Chapter 9 Coding Guidelines and Applications (HCPCS, ICD-10-PCS, and ICD-10-CM) Outline RELATIONSHIP BETWEEN BILLING AND CODING CODING SYSTEM VARIATIONS ICD-10-CM OFFICIAL DIAGNOSIS CODING GUIDELINES HCPCS CODING GUIDELINES ICD-10-PCS GENERAL CODING…
Chapter 8 Procedure Coding (HCPCS and ICD-10-PCS) HISTORY OF PROCEDURE CODING PURPOSE OF PROCEDURE CODING PROCEDURE CODING RELATIONSHIPS PROCEDURE CODING SYSTEM VARIATIONS HCPCS LEVEL I—CPT HCPCS LEVEL II—MEDICARE NATIONAL CODES…
Chapter 3 Health Insurance Portability and Accountability Act (HIPAA) Outline HIPAA OVERVIEW HIPAA LEGISLATION HIPAA REGULATIONS HIPAA TITLE II: ADMINISTRATIVE SIMPLIFICATION (HIPAA-AS) HIPAA TITLE II: PRIVACY RULE HIPAA TITLE II: SECURITY…
Chapter 12 Prospective Payment Systems (PPS) Outline PROSPECTIVE PAYMENT SYSTEMS (PPS) DEFINED PROSPECTIVE PAYMENT SYSTEM (PPS) EVOLUTION INPATIENT PROSPECTIVE PAYMENT SYSTEM (IPPS) OUTPATIENT PROSPECTIVE PAYMENT SYSTEM (OPPS) Chapter Objectives 1. Define…
Chapter 5 Hospital Billing Process Outline PURPOSE OF THE HOSPITAL BILLING PROCESS PAYER GUIDELINES CHARGE DESCRIPTION MASTER (CDM) CODING SYSTEMS CLAIM FORMS HOSPITAL REVENUE CYCLE Chapter Objectives 1. Define terms, phrases,…
Chapter 6 ICD-9-CM Diagnosis and Procedure Coding Outline HISTORY OF DIAGNOSIS CODING PURPOSE OF DIAGNOSIS CODING DIAGNOSIS CODING RELATIONSHIPS ICD-9-CM CONTENT ICD-9-CM OFFICIAL CONVENTIONS STEPS TO CODING USING ICD-9-CM ICD-9-CM…
Chapter 7 ICD-10-CM Diagnosis Coding Outline EVOLUTION OF DIAGNOSIS CODING IMPACT OF ICD-10 ICD-10-CM DATA USAGE TRANSITION TO ICD-10-CM ICD-10-CM CONTENT ICD-10-CM OFFICIAL CONVENTIONS STEPS TO CODING USING ICD-10-CM Chapter…
Chapter 11 Health Care Payers Outline TYPES OF HEALTH INSURANCE PLANS THIRD-PARTY PAYERS PRIVATE PAYERS GOVERNMENT PAYERS INSURANCE PLAN TERMS AND SPECIFICATIONS Chapter Objectives 1. Define terms, phrases, abbreviations, and acronyms….
Chapter 13 Accounts Receivable (A/R) Management Outline LIFE CYCLE OF A HOSPITAL CLAIM HOSPITAL BILLING PROCESS ACCOUNTS RECEIVABLE (A/R) MANAGEMENT CREDIT AND COLLECTION LAWS COLLECTION ACTIVITIES APPEALS PROCESS Chapter Objectives…
Chapter 4 Patient Accounts and Data Flow Outline PATIENT ACCOUNTS AND DATA FLOW PATIENT CARE PROCESS PATIENT ADMISSION ADMISSION PROCESS MEDICAL RECORD DOCUMENTATION PATIENT CARE SERVICES CHARGE CAPTURE PATIENT DISCHARGE…
