LOCATION: Outpatient‚ Hospital PATIENT: Stan Hope SURGEON: Mohamad Almaz‚ MD PREOPERATIVE DIAGNOSIS: Left shoulder pain and numbness‚ past shoulder injury POSTOPERATIVE DIAGNOSIS: Normal shoulder PROCEDURE PERFORMED: Diagnostic arthroscopy‚ left shoulder CLINICAL HISTORY: This is a 57-year-old with a l0-year-old rotator cuff tear injury to his left shoulder. The patient does heavy lifting for a living. For the past 6 months the patient has been experiencing pain in this shoulder with
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Week 6 DB Billing 2 Discuss why it is important for billers and coders to be familiar with software programs. Software programs like Epic‚ Centricity‚ AdvancedMD‚ Flash Code‚ Eclipse‚ and others have fields where coders can enter the correct procedure and diagnosis codes. These software programs may come with look-up tools that help coders find the correct code‚ but coders should always use their coding manuals to get the last word on which codes to use. The benefits of working with coding software
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Medical Records Documentation and Billing Medical Records Documentation and Billing Compliance plans are put into place to find‚ correct‚ and prevent illegal medical office practices. In correlation with medical records documentation standards‚ these plans eliminate the possibility of errors by training staff members who work with medial records including front office staff along with billers and coders. Steps five and six of the medical billing process are related to compliance plans
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The Medical Billing Process is composed of ten different steps‚ each as equally important as the next. These ten steps are pre-register patients‚ establish financial responsibility‚ check in patients‚ review coding compliance‚ review billing compliance‚ check out patients‚ prepare and transmit claims‚ monitor payer adjudication‚ generate patient statements‚ and follow up payments and collections. When you bill a patient you want to be sure that you are not only doing it correctly but that you are
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How HIPAA Violations Affect the Medical Billing Process HCR/220 October 7‚ 2012 How HIPAA Violations Affect the Medical Billing Process In this paper we will discuss how HIPAA violations affect the medical billing process and why HIV and AIDS information is more sensitive than other types of health conditions. We will also examine the social‚ legal‚ and ethical ramifications of improper information disclosure. In 1996 on August 21‚ the Health Insurance Portability and Accountability
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contains its own codes and has its own role in the medical billing. To help you determine which section you are going to use‚ I have made the following buzzwords for each section. Category I is the most important category of the CPT Process. We will use this section for all billing situations. Because this is the most important section we are going to consider it the heart of our billing world. Just like our bodies can’t function without our heart‚ a billing specialist can’t function without section 1
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CPR is the abbreviation for cardiopulmonary resuscitation. CPR is a procedure used to keep the heart pumping and oxygen flowing until emergency care arrives (Tyler‚ 200). First Aid is where help is given to a sick or injured person until full medical treatment is available. First Aid and CPR is very important to the healthcare worker in so many ways and I plan to explain these reasons in my paper. First Aid and CPR are very important to know in the healthcare field. Nurses‚ doctors‚ and etc
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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
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describe the patient’s condition‚ using terminology that includes either specific diagnoses and/or symptoms‚ problems‚ or reasons for the encounter. In the instance where a discrepancy is discovered‚ determining the first-listed diagnosis per the coding conventions of ICD-9-CM‚ as well as the general and disease-specific guidelines within ICD-9-CM‚ will have precedence over the outpatient guidelines. •In the outpatient setting‚ code all documented conditions that coexist at the time of the encounter
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Errors and Compliance in Coding The integrity of the request for payment rests on the accuracy and honesty of the coding and billing within a practice. Incorrect work could simply be an error‚ or it could represent a deliberate effort to obtain fraudulent payment. Medical billers and coders are responsible for ensuring that these errors are limited and promptly fixed. Among the most common causes of errors in coding and billing are truncated coding‚ up-coding or down-coding‚ and using an inappropriate
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