Relating Hippa, Icd, Cpt and Hcpcs to the Medical Billing Process
Relating HIPPA, ICD, CPT and HCPCS to the Medical Billing Process
Laura Alfonso
HCR/220
November 27, 2010
Ronald Dearinger
Relating HIPAA, ICD, CPT and HCPCS to the Medical Billing Process
The medical billing and coding process involves ten steps that must be completed by office staff members of a medical facility in order to provide quality care while protecting the privacy of patients and hastening the payment of services.
Step 1
The first step is pre-registration, during this step printed HIPAA privacy practices are given to the patient for their review and signature; this informs the patient of his or her rights and protects the facility as well. A copy must be filed in the patients chart as well as a copy given to the patients for their own records. These policies inform the patient of specific processes necessary for transmitting claims and explain the facilities commitment to confidentiality. This step also uses careful HIPAA measures to retrieve demographic and insurance information to schedule or update appointments in a manner that protects the patient 's privacy.
Steps 2, 3 and 4
During the next step, establishing financial responsibility, patient check in, and patient check out staff members follow HIPAA regulations to review demographic, medical, financial, and insurance information, and all is done in a manner that protects the patient’s privacy by following HIPAA guidelines. During check out codes from the ICD-9 code book, and five digit CPT codes, are added to the super bill to identify diagnosis’, treatments, procedures, injections and/or immunizations. These may include two digit modifiers, subcategories or classifications, and V or E codes. HCPCS codes are codes are used when durable medical equipment and supplies are used during the course of treatment. Every code provides easily identifiable information that designates specific circumstances needed to establish medical necessity for documentation to acquire timely and appropriate
Laura Alfonso
HCR/220
November 27, 2010
Ronald Dearinger
Relating HIPAA, ICD, CPT and HCPCS to the Medical Billing Process
The medical billing and coding process involves ten steps that must be completed by office staff members of a medical facility in order to provide quality care while protecting the privacy of patients and hastening the payment of services.
Step 1
The first step is pre-registration, during this step printed HIPAA privacy practices are given to the patient for their review and signature; this informs the patient of his or her rights and protects the facility as well. A copy must be filed in the patients chart as well as a copy given to the patients for their own records. These policies inform the patient of specific processes necessary for transmitting claims and explain the facilities commitment to confidentiality. This step also uses careful HIPAA measures to retrieve demographic and insurance information to schedule or update appointments in a manner that protects the patient 's privacy.
Steps 2, 3 and 4
During the next step, establishing financial responsibility, patient check in, and patient check out staff members follow HIPAA regulations to review demographic, medical, financial, and insurance information, and all is done in a manner that protects the patient’s privacy by following HIPAA guidelines. During check out codes from the ICD-9 code book, and five digit CPT codes, are added to the super bill to identify diagnosis’, treatments, procedures, injections and/or immunizations. These may include two digit modifiers, subcategories or classifications, and V or E codes. HCPCS codes are codes are used when durable medical equipment and supplies are used during the course of treatment. Every code provides easily identifiable information that designates specific circumstances needed to establish medical necessity for documentation to acquire timely and appropriate
References: Centers for Medicare & Medicaid services. (n.d.). electronic billing & edi transactions. Retrieved from http://www.cms.gov/ElectronicBillingEDITrans/ Valerius, J., Bayes, N., Newby, C., & Seggern, J. (2008). Medical insurance: An integrated claims process approach (3rd ed.). Boston: McGraw-Hill.