JustCoding's Guide to Modifiers: Hospital Outpatient Edition

JustCoding's Guide to Modifiers: Hospital Outpatient Edition PDF Author: Susan E. Garrison
Publisher:
ISBN: 9781556454837
Category :
Languages : en
Pages : 0

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Book Description
JustCoding's Guide to Modifiers: Hospital Outpatient Edition Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H Modifiers are a frequent audit target of CMS and the Office of Inspector General, with focused efforts against modifiers such as -25 and -59. JustCoding's Guide to Modifiers: Hospital Outpatient Edition features a comprehensive explanation of when to report each CPT(R)/HCPCS modifier, including coding tips and the latest regulations and guidance. Each chapter contains exercises that let you use real-life documentation, including operative reports and case studies, to test your knowledge on how to apply each modifier. This book will review the most recent guidance for each modifier, with citations from relevant regulatory documents. Table of Contents About the Author 1. Introduction 2. National Correct Coding Initiative Modifiers(Subsections: Modifiers -59, -XE, -XS, -XP, -XU, -58, -76 to -79, and -91)3. Evaluation and Management Modifiers (Subsections: Modifiers -25 and -27) 4. Anatomical Modifiers(Subsections: Modifiers -50, -RT, -LT, -E1 to -E4, -F1 to -F9, -FA, -LC, -LD, -LM, -RC, -RI, -T1 to -T9, and -TA)5. Reduced/Discontinued Services Modifiers (Subsections: Modifiers -52, -53, -73, and -74) 6. Medical Necessity Modifiers(Subsections: Modifiers -GA, -GX, -GY, and -GZ)7. Screening Services Modifiers(Subsections: Modifiers -GG and -PT)8. Outpatient Therapy Modifiers(Subsections: Modifiers -GN to -GP and -KX)9. Miscellaneous Modifiers(Subsections: Modifiers -CA, -ET, -JW, and -PA to -PC)10. Modifier Coding Compliance Quiz 11. Answer Key Benefits: Properly use modifiers to prevent audits Reduce confusion about when to use modifiers Get coding tips to clarify regulatory guidance and provide examples of which modifiers apply in different situations Access case studies and operative reports to test your knowledge of modifiers

JustCoding's Guide to Modifiers: Hospital Outpatient Edition

JustCoding's Guide to Modifiers: Hospital Outpatient Edition PDF Author: Susan E. Garrison
Publisher:
ISBN: 9781556454837
Category :
Languages : en
Pages : 0

Get Book Here

Book Description
JustCoding's Guide to Modifiers: Hospital Outpatient Edition Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H Modifiers are a frequent audit target of CMS and the Office of Inspector General, with focused efforts against modifiers such as -25 and -59. JustCoding's Guide to Modifiers: Hospital Outpatient Edition features a comprehensive explanation of when to report each CPT(R)/HCPCS modifier, including coding tips and the latest regulations and guidance. Each chapter contains exercises that let you use real-life documentation, including operative reports and case studies, to test your knowledge on how to apply each modifier. This book will review the most recent guidance for each modifier, with citations from relevant regulatory documents. Table of Contents About the Author 1. Introduction 2. National Correct Coding Initiative Modifiers(Subsections: Modifiers -59, -XE, -XS, -XP, -XU, -58, -76 to -79, and -91)3. Evaluation and Management Modifiers (Subsections: Modifiers -25 and -27) 4. Anatomical Modifiers(Subsections: Modifiers -50, -RT, -LT, -E1 to -E4, -F1 to -F9, -FA, -LC, -LD, -LM, -RC, -RI, -T1 to -T9, and -TA)5. Reduced/Discontinued Services Modifiers (Subsections: Modifiers -52, -53, -73, and -74) 6. Medical Necessity Modifiers(Subsections: Modifiers -GA, -GX, -GY, and -GZ)7. Screening Services Modifiers(Subsections: Modifiers -GG and -PT)8. Outpatient Therapy Modifiers(Subsections: Modifiers -GN to -GP and -KX)9. Miscellaneous Modifiers(Subsections: Modifiers -CA, -ET, -JW, and -PA to -PC)10. Modifier Coding Compliance Quiz 11. Answer Key Benefits: Properly use modifiers to prevent audits Reduce confusion about when to use modifiers Get coding tips to clarify regulatory guidance and provide examples of which modifiers apply in different situations Access case studies and operative reports to test your knowledge of modifiers

Principles of CPT Coding

Principles of CPT Coding PDF Author: American Medical Association
Publisher: American Medical Association Press
ISBN: 9781622025510
Category : Medical
Languages : en
Pages : 0

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Book Description
The newest edition of this best-selling educational resource contains the essential information needed to understand all sections of the CPT codebook but now boasts inclusion of multiple new chapters and a significant redesign. The ninth edition of Principles of CPT(R) Coding is now arranged into two parts: - CPT and HCPCS coding - An overview of documentation, insurance, and reimbursement principles Part 1 provides a comprehensive and in-depth guide for proper application of service and procedure codes and modifiers for which this book is known and trusted. A staple of each edition of this book, these revised chapters detail the latest updates and nuances particular to individual code sections and proper code selection. Part 2 consists of new chapters that explain the connection between and application of accurate coding, NCCI edits, and HIPAA regulations to documentation, payment, insurance, and fraud and abuse avoidance. The new full-color design offers readers of the illustrated ninth edition a more engaging and far better educational experience. Features and Benefits - New content! New chapters covering documentation, NCCI edits, HIPAA, payment, insurance, and fraud and abuse principles build the reader's awareness of these inter-related and interconnected concepts with coding. - New learning and design features -- Vocabulary terms highlighted within the text and defined within the margins that conveniently aid readers in strengthening their understanding of medical terminology -- "Advice/Alert Notes" that highlight important information, exceptions, salient advice, cautionary advice regarding CMS, NCCI edits, and/or payer practices -- Call outs to "Clinical Examples" that are reminiscent of what is found in the AMA publications CPT(R) Assistant, CPT(R) Changes, and CPT(R) Case Studies -- "Case Examples" peppered throughout the chapters that can lead to valuable class discussions and help build understanding of critical concepts -- Code call outs within the margins that detail a code description -- Full-color photos and illustrations that orient readers to the concepts being discussed -- Single-column layout for ease of reading and note-taking within the margins -- Exercises that are Internet-based or linked to use of the AMA CPT(R) QuickRef app that encourage active participation and develop coding skills -- Hands-on coding exercises that are based on real-life case studies

Documentation Guidelines for Evaluation and Management Services

Documentation Guidelines for Evaluation and Management Services PDF Author: American Medical Association
Publisher: American Medical Association Press
ISBN:
Category : Decision making
Languages : en
Pages : 26

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Book Description


CPT Professional 2022

CPT Professional 2022 PDF Author: American Medical Association
Publisher:
ISBN: 9781640160873
Category :
Languages : en
Pages : 1200

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Book Description
CPT(R) 2022 Professional Edition is the definitive AMA-authored resource to help healthcare professionals correctly report and bill medical procedures and services.

Principles and Practice of Hospital Medicine

Principles and Practice of Hospital Medicine PDF Author: Sylvia McKean
Publisher: McGraw Hill Professional
ISBN: 0071603905
Category : Medical
Languages : en
Pages : 2351

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Book Description
The definitive guide to the knowledge and skills necessary to practice Hospital Medicine Presented in full color and enhanced by more than 700 illustrations, this authoritative text provides a background in all the important clinical, organizational, and administrative areas now required for the practice of hospital medicine. The goal of the book is provide trainees, junior and senior clinicians, and other professionals with a comprehensive resource that they can use to improve care processes and performance in the hospitals that serve their communities. Each chapter opens with boxed Key Clinical Questions that are addressed in the text and hundreds of tables encapsulate important information. Case studies demonstrate how to apply the concepts covered in the text directly to the hospitalized patient. Principles and Practice of Hospital Medicine is divided into six parts: Systems of Care: Introduces key issues in Hospital Medicine, patient safety, quality improvement, leadership and practice management, professionalism and medical ethics, medical legal issues and risk management, teaching and development. Medical Consultation and Co-Management: Reviews core tenets of medical consultation, preoperative assessment and management of post-operative medical problems. Clinical Problem-Solving in Hospital Medicine: Introduces principles of evidence-based medicine, quality of evidence, interpretation of diagnostic tests, systemic reviews and meta-analysis, and knowledge translations to clinical practice. Approach to the Patient at the Bedside: Details the diagnosis, testing, and initial management of common complaints that may either precipitate admission or arise during hospitalization. Hospitalist Skills: Covers the interpretation of common “low tech” tests that are routinely accessible on admission, how to optimize the use of radiology services, and the standardization of the execution of procedures routinely performed by some hospitalists. Clinical Conditions: Reflects the expanding scope of Hospital Medicine by including sections of Emergency Medicine, Critical Care, Geriatrics, Neurology, Palliative Care, Pregnancy, Psychiatry and Addiction, and Wartime Medicine.

ICD-10-CM Official Guidelines for Coding and Reporting - FY 2021 (October 1, 2020 - September 30, 2021)

ICD-10-CM Official Guidelines for Coding and Reporting - FY 2021 (October 1, 2020 - September 30, 2021) PDF Author: Department Of Health And Human Services
Publisher: Lulu.com
ISBN: 9781716599989
Category : Medical
Languages : en
Pages : 128

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Book Description
These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated.

The Essential Guide to Coding in Otolaryngology

The Essential Guide to Coding in Otolaryngology PDF Author: Seth M. Brown
Publisher: Plural Publishing
ISBN: 1635503825
Category : Medical
Languages : en
Pages : 473

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Book Description
The Essential Guide to Coding in Otolaryngology: Coding, Billing, and Practice Management, Second Edition is a comprehensive manual on how to properly and compliantly code for both surgical and non-surgical services. It is a practical guide for all otolaryngology providers in the United States, including physicians early in their career requiring a working knowledge of the basics, experienced providers looking to understand the latest updates with ICD-10-CM and CPT changes, related specialists (audiology, speech pathology, and physician extenders) providing otolaryngologic health care, and office administrative teams managing coding and billing. Included are sections on how to approach otolaryngology coding for all subspecialties in both the office and operating room. Foundational topics, such as understanding the CPT and ICD-10-CM systems, use of modifiers, managing claim submissions and appeals, legal implications for the provider, coding for physician extenders, and strategies to optimize billing, are presented by experts in the field. Focused on a practical approach to coding, billing, and practice management, this text is user-friendly and written for the practicing physician, audiologist, speech pathologist, physician extender, and coder. The income and integrity of a medical practice is tied to the effectiveness of coding and billing management. As profit margins are squeezed, the ability to optimize revenue by compliant coding is of the upmost importance. The Essential Guide to Coding in Otolaryngology: Coding, Billing, and Practice Management, Second Edition is vital not only for new physicians but for experienced otolaryngologists. New to the Second Edition: * Strategies for integrating revised guidelines for coding and documenting office visits * New and evolving office and surgical procedures, including Eustachian tube dilation and lateral nasal wall implants * Updated coding for endoscopic sinus surgery and sinus dilation * Billing for telehealth visits * Revision of all sub-specialty topics reflecting changes in coding and new technologies * New and revised audiologic diagnostic testing codes Key Features * All chapters written by practicing otolaryngologists, health care providers, practice managers, legal experts, and coding experts * Discussion of the foundations of coding, billing, and practice management as well as advanced and complex topics * Otolaryngology subspecialty-focused discussion of office-based and surgical coding * Tips on how to code correctly in controversial areas, including the use of unlisted codes * A robust index for easy reference

ICD-9-CM Official Guidelines for Coding and Reporting

ICD-9-CM Official Guidelines for Coding and Reporting PDF Author:
Publisher:
ISBN:
Category : Nosology
Languages : en
Pages : 76

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Book Description


Coding with Modifiers

Coding with Modifiers PDF Author: Deborah J. Grider
Publisher: American Medical Association Press
ISBN:
Category : Business & Economics
Languages : en
Pages : 436

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Book Description
Don't forget about the modifier. Missing or incorrect usage of modifiers is the most common reason that claims are rejected by payors. Leave off a modifier, or put in the wrong one, and your claim may be denied or paid the wrong amount. Coding with Modifiers: A Guide to Correct CPT and HCPCS Level II Modifier Usage provides step-by-step guidance for the proper use of CPT and HCPCS modifiers. Also included are specific requirements for modifier usage in both professional service and hospital reporting.

CPT Professional 2020

CPT Professional 2020 PDF Author: American Medical Association
Publisher: American Medical Association Press
ISBN: 9781622028986
Category : Health insurance claims
Languages : en
Pages : 0

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Book Description
This AMA-authored resource helps health care professionals correctly report and bill medical procedures and services.