When it comes to HIPAA, ICD, CPT, and HCPCS on how they influence each of the ten steps of the medical billing process, HIPAA influences the billing process by maintaining HIPAA compliance, as far as confidentiality and the handling of the medical record. When it comes to ICD, CPT, and HCPCS they influence the billing process they are the reference source where the codes are contained that are used to find the diagnosis, procedure, and the supply codes. But the HIPAA, ICD, CPT, and HCPCS they are all some kind of way related to have something to do with the billing process, but the ten steps during the process are…
When it comes to outpatient services, physicians are paid using CPT/HCPCS codes. Where as inpatient/hospitals are paid using a complex formula (MS-DRG), because of housing, feeding, and nursing the patient back to health. During an inpatient stay the hospital charges for the amount of time and effort spent on nursing a patient back to health. So when it comes to an operation on an elderly person, a complicated birth or even replacing an old pacemaker, the hospital will charge based on the severity of the patient’s illness. That is why inpatient coding requires daily coding of each service on each day of hospitalization, as for outpatient coding, the first listed diagnostic code indicates the reason for the encounter.…
The Medicare National Correct Coding Initiative effects the billing and coding process in many ways. This organization was established to prevent improper coding and billing. The benefits of the CCI, is it performs audits that catch most of the improper coding. It detects codes that should not be coded together, which could cause the patient to be double billed, or improperly billed. The system stops the physician from billing the patient until the codes are properly…
There are a few differences and similarities among small, medium, and large facilities concerning the organization of patient records and in how they handle loose reports. I have noticed that most facilities prefer that their loose records are permanently anchored in their charts, which makes sense to me because it prevents the loose reports from being misplaced and lost. However, the different sizes of facilities tend to organize patient files differently according to each particular facility’s policies. The most popular methods of organization that I have seen include chronologically, form numbers, report type, and category.…
The Healthcare Common Procedural Coding System (HCPCS) was created in 1978 and is based off CPT codes to provide a standardized coding system for descriptive specific services and…
What do you think is the reasoning for not filing incident reports in medical records? Provide examples of three incidents and explain why they could be problematic in patients’ files.…
The Healthcare Common Procedure Coding System (HCPCS) are codes that are for reporting professional services, procedures and supplies. Included in that is medical equipment , ambulance services, orthotics, supplies, medication and dental procedures. The HCPCS was developed by the Health Care Financing Administration in 1983. As of 2001 the HCFA is now Centers for Medicare and Medicaid Services (CMS). HCPCS is divided into two subsystems, Level I and Level II. Level I is CPT (Current Procedural Terminology) is used for medical procedures and services done by healthcare professionals. Level I codes are all numeric. Level II codes are used to identify products, supplies and services not included in the CPT codes, such as Ambulance, prosthetics…
Alzheimer’s disease? , Which is a case study, was very helpful for anyone whom may be researching such a case? The article basically provided explanations as to how the research for the article at hand. Research requires a lot of time and discipline. It is a vital process that contains specific stages, which we like leads to valid conclusions. The stages that are involved consist of selection of an issue to conduct the research on form a hypothesis, review the information that is backing up the hypothesis and also providing an explanation and formulating a useful conclusion. Case control study which was conducted within this article, consisted of participants and informants who provided consent written/verbal to have these studies done on their self’s. The research design that was used to identify and provide factors which were thought to play a role within certain medical conditions. When research is conducted there usually follows a hypothesis to be formulated. In this particular case study there were a total of 217 participants which all were diagnosed to have onset Alzheimer’s disease. The gender break down of the case study consisted of 57 males and 160 females. The control groups were composed of 76 siblings who do not have the same condition which was Alzheimer’s. The control group consisted of 32 males and 44 females and ages ranged between 61-68 years…
When I started my first job in an eye clinic, I was hired to work the front desk of the main office along with three other ladies. I was the youngest at 22 , one gal was about 5 years older than myself, and the other two were in their early 60's. One of the older ladies had worked there a significant amount of time while the other two and myself were hired at the same time. There was an initial friction between one of the older ladies and my younger co-worker and myself. We thought she was bossy and tried to micro-manage us even though she was not in a supervisory position. She also would try and tell us how the older patients liked to be spoken to. After a while, management stepped in to try and mediate the conflict. As it turned out, my bossy co-worker was simply taught her work ethic and interpersonal skills in a different era. She felt more senior than my co-worker and I because she was older, with more life experience. She also thought that being from an older generation herself, that she knew how to communicate better with our patients. We were all trying to help our patients, do our jobs well, and effectively communicate, but our different backgrounds and significant difference in age, were creating an interpersonal conflict.…
All of these characteristics are characteristics of a knowledge and value based manager. The first one is vision; this helps because everyone starts something with a view of what it will become. This will also help motivate the staff to do their best because knowing the company succeeded is because the whole team has worked together. You need a vision so you have a goal or something to work towards. A manager needs to be efficient, because they have many responsibilities that need to be fulfilled and people depending on them. They also need to be organized because they have so many responsibilities and tasks that need to be done in a timely manner.…
A medical billing and coding specialist’s main goal is to provide medical billing and coding services so the health provider is paid for medical services rendered. Every medical service is assigned a numeric code to define diagnostics, treatments and procedures. It is the medical biller and coder’s job to enter this information into a database using medical billing and coding protocol to produce a statement or claim. If the claim is denied by the third-party payer, the medical billing and coding specialist must investigate the claim, verify its information, and update new details into the database. Medical billing and coding specialists are also responsible for dealing with collections and insurance fraud.…
Review Procedures and Documents from Physicians: Every physician will provide a written record of the procedures performed with each patient. As a medical billing and coding specialist, you’ll be expected to translate these procedures into numerical codes read…
The article that I have chosen is Spinal Bifida A Multidisciplinary Prospective. In this article it explains the different effects of spinal bifida within different domains , with an effort to promote awareness and different treatments. This article also focuses on treatment statigies and that can help with the developmental disabilities associated with Spinal Bifida.…
Throughout my intensive learning at Midlands Technical College Health Information Management Program, I have achieved coding comprehension of ICD-10 CM, HCPCS, CPT, PCS codes. Not only did I graduate from the program, but earned a highly known credential in the healthcare field: RHIT. The clinical portion of my program allowed me to learn the importance of coding edits involving claims. Centers of Medicare and Medicaid Services (CMS) developed the National Correct Coding Initiative (NCCI) to promote national correct coding procedures and control improper coding leading to inappropriate payment in Part B claims. The National Correct Coding Initiative contains two types of edits: The first edit is NCCI procedure-to-procedure (PTP) edits define…
Medical billing and coding are the key resources in providing healthcare organization revenue and salaries. Based on the amount of each patient visit and if the visit was cleared and processed. The medical coder and biller must collect the accurate information, which can provide hospitals reliable revenue to function.…