last not least, the keen wit of the poet Motherwell,[N] and the great statistical learning and industry of M’Queen were
- 36. arrayed on theside of the slave-holder. Sugar and cotton and rum were lords of the ascendant! Yet the poor surveyor and the humble grocer fought on; nor did they fight alone; the silvery voice and keen acumen of Ralph Wardlaw, the earnest and powerful Hugh Heugh, the inexorable logic and burning sarcasm of swarthy Wully Anderson, and the princely munificence of James Johnston, combined to awaken the people to the enormity of slavery. And the Voluntary Church movement, and the fight for the Reform Bill aroused a varied eloquence in the orators who plead for, and a kindling enthusiasm in the people who were struggling on the liberal side of all these questions; for the people, battling for their own rights, had heart room to hear the prayer for the rights of others more deeply oppressed. Thus ever will liberty be expansive and expanding in the direction of human brotherhood. Then Knibb came along with his fiery eloquence, which swept over and warmed the hearts of the people with indignation at the dishonor done religion in the martyrdom of the missionary Smith; and then the grand scene in the British emancipation drama, the overthrow of Bostwick by George Thompson, and the monster petitions and the reluctant assent of the ministry and the passage of the bill. Those were stirring times in Glasgow, and it did one’s heart good to see John Murray in their midst. The arrangements for nearly all those movements originated with, and were carried out by him; he never made a speech of one minute long, yet he most effectively arranged all the speaking, drew up all the resolutions and reports and addresses; and most of the movements in England, the pressure upon the ministry, and the advocacy in Parliament were the result of his wide and laborious correspondence. He used more than one ream of paper for manuscripts upon the great cause which he seemed born to carry out successfully. In addition to his other correspondence, nearly every issue of two of the Glasgow tri-weekly papers contained able articles from his pen in reply to the elaborate defence of slavery carried on in the Glasgow Courier by Mr. M’Queen. And yet this man, doing this mighty work, was so entirely
- 37. James M’Cune Smith unobtrusive,so quiet in his labors, that few beyond the committee knew him other than the silent secretary of the Glasgow Emancipation Society. And I shall not soon forget the perfect consternation with which he heard a vote of thanks tendered him by resolution at an annual meeting of the society. In 1835 or 1836, Mr. Murray was promoted to the office of collector at Bowling Bay, for the company he had so long and faithfully served. And many an anti-slavery wayfarer can testify to the warm welcome and genial hospitality of the snug little stone building so beautifully packed on the Clyde entrance of the Forth and Clyde canal. A charming family, consisting of a devoted wife, two most promising boys, and a retiring, sweet tempered girl, made happy the declining years of this great friend of the slave, and earnest pioneer in many reforms. Freedom for Ireland, the Peace Question, Radical Reform, a Free Church, and Total Abstinence, were questions to all of which Mr. Murray devoted his pen and his purse. His soul received and advocated whatever looked towards human progress. In person, Mr. Murray was tall and gaunt, and would strongly remind one of Henry Clay. About a mile from Bowling Bay, within the enclosure that surrounds the Relief Church, in a sweet quiet spot, the green turf now covers what remains of the once active frame of John Murray; and as, with moistened cheek, I fling this pebble upon his cairn, I cannot help thinking how much more has been done for the cause of human progress by this faithful servant to his own convictions of the truth, than by the nation-wept sage of Ashland. New York, Sept. 25, 1852.
- 38. POWER OF AMERICANEXAMPLE. At the last anniversary of the American Home Missionary Society, Rev. John P. Gulliver made an eloquent address on the duty of bringing the American people under the full influence of Christian principle, in an argument drawn from the bearings of our national example on the people of other lands. Christianity, he said, alone can make the nations free. We fully believe in this sentiment. In answer to the question, How is Christianity to effect this result?—Mr. Gulliver’s answer was: America is to be the agent. Other nations, he thought, might do much in working out this great result; but the chief hopes of the friends of freedom, he suggested, are centered upon this country. The world needs an example; and he pointed to what the example of this nation has already done, imperfect as it is. “It is doing, at this moment, more to change the political condition of man than all the armies and navies,—than all the diplomacy and king-craft of the world.” If it be so, if, as the speaker declared, “the battle of the world’s freedom is to be fought on our own soil,” it would be interesting to look at the obstacles in the way. The United States must present a very different example from that exhibited the last twenty-five years, and now exhibited, before this country will be the agent of Christianity in evangelizing the world. Think of three millions of our countrymen in chains! Think of the large numbers held by ministers of the gospel and members of churches! Think of the countenance given to slave-holders by our ecclesiastical assemblies, by Northern preachers, by Christian lawyers, merchants, and mechanics! Think of the platforms, adopted by the two leading political parties of the country, composed partly of religious men! Think of the dumbness of those that minister at the altar, in view of the great national iniquity, and then consider the
- 39. effects of suchan example upon other nations, Christian and Heathen! Dr. Hawes is stated to have said at the last annual meeting of the A. B. C. F. M., that Dr. John H. Rice said, in his hearing, more than twenty years ago: “I do not believe the Lord will suffer the existing type or character of the Christian world to be impressed on the heathen.” We also heard the remark, and believe that Dr. Rice, in alluding to the state of religion in this country, said, “it was so far short of what Christianity required, that sanguine as many were that the United States was speedily to be the agent of the world’s conversion, he did not believe, for one, that God would suffer the Christianity of this country, as it then was, to be impressed upon the heathen world.” If the character of our religion was thus twenty years ago, what is it now? As a religious people we have been boastful. We have acted as if we thought God could not convert the world without the instrumentality of this country. It is far more probable that the converted heathen will send missionaries to the United States to teach us the first rudiments of Christianity, than that this country, at the present low ebb of religion, will be the agent of converting heathen nations to God. Dr. Hawes believed “that if the piety of the church were corrected and raised to the standard of Paul, God would soon give to the Son the heathen for his inheritance.” No doubt of it. Such piety would do away with chattel slavery, with caste, with slavery platforms, with ungodly rulers, with Indian oppression, with divorcing Christianity from the ballot-box, with heathenism at home. Let us pray for such piety; and that hundreds of such men as Rice and Hawes may lift up their voices like a trumpet, and put forth corresponding action, until the nation shall be regenerated and become fit to enlighten, and, through the grace of God, save a dying world.
- 40. “THE GOSPEL ASA REMEDY FOR SLAVERY.” In one of the leading Congregational papers, a writer, W. C. J., has commenced a series of communications under the above heading. It is well to discuss the subject. The writer says, “There are, it is true, many among our three millions of slaves who are acquainted with the rudiments of religious truth, and are leading lives of sincere piety.” Dr. Nelson, a native of a slave State, stated, as the result of experience for many years, that he had never known more than three or four slaves who he had reason to believe were truly and intelligently pious. The Synod of South Carolina and Georgia published to the world, some years since, that the great mass of slaves were heathen, as much so as the heathen of any portion of the globe. What authority W. C. J. has for saying there are, among the three millions of American slaves, “many” who are “leading lives of sincere piety,” I do not know. It is probably the mere conjecture of an ardent mind. He qualifies the expression by asking, “What is the type of the religion that too generally appears among the slaves?” And then replies to his own question, “It is sickly and weak, like a plant growing in a cellar, or a cave; a compound of sincere piety with much of superstition and fanaticism.” What sort of piety is that? A sagacious observer has remarked, that there never can be, in our day, intelligent piety where men are not possessed of property, especially where they are mere serfs or slaves. How many American slaves have the piety of “Uncle Tom,” we are unable to say. Probably very few. And it must fill the heart of every one who loves the souls of men, with anguish to contemplate the spiritual destitution of the slaves in this country; kept in bondage by the religious and political apathy or acts of professing Christians, of different denominations, in
- 41. Lewis Tappan their individualor associated capacity. But to the question: Is the gospel a remedy for slavery? We answer, unhesitatingly, not such a gospel as is preached to them; for while it does very little to enlighten either slave or master, it enjoins upon the former passive obedience, and inculcates upon the latter the right and duty of holding their fellow men in bondage. Nor have we much hesitation in avowing it as our belief, that the gospel, as generally preached in the free States, is quite inadequate to put an end to slavery. It does not reach the conscience of the tens of thousands who are, in various ways, connected with slave-holding by relationship, business correspondence, or political or ecclesiastical ties. As proof of this, we need only contemplate the action of the Northern divisions of the political and religious national parties. Slavery is countenanced, strengthened, increased, extended by their connivance or direct agency. The truth is, Christianity, as promulgated by the great mass of the preachers and professors at this day even in the free States, is not a remedy for slavery. It is a lamentable truth, one that might justly occasion in the heart of every true Christian the lamentation of the prophet Jeremiah: “Oh that my head were waters, and mine eyes a fountain of tears, that I might weep, day and night, for the slain of the daughters of my people!” And it is in view of this truth, that the friends of a pure and full gospel have great encouragement to persevere in their work of faith and love. The missionaries connected with the American Missionary Association, at home and abroad, inculcate, fearlessly and persistently, a gospel of freedom, and make no more apology or allowance for slave-holding than for any other sin or crime. Such missionaries should be sustained, their numbers augmented, and prayer ascend for them continually.
- 42. C. G. Finney LETTERTO THE PRESIDENT OF THE SOCIETY. Dear Madam:— Your request to transmit my name, with a short article, for insertion in your contemplated publication, is before me. I have neither time nor words in which to express my unalterable abhorrence of slavery, with all the odious apologies and blasphemous claims of Divine sanction for it, that have been attempted. I regard all attempts, by legislation or otherwise, to give the abominable system “aid and comfort” as involving treason against the government of God, and as insulting the consciences and common sense of men. Yours truly, Oberlin, 24 Sept., 1852.
- 43. Catharine E. Beecher. THESLAVE’S PRAYER. The first effort of my early life in narrative writing, was in behalf of those who, in even darker days than these, were preëminently those who, on earth, “had no helper.” From this tale is selected these few lines—a song introduced into the story—not because it has any poetic merit, but because to me and perhaps to others, it seems interesting from the above circumstance. SONG OF PRAISE.
- 44. Though man neglectsmy sighing, And mocks the bitter tear, Yet does not God my crying With kindest pity hear? And when with fierce heat panting His hand can be my shade, And when with weakness fainting Support my aching head. And when I felt my cares For those his love can save, Will he not hear the prayers Of the poor negro slave? Yes, for the poor and needy He promises to save, And who is poor and needy Like the poor negro slave!
- 45. Charles Sumner THE STRUGGLE. Oursis a noble cause; nobler even than that of our fathers, inasmuch as it is more exalted to struggle for the freedom of others, than for our own. The love of right, which is the animating impulse of our movement, is higher even than the love of freedom. But right, freedom, and humanity, all concur in demanding the abolition of slavery. Boston, Oct. 16, 1852.
- 46. WORK AND WAIT. MyFriend:— I have found no moment till the present that I could devote to a compliance with your request, and I am now probably too late. However, let me hastily proffer a few suggestions to opponents of slavery, which I trust may not be found unprofitable. I would say, then: 1. Do not choose to separate and isolate yourselves from the general movement of humanity, save as you may be constrained to oppose certain eddies of that movement. Had Wilberforce, Clarkson, and their associate pioneers in the cause of British abolition, seen fit to cut themselves loose from all preëxisting sects and parties, and for a special anti-slavery church and party, I think the triumph of their cause would have been still unattained. 2. Do not refuse to do a little good because you would much prefer to do a greater which is now unattainable. The earth revolves in her vast orbit gradually; and he who has done whatever good he can, need not reproach himself for his inability to do more. 3. Be foremost in every good work that the community around you will appreciate,—not because they will appreciate it, but because their appreciation and sympathy will enable you to do good in other spheres, and do it more effectually. 4. Be preëminent in your consideration and regard for the rights and wrongs of labor in your own circle, even the rudest and humblest. An abolitionist who hires his linen made up at the lowest market rate, and pays his wash-woman in proportion, will do little good to the anti-slavery or any other philanthrophic cause. The man of liberal culture and generous heart who unostentatiously tries to
- 47. Horace Greeley elevate themost depressed to his own level, is doing a good work against slavery, however unconsciously. 5. Have faith, with a divine patience; man is privileged to labor for a good cause, but the glory of its success must redound to his Maker. Next to a great defeat, the most fatal event for slavery would be a great triumph. Doubtless, the bolts are now forging in some celestial armory destined to strike the shackles from the limbs of the bondman, and cleanse the land from the foulest and blackest iniquity ever organized and legalized in the christian world. The shout of deliverance may come when it is least expected,—nay, the very means employed to render its coming impossible, will probably secure and hasten it. For that and every other needed reform, let the humane and hopeful strive, not despairing in the densest midnight, and realizing that the darkest hour is often that preceding the dawn. Let them, squandering no opportunity, and sacrificing no principle, “Learn to labor, and to wait.”
- 48. Gerrit Smith THE GREATEMANCIPATION. Beautiful and happy will this world be, when slavery and every other form of oppression shall have ceased. But this change can be produced only by the religion of Jesus Christ. Reliance on any other power to overthrow slavery, or restore to order and happiness this sin-crazed and sin-ruined world, will be vain. Peterboro’, Sept. 22, 1852.
- 49. ODE Sung at thecelebration of the First Anniversary of the kidnapping, at Boston, of Thomas Sims, a fugitive slave:—the kidnapping done under the forms of law, and by its officers, 12 June 1851. The deed celebrated at the Melodeon, Boston, 12 June 1852. BY REV. JOHN PIERPONT. Souls of the patriot dead, On Bunker’s height who bled! The pile, that stands On your long-buried bones,— Those monumental stones,— Should not suppress the groans, This day demands. For Freedom there ye stood; There gave the earth your blood; There found your graves; That men of every clime, Faith, color, tongue, and time, Might, through your death sublime, Never be slaves.
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- 51. Over your bed,so low, Heard ye not, long ago, A voice of power[O] Proclaim to earth and sea, That, where ye sleep, should be A home for Liberty, Till Time’s last hour? Hear ye the chains of slaves, Now clanking round your graves? Hear ye the sound Of that same voice, that calls From out our Senate halls,[P] “Hunt down those fleeing thralls, With horse and hound!” That voice your sons hath swayed! ’Tis heard, and is obeyed! This gloomy day Tells you of ermine stained, Of Justice’ name profaned, Of a poor bondman, chained And borne away! Over Virginia’s Springs, Her eagles spread their wings, Her Blue Ridge towers:— That voice,[Q]—once heard with awe,— Now asks,—“Who ever saw, Up there, a higher law Than this of ours?” Must we obey that voice? When God, or man’s the choice, Must we postpone H h f Si i k ?
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