Download or read book Understanding Hospital Billing and Coding written by Debra P. Ferenc and published by Elsevier Health Sciences. This book was released on 2013-02-26 with total page 626 pages. Available in PDF, EPUB and Kindle. Book excerpt: - Updated Claim Forms chapter covers the UB-04 claim form. - Updated information covers diagnosis and procedural coding, with guidelines and applications. - Updated claim forms and names are used throughout.

Download or read book Understanding Hospital Coding and Billing A Worktext written by Marsha S Diamond and published by Cengage Learning. This book was released on 2015-01-23 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Packed with real-world applications, UNDERSTANDING HOSPITAL CODING AND BILLING: A WORKTEXT, 3e offers a comprehensive guide to both hospital billing and coding that helps students learn to create results with greater specificity, and accuracy. Enabling instructors to easily adapt to the postponement of ICD-10-CM and ICD-10-PCS, the new edition provides instruction on the current ICD-9-CM concepts as well as prepares students for ICD-10 guidelines. Features more than 30 case studies with patient record activities for practicing completing the UB-04 billing form Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.

Download or read book Medical Billing Coding For Dummies written by Karen Smiley and published by John Wiley & Sons. This book was released on 2019-12-05 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: The definitive guide to starting a successful career in medical billing and coding With the healthcare sector growing at breakneck speed—it’s currently the largest employment sector in the U.S. and expanding fast—medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered. This updated edition provides everything you need to begin—and then excel in—your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered. Find out about the flexible employment options available and how to qualify Understand the latest updates to the ICD-10 Get familiar with ethical and legal issues Discover ways to stay competitive and get ahead The prognosis is good—get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!

Download or read book Hospital Billing written by Susan Magovern and published by . This book was released on 2009 with total page 426 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Buck s Step by Step Medical Coding 2021 Edition written by Elsevier and published by Elsevier Health Sciences. This book was released on 2020-11-08 with total page 836 pages. Available in PDF, EPUB and Kindle. Book excerpt: Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! The bestselling Buck's Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. To reinforce your understanding, practice exercises follow the explanations of each coding concept. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other book so thoroughly covers all coding sets! - Theory and practical review questions (located at the end of each chapter) focus on recalling important chapter information and application of codes. - A step-by-step approach makes it easier for students to build coding skills and remember the material. - Learning objective and glossary review questions reinforce student understanding of key chapter concepts and terms. - 30-day trial to TruCode® Encoder Essentials gives students experience with using an encoder (plus access to additional encoder practice exercises on the Evolve website). - UNIQUE! "Real-life" coding reports (cleared of any confidential information) simulate the reports students will encounter as coders, and help them apply coding principles to actual cases. - Online activities on Evolve provide extra practice with assignments, including coding reports. - More than 450 illustrations help in understanding the types of medical conditions and procedures being coded, and include examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop students' coding ability and critical thinking skills. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample EHR screenshots (in Appendix D) show examples similar to the electronic health records students will encounter in the workplace. - NEW! Coding updates include the latest information available, promoting accurate coding and success on the job. - NEW! Coverage of CPT E/M Guidelines changes for Office and Other Outpatient codes.

Download or read book Understanding Hospital Billing and Coding written by Debra P. Ferenc and published by Elsevier Health Sciences. This book was released on 2013-02-26 with total page 626 pages. Available in PDF, EPUB and Kindle. Book excerpt: A basic guide to hospital billing and reimbursement, Understanding Hospital Billing and Coding, 3rd Edition helps you understand, complete, and submit the UB-04 claim form that is used for all Medicare and privately insured patients. It describes how hospitals are reimbursed for patient care and services, showing how the UB-04 claim form reflects the flow of patient data from the time of admission to the time of discharge. Written by coding expert Debra P. Ferenc, this book also ensures that you understand the essentials of ICD-10-CM and develop skills in both inpatient coding and outpatient/ambulatory surgery coding. UB-04 Claim Simulation on the companion Evolve website lets you practice entering information from source documents into the claim form. Over 300 illustrations and graphics bring important concepts to life. Detailed chapter objectives highlight what you are expected to learn. Key terms, acronyms, and abbreviations with definitions are included in each chapter. Concept Review boxes reinforce key concepts. Test Your Knowledge exercises reinforce lessons as you progress through the material. Chapter summaries review key concepts. Practice hospital cases let you apply concepts to real-life scenarios. Updated Claim Forms chapter covers the UB-04 claim form. Updated information covers diagnosis and procedural coding, with guidelines and applications. Updated claim forms and names are used throughout.

Download or read book CPT Professional 2022 written by American Medical Association and published by . This book was released on 2021-09-17 with total page 1200 pages. Available in PDF, EPUB and Kindle. Book excerpt: CPT(R) 2022 Professional Edition is the definitive AMA-authored resource to help healthcare professionals correctly report and bill medical procedures and services.

Download or read book Cases in Pediatric Acute Care written by Andrea Kline-Tilford and published by John Wiley & Sons. This book was released on 2020-03-30 with total page 528 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cases in Pediatric Acute Care presents over 100 real-world pediatric acute care cases, each including a brief patient history, a detailed history of present illness, presenting signs and symptoms, vital signs, and physical examination findings. Ideal for developing a systematic approach to diagnosis, evaluation, and treatment, this resource provides students and advanced practitioners with the tools required to deliver comprehensive care to acute, chronic and critically ill children. The cases encompass a wide range of body systems, medical scenarios, professional issues and general pediatric concerns, and feature laboratory data, radiographic images and information on case study progression and resolution. Develops the essential skills necessary to provide the best possible pediatric acute care Discusses the most appropriate differential diagnoses, diagnostic evaluation, and management plans for each case Presents cases related to pulmonary, cardiac, neurologic, endocrine, metabolic, musculoskeletal, and other body systems Highlights key points in each case to quickly identify critical information Cases in Pediatric Acute Care is an excellent resource for advanced practice provider students and pediatric healthcare providers managing acutely ill children.

Download or read book Principles of Coding and Reimbursement for Surgeons written by Mark Savarise and published by Springer. This book was released on 2016-12-30 with total page 342 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text provides the in-depth understanding of the mechanisms that guide coding and reimbursement. The text is meant to be useful to surgeons in practice, both in general surgery and in surgical subspecialties; practice management teams of surgical practices and to resident physicians in surgery. Part 1 of the text addresses the CPT coding process, the relative valuation system (RVU), the ICD-9 and ICD-10 systems of classification, Medicare Part B payment rules for physicians, the DRG system and Medicare Part A payment for hospitals, alternative payment models, and the myriad of quality measures of importance to surgeons. Part 2 of the text addresses specific coding in areas where surgeons historically have had the most difficulty. This is not meant to substitute for the available texts, software or courses on coding, but to provide the historical background and rationale for the specific coding rules. Principles of Coding and Reimbursement for Surgeons will be of great value to general surgeons and surgical subspecialists in private practice, academic institutions, and employed positions. It will provide direction to management teams from practice and institutional levels. It is also of use to surgical trainees and to researchers in health policy issues.

Download or read book ICD 10 CM Official Guidelines for Coding and Reporting FY 2021 October 1 2020 September 30 2021 written by Department Of Health And Human Services and published by Lulu.com. This book was released on 2020-09-06 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated.

Download or read book Pediatric Coding Basics written by American Academy of Pediatrics Committee on Coding and Nomenclature and published by . This book was released on 2020-05-15 with total page 136 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pediatric Coding Basics was developed to give pediatric healthcare professionals a basic overview of medical coding for services completed.

Download or read book Understanding Health Insurance written by Jo Ann C. Rowell and published by Cengage Learning. This book was released on 2004 with total page 724 pages. Available in PDF, EPUB and Kindle. Book excerpt: Understanding Health Insurance: A Guide to Professional Billing, 7th edition,utilizes a step-by-step approach to provide instruction about the completion of health insurance claims. the objectives of this edition are to 1) introduce information about major third party payer programs and federal health care regulations, 2) clarify coding guidelines and provide application exercises for each national diagnosis and procedure coding system, and 3) simplify the process of completing claims. Case studies and review exercises provide users with numerous opportunities to apply knowledge and to build s

Download or read book JustCoding s Guide to Modifiers Hospital Outpatient Edition written by Susan E. Garrison and published by . This book was released on 2015-11-23 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: JustCoding's Guide to Modifiers: Hospital Outpatient Edition Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H Modifiers are a frequent audit target of CMS and the Office of Inspector General, with focused efforts against modifiers such as -25 and -59. JustCoding's Guide to Modifiers: Hospital Outpatient Edition features a comprehensive explanation of when to report each CPT(R)/HCPCS modifier, including coding tips and the latest regulations and guidance. Each chapter contains exercises that let you use real-life documentation, including operative reports and case studies, to test your knowledge on how to apply each modifier. This book will review the most recent guidance for each modifier, with citations from relevant regulatory documents. Table of Contents About the Author 1. Introduction 2. National Correct Coding Initiative Modifiers(Subsections: Modifiers -59, -XE, -XS, -XP, -XU, -58, -76 to -79, and -91)3. Evaluation and Management Modifiers (Subsections: Modifiers -25 and -27) 4. Anatomical Modifiers(Subsections: Modifiers -50, -RT, -LT, -E1 to -E4, -F1 to -F9, -FA, -LC, -LD, -LM, -RC, -RI, -T1 to -T9, and -TA)5. Reduced/Discontinued Services Modifiers (Subsections: Modifiers -52, -53, -73, and -74) 6. Medical Necessity Modifiers(Subsections: Modifiers -GA, -GX, -GY, and -GZ)7. Screening Services Modifiers(Subsections: Modifiers -GG and -PT)8. Outpatient Therapy Modifiers(Subsections: Modifiers -GN to -GP and -KX)9. Miscellaneous Modifiers(Subsections: Modifiers -CA, -ET, -JW, and -PA to -PC)10. Modifier Coding Compliance Quiz 11. Answer Key Benefits: Properly use modifiers to prevent audits Reduce confusion about when to use modifiers Get coding tips to clarify regulatory guidance and provide examples of which modifiers apply in different situations Access case studies and operative reports to test your knowledge of modifiers

Download or read book CPT 2021 Professional Edition written by American Medical Association and published by . This book was released on 2020-09-17 with total page 1000 pages. Available in PDF, EPUB and Kindle. Book excerpt: CPT® 2021 Professional Edition is the definitive AMA-authored resource to help health care professionals correctly report and bill medical procedures and services. Providers want accurate reimbursement. Payers want efficient claims processing. Since the CPT® code set is a dynamic, everchanging standard, an outdated codebook does not suffice. Correct reporting and billing of medical procedures and services begins with CPT® 2021 Professional Edition. Only the AMA, with the help of physicians and other experts in the health care community, creates and maintains the CPT code set. No other publisher can claim that. No other codebook can provide the official guidelines to code medical services and procedures properly. FEATURES AND BENEFITS The CPT® 2021 Professional Edition codebook covers hundreds of code, guideline and text changes and features: CPT® Changes, CPT® Assistant, and Clinical Examples in Radiology citations -- provides cross-referenced information in popular AMA resources that can enhance your understanding of the CPT code set E/M 2021 code changes - gives guidelines on the updated codes for office or other outpatient and prolonged services section incorporated A comprehensive index -- aids you in locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym or abbreviation to allow for a clearer, quicker search Anatomical and procedural illustrations -- help improve coding accuracy and understanding of the anatomy and procedures being discussed Coding tips throughout each section -- improve your understanding of the nuances of the code set Enhanced codebook table of contents -- allows users to perform a quick search of the codebook's entire content without being in a specific section Section-specific table of contents -- provides users with a tool to navigate more effectively through each section's codes Summary of additions, deletions and revisions -- provides a quick reference to 2020 changes without having to refer to previous editions Multiple appendices -- offer quick reference to additional information and resources that cover such topics as modifiers, clinical examples, add-on codes, vascular families, multianalyte assays and telemedicine services Comprehensive E/M code selection tables -- aid physicians and coders in assigning the most appropriate evaluation and management codes Adhesive section tabs -- allow you to flag those sections and pages most relevant to your work More full color procedural illustrations Notes pages at the end of every code set section and subsection

Download or read book Hospital Billing from A to Z written by Charlotte L. Kohler and published by . This book was released on 2014-08-21 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospital Billing from A to Z Charlotte L. Kohler, RN, CPA, CVA, CRCE-I, CPC, ACS, CHBC With Kohler HealthCare Consulting, Inc., associates Catherine Clark, CPC, CRCE-I Darrin Cornwell, CRCS-I Janet Ellis, RN, BSN, MS Dawn Doll Homer, CPC, CRCS-I, CDC Daria Malan, RN, LNHA, MBA, RAC-CT(R) John Ninos, MS, MT(ASCP), CCS Robin Stover, RN, BSBA, CPC, CPC-H, CMAS Deanna Turner, MBA, CPOC, CPC, CPC-I, CSSGB Susan Walberg, JD, MPA, CHC Hospital billing departments are known by various names, but their staff all experience the same problems understanding and complying with Medicare's many billing requirements. Hospital Billing From A to Z is a comprehensive, user-friendly guide to hospital billing requirements, with particular emphasis on Medicare. This valuable resource will help hospital billers understand how compliance, external audits, and cost-cutting initiatives affect the billing process. Beginning with Advance Beneficiary Notice and ending with Zone Program Integrity Contractors, this book addresses 88 topics in alphabetical order, including the following: 2-Midnight Rule and Inpatient Admission Criteria Correct Coding Initiative CPT(R), HCPCS, Condition Codes, Occurrence Codes, Occurrence Span Codes, Revenue Codes, and Value Codes Critical Access Hospitals Deductibles, Copayments, and Coinsurance Denials, Appeals, and Reconsideration Requirements Dialysis and DME Billing in Hospitals Hospital-Issued Notice of Noncoverage Laboratory Billing and Fee Schedule Local and National Coverage Determinations Medically Unlikely Edits and Outpatient Code Editor Medicare Advantage Plans Medicare Beneficiary Numbers and National Provider Identifier Medicare Part A and Part B No-Pay Claims Observation Services Outlier Payments Present on Admission Rejected and Returned Claims UB-04 Form Definitions Who should read this book? Finance and reimbursement staff Chargemaster staff Billers and coders HIM staff Clinical department staff Revenue managers Compliance officers and auditors Registration staff Fiscal intermediary staff Healthcare attorneys, consultants, and CPAs Legal department staff

Download or read book ICD 10 PCs 2021 The Complete Official Codebook written by American Medical Association and published by . This book was released on 2020-08 with total page 900 pages. Available in PDF, EPUB and Kindle. Book excerpt: ICD-10-PCS 2021: The Complete Official Codebook contains the complete ICD-10-PCS code set and supplementary appendixes required for reporting inpatient procedures. This illustrated codebook presents the code set in 17 sections of tables arranged by general procedure type. Tables within the extensive Medical and Surgical section are additionally sectioned out by body system, indicated by color-coded page borders. ICD-10-PCS contains classifications for procedures, devices and technologies. FEATURES AND BENEFITS Summary of changes. Quickly see how additions and deletions affect each section of ICD-10-PCS. Complete 2021 ICD-10-PCS code set. The code set is organized in 17 sections. Each section contains a code table by which a code can be built through character selections that reflect the procedure performed. A character meanings table and citations to American Hospital Association's Coding Clinic start each section. Official coding guidelines. Learn how to use the code set appropriately following the guidelines specific for each section. Illustrations. The full-color illustrations provide a visual explanation of anatomy and procedural approach. - Approach illustrations show the access location, method, and instrumentation that determine the approach. - Body parts with indicators to applicable code characters (provided immediately after the Character Meaning tables in the Medical/Surgical sections) Visual alerts. This edition provides color-coding and symbols that identify male/female procedures and new/revised character values. Detailed information on structure and conventions of ICD-10-PCS. Learn about the unique structure and the specific definitions and functions of each character. Practice your skills with sample exercises (answers included). Color-coding and symbols for the Medicare Code Edits. This edition includes color-coding and symbols for the most comprehensive coverage of ICD10 MS-DRG MCEs for procedures including; - Non-covered procedures - Limited coverage procedures - Combination only procedures - Non-operating room procedures affecting MS-DRG assignment - Non-operating room procedures NOT affecting MS-DRG assignment - Hospital acquired condition (HAC)-related procedures Procedure combination tables. Identify ICD-10-PCS code combination requirements needed to satisfy certain MS-DRG requirements. Valuable resources to enhance productivity. Resources to help guide the user, including: - Root operation definition table for medical/surgical section - Root operation for medical/surgical section grouped by objective - Operation/Type definition tables for other ICD-10-PCS sections - Body part definitions and body part key for accurate identification of correct body part character - Device key and device aggregation tables - Approach definitions - Substance key

Download or read book ICD 10 CM 2021 The Complete Official Codebook with Guidelines written by American Medical Association and published by . This book was released on 2020-09-20 with total page 1250 pages. Available in PDF, EPUB and Kindle. Book excerpt: ICD-10-CM 2021: The Complete Official Codebook provides the entire updated code set for diagnostic coding, organized to make the challenge of accurate coding easier. This codebook is the cornerstone for establishing medical necessity, determining coverage and ensuring appropriate reimbursement. Each of the 21 chapters in the Tabular List of Diseases and Injuries is organized to provide quick and simple navigation to facilitate accurate coding. The book also contains supplementary appendixes including a coding tutorial, pharmacology listings, a list of valid three-character codes and additional information on Z-codes for long-term drug use and Z-codes that can only be used as a principal diagnosis. Official coding guidelines for 2021 are bound into this codebook. FEATURES AND BENEFITS Full list of code changes. Quickly see the complete list of new, revised, and deleted codes affecting the FY 2021 codes, including a conversion table and code changes by specialty. QPP symbol in the tabular section. The symbol identifies diagnosis codes associated with Quality Payment Program (QPP) measures under MACRA. New and updated coding tips. Obtain insight into coding for physician and outpatient settings. New and updated definitions in the tabular listing. Assign codes with confidence based on illustrations and definitions designed to highlight key components of the disease process or injury and provide better understanding of complex diagnostic terms. Intuitive features and format. This edition includes full-color illustrations and visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, codes associated with CMS hierarchical condition categories (HCC), Medicare Code Edits (MCEs), manifestation codes, other specified codes, and unspecified codes. Placeholder X. This icon alerts the coder to an important ICD-10-CM convention--the use of a "placeholder X" for three-, four- and five-character codes requiring a seventh character extension. Coding guideline explanations and examples. Detailed explanations and examples related to application of the ICD-10-CM chapter guidelines are provided at the beginning of each chapter in the tabular section. Muscle/tendon translation table. This table is used to determine muscle/tendon action (flexor, extensor, other), which is a component of codes for acquired conditions and injuries affecting the muscles and tendons Index to Diseases and Injuries. Shaded guides to show indent levels for subentries. Appendices. Supplement your coding knowledge with information on proper coding practices, risk adjustment coding, pharmacology, and Z codes.