Correct Coding For Medicare Compliance And Reimbursement

Two CD-ROM discs in pocket.

Answer Key, supplemental activities based on real-world scenarios, lesson plans, sample syllabi and lecture notes.

While the vast majority of providers never intend to commit fraud or file false claims, complex procedures, changing regulations, and evolving technology make it nearly impossible to avoid billing errors. For example, if you play by HIPAA‘s rules, a physician is a provider; however, Medicare requires that the same physician must be referred to as a

Combining the basics of coding, insurance, and reimbursement in one concise text, this reader-friendly resource is your key to understanding the fundamentals of medical billing and coding. Clearly organized, full-color chapters guide you through the entire coding and claims process, detailing coding rules and applications, insurance guidelines, and the reimbursement system, all accompanied by real-world practice to help you apply what you’ve learned in the field! Highlighted examples illustrate concepts in realistic medical office settings to enhance your understanding. Coding exercises teach you how to correctly code using the ICD-9-CM and CPT-4 manuals. Test Your Knowledge questions within each chapter help you assess your strengths and weaknesses and prepare for exams. Critical thinking problems challenge you to apply chapter concepts to common coding scenarios. Code It and Claim It! software familiarizes you with a professional coding claim interface similar to programs you’ll use on the job and provides real-world practice with actual patient cases. Key term lists and an extensive glossary reinforce your understanding of important coding and insurance terminology. NEW application exercises help you put your knowledge of coding and reimbursement into practice.

The most comprehensive resource for hospital inpatient coding and reimbursement! Provides educators, students, and healthcare practitioners with the most authoritative guidance available for managing inpatient coding and reimbursement issues. This must-have resource was developed to give you easier access to the most up-to-date information you need for inpatient coding and reimbursement. You'll save time and make more effective decisions with this one-of-a-kind resource.Covers reimbursement methodologies for hospital inpatient services, the structure and organization of hte Medicare Inpatient Acute Care Prospective Payment System, the relationship between coding and DRG assignment, and data quality and coding compliance processes related to coding and reimbursement for inpatient services.

In clear and straightforward language, Medical Coding: What It Is and How It Works, Second Edition provides an overview of the evolution of medical coding and all the various coding systems, how they relate, and how they function. Reasoning and consequences of the delayed ICD-10 implementation are explained along with a sound overview of the ICD-10-CM and PCS classification systems. For those contemplating a career in the coding field, this book is ideal as a basic orientation. Other individuals in healthcare management and administration will also benefit from a basic understanding of how coding works. Unlike other publications that focus only on coding, this book integrates coding guidelines and principles into the billing and reimbursement process, giving the student a more practical foundation in the rationale for correct coding. Healthcare fraud and abuse is addressed as well, to assure that readers understand ethical concerns inherent in coding for reimbursement. Instructor Resources: Instructor's Manual, PowerPoint slides, Test Bank