Book Description
- 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.
Author : Debra P. Ferenc
Publisher : Elsevier Health Sciences
Page : 626 pages
File Size : 50,47 MB
Release : 2013-02-26
Category : Medical
ISBN : 0323292267
- 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.
Author : United States. Social Security Administration
Publisher :
Page : 72 pages
File Size : 36,40 MB
Release : 1966
Category : Hospitals
ISBN :
Author : Department Of Health And Human Services
Publisher : Lulu.com
Page : 128 pages
File Size : 34,12 MB
Release : 2020-09-06
Category : Medical
ISBN : 9781716599989
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.
Author :
Publisher :
Page : 76 pages
File Size : 13,94 MB
Release : 1991
Category : Classification
ISBN :
Author : Susan E. Garrison
Publisher :
Page : 0 pages
File Size : 19,87 MB
Release : 2015-11-23
Category :
ISBN : 9781556454837
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
Author : Andrea Kline-Tilford
Publisher : John Wiley & Sons
Page : 526 pages
File Size : 23,66 MB
Release : 2020-03-30
Category : Medical
ISBN : 111956820X
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.
Author : Karen Smiley
Publisher : John Wiley & Sons
Page : 355 pages
File Size : 48,32 MB
Release : 2019-12-05
Category : Medical
ISBN : 1119625440
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!
Author : Medicare Payment Advisory Commission (U.S.)
Publisher :
Page : 184 pages
File Size : 30,20 MB
Release : 1998
Category : Hospitals
ISBN :
Author :
Publisher :
Page : 262 pages
File Size : 46,11 MB
Release : 1995
Category : Employers' liability
ISBN :
Author : Gina M. Reese
Publisher : Hcpro, a Division of Simplify Compliance
Page : 0 pages
File Size : 29,41 MB
Release : 2017
Category : Hospitals
ISBN : 9781683081906
This book serves as a comprehensive guide to provider-based clinics, from qualifying under CMS, to unique billing and coding rules, and the business decisions behind owning or acquiring these clinics. It will help readers sort through the complex regulations relevant to this unique provider type, and provide insight into recent changes, such as the introduction of Modifier -PO. CMS is looking to implement the Section 603 provisions of the Bipartisan Budget Act of 2015 regarding off-campus, provider-based departments (PBD) by January 1, 2017, according to the 2017 OPPS proposed rule. The agency is proposing to pay the nonfacility or office Medicare Physician Fee Schedule (MPFS) amount to the performing/supervising physician and preclude hospitals from billing on a UB-04 form or receiving OPPS payment for services performed at these locations for 2017, but plans to explore other options for 2018 and beyond. Physicians would be paid at the higher nonfacility rate of the MPFS, but only hospitals that have employed or contracted physicians that reassign their billing to the hospital would get paid under the MPFS for these services. Hospitals would be able to bill claims on CMS-1500 forms for physicians who have already reassigned their billing to the hospital, as in the case of employed physicians. Otherwise, hospitals would have the option of enrolling the location as the type of provider or supplier it wishes to bill to meet the requirements of that payment system (e.g., ambulatory surgery center or group practice).