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Author: Mark Savarise
Publisher: Springer
ISBN: 3319435957
Category : Medical
Languages : en
Pages : 342
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Book Description
This text provides the in-depth understanding of the mechanisms that guide coding and reimbursement. The text is meant to be useful to surgeons in practice, both in general surgery and in surgical subspecialties; practice management teams of surgical practices and to resident physicians in surgery. Part 1 of the text addresses the CPT coding process, the relative valuation system (RVU), the ICD-9 and ICD-10 systems of classification, Medicare Part B payment rules for physicians, the DRG system and Medicare Part A payment for hospitals, alternative payment models, and the myriad of quality measures of importance to surgeons. Part 2 of the text addresses specific coding in areas where surgeons historically have had the most difficulty. This is not meant to substitute for the available texts, software or courses on coding, but to provide the historical background and rationale for the specific coding rules. Principles of Coding and Reimbursement for Surgeons will be of great value to general surgeons and surgical subspecialists in private practice, academic institutions, and employed positions. It will provide direction to management teams from practice and institutional levels. It is also of use to surgical trainees and to researchers in health policy issues.
Author: Mark Savarise
Publisher: Springer
ISBN: 3319435957
Category : Medical
Languages : en
Pages : 342
Get Book Here
Book Description
This text provides the in-depth understanding of the mechanisms that guide coding and reimbursement. The text is meant to be useful to surgeons in practice, both in general surgery and in surgical subspecialties; practice management teams of surgical practices and to resident physicians in surgery. Part 1 of the text addresses the CPT coding process, the relative valuation system (RVU), the ICD-9 and ICD-10 systems of classification, Medicare Part B payment rules for physicians, the DRG system and Medicare Part A payment for hospitals, alternative payment models, and the myriad of quality measures of importance to surgeons. Part 2 of the text addresses specific coding in areas where surgeons historically have had the most difficulty. This is not meant to substitute for the available texts, software or courses on coding, but to provide the historical background and rationale for the specific coding rules. Principles of Coding and Reimbursement for Surgeons will be of great value to general surgeons and surgical subspecialists in private practice, academic institutions, and employed positions. It will provide direction to management teams from practice and institutional levels. It is also of use to surgical trainees and to researchers in health policy issues.
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
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
Author: Dalila Patrizia Greco
Publisher: Springer
ISBN: 3030024261
Category : Medical
Languages : en
Pages : 234
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Book Description
This book presents different patient-oriented perspectives from surgeons, economic evaluation and management researchers, and business companies active in the healthcare sector, striking a balance between the appropriateness/effectiveness of treatment and efficiency/cost. It does not include technical surgical details, but instead provides the necessary knowledge regarding different groups of patients to help economic and management researchers make accurate evaluations. Although partially based on the specific case of abdominal wall surgery in the Italian health system, the book defines a model that can, with the necessary adaptations, be applied in other national contexts. It also analyzes different reimbursement systems and methods of data collection. This approach supports the evolution from evidence-based medicine (EBM) to the future of real-world data (big data analysis). Further, it highlights the critical issue of “silos” reimbursement, which is the pillar of DRG, and proposes methodology to evaluate the direct and indirect benefit and costs of surgery (for example quality of care, costs incurred in cases of surgical complications due to the use of inappropriate, low-cost material or due to surgical procedure. It is a valuable resource for clinicians, surgeons, policymakers and managers in the field.
Author: Caryn Bredenkamp
Publisher: World Bank Publications
ISBN: 1464815216
Category : Medical
Languages : en
Pages : 69
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Book Description
This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.
Author: Djamal Benslimane
Publisher: Springer
ISBN: 3319644718
Category : Computers
Languages : en
Pages : 472
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Book Description
This two volume set LNCS 10438 and LNCS 10439 constitutes the refereed proceedings of the 28th International Conference on Database and Expert Systems Applications, DEXA 2017, held in Lyon, France, August 2017. The 37 revised full papers presented together with 40 short papers were carefully reviewed and selected from 166 submissions. The papers discuss a range of topics including: Semantic Web and Semantics; Graph Matching; Data Modeling, Data Abstraction, and Uncertainty; Preferences and Query Optimization; Data Integration and RDF Matching; Security and Privacy; Web Search; Data Clustering; Top-K and Skyline Queries; Data Mining and Big Data; Service Computing; Continuous and Temporal Data, and Continuous Query Language; Text Processing and Semantic Search; Indexing and Concurrency Control Methods; Data Warehouse and Data Stream Warehouse; Data Mining and Machine Learning; Recommender Systems and Query Recommendation; Graph Algorithms; Semantic Clustering and Data Classific ation.
Author: Paul A. Ruggieri M.D.
Publisher: Penguin
ISBN: 0698143817
Category : Business & Economics
Languages : en
Pages : 230
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Book Description
Why is surgery so expensive? Surgeon Paul A. Ruggieri reveals little-known truths about his profession—and the hidden flaws of our healthcare system—in this compelling and troubling account of real patients, real doctors, and how money influences medical decisions behind the scenes. Even many well-informed patients have no idea what may be contributing to the cost of their surgery. With up-to-date research and stories from his practice, Ruggieri shows how business arrangements among hospitals, insurance companies, and surgeons affect who gets treatment—and whether they get the right treatment. Pulling back the curtain from the hospital bed, he explains how to safeguard one’s own health (and finances), and how America can make surgery more affordable for all without sacrificing quality care.
Author:
Publisher:
ISBN:
Category : Employers' liability
Languages : en
Pages : 262
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Book Description
Author: Agency for Healthcare Research and Quality/AHRQ
Publisher: Government Printing Office
ISBN: 1587634333
Category : Medical
Languages : en
Pages : 385
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Book Description
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Author: Carol J. Buck
Publisher:
ISBN: 9780323430821
Category : Classification
Languages : en
Pages : 0
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Book Description
Resource ordered for the Health Information Technology program 105301.
