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Category Archives: outpatient coding certificate
Assigning diagnosis and procedure codes | Online medical billing …
The chant of the medical coder always comes in handy. When in doubt or faced with incomplete documentation, remember: “If the doctor didn’t say it, it wasn’t done.” Period.
When the documentation is missing or ambiguous, it’s your responsibility to clarify with the physician. Although some physicians become defensive or irritated when the coder questions the documentation, those who under- stand that your questions can maximize their reimbursement will gladly amend the documentation to clear up the problem.
Time to play “Name that Illness!” Upon reading the operative report or office notes, you must identify the illness or disease and find the corresponding diagnosis code in the International Classification of Diseases (ICD) book, Volumes 1 and 2.
After finding the diagnosis codes, you then look up the procedure codes that best describe the work done, using one of the following books:
✓ The Current Procedural Terminology (CPT) book: The CPT book con- tains all the procedure codes as determined by the American Medical Association (AMA) and includes the definition of each procedure. Physicians and outpatient facilities choose a code from the CPT book.
✓ The ICD-9 Volume 3 book: Hospital inpatient procedures are chosen from the ICD-9 Volume 3 book.
Because so many different codes and corresponding procedures exist, you may suffer from “coding drama.” Coding a procedure with a lot of moving parts can get a bit complicated. Sure, capturing all the procedures that were performed during a surgery is important, for example, but they each must be separately billable or have involved extra work by the surgeon in order to jus- tify unbundling them (or billing them separately). The point? Coding can get
pretty complicated. Before you panic, keep this in mind: Coding a procedure is simple if you remember to break it down into small bites.
Physician coding
Physician coding is just what it sounds like: coding diagnoses and proce- dures representing the work performed by a physician. Under certain cir- cumstances, work performed in an outpatient setting, such as an ambulatory surgery center (ASC), also uses physician coding.
Physician offices, ambulatory surgery centers, and other outpatient facili- ties use the CPT code sets to represent the procedure performed. Physician claims are submitted on the HCFA/CMS-1500 claim form. In most circum- stances, facilities bill commercial carriers on the UB-04 claim form. Both of these forms are discussed later in this chapter.
Facility coding
Coding for facility reimbursement often pertains to hospital coding. Specific coding and billing guidelines exist for hospital billing. If you are working as
a facility coder in a hospital, you use Volume 3 of the ICD-9 book to identify the procedures.
Basically, facility coding is for the hospital inpatient setting. Outpatient cen- ters, including those run by the hospital, use physician coding.
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3M and Nextgen Healthcare partner to offer web-based ICD-10 …
NextGen Healthcare Information Systems, LLC., a wholly owned subsidiary of Quality Systems, Inc. (NASDAQ: QSII) and a leading provider of healthcare information systems and connectivity solutions, announced today it has teamed with 3M Health Information Systems to offer 3M’s robust, web-based ICD-10 Education Program industry wide. The agreement strengthens the arsenal of resources NextGen Healthcare makes available to aid both clients and non-clients as they successfully transition to ICD-10.
Designed to help ease the transition from ICD-9 to ICD-10, the 3M ICD-10 Education Program is available as a web-based subscription service with training delivered on-demand so that it can be easily accessed and reviewed as frequently as needed. The program offers 22 complete interactive training modules with special emphasis on in-depth ICD-10 education for inpatient, outpatient and professional fee coders and documentation improvement specialists. These 90-minute modules feature case studies, self-assessments, practice questions, tests and progress and completion reports.
The program provides physicians with comprehensive ICD-10 training based on medical specialty, allowing physicians to focus on the ICD-10 issues most relevant to their practice. Coursework includes a review of ICD-10-CM coding guidelines, specialty-specific physician modules and other ICD-10 educational materials to identify areas where increased clinical knowledge is needed.
For more information or to register for the 3M ICD-10 Education Program, NextGen Healthcare clients should visit https://store.nextgen.com/p/137/3m-icd-10-training-module?Lead=PR; non-clients should visit https://store.nextgen.com/p/138/3m-icd-10-training-module?Lead=PR.
“Although ICD-10 has been delayed until October 1, 2015, healthcare organizations should continue to work toward readiness,” said Terri McCubbin Graves, RN, Director of Consulting Services for 3M Health Information Systems. “Continuing to focus on essential transition activities, such as clinical documentation improvement, physician education, and ICD-10 coding accuracy, will help facilities maintain momentum and preserve the substantial investment they have already made in their ICD-10 transition.”
“Delayed yet inevitable, the ICD-10 transition is a challenging process for every single healthcare provider and facility throughout the nation. With documentation of clinical care, physician productivity and practice reimbursement potentially impacted, education and training are key elements that will help organizations avoid frustration and backlogs and lost revenue,” said Michael Lovett, executive vice president and general manager for NextGen Healthcare. “Preparing coders, physicians and other staff for the ICD-10 transition is critically important. Through our agreement with 3M, we are providing the industry with the leading ICD-10 educational and comprehensive training resource to help assist their transition preparedness. Adding this online-training program to our portfolio of ICD-10 preparation resources we make available to clients and non-clients alike underscores our commitment to ensuring a successful ICD-10 transition for all healthcare organizations and helps to improve the delivery system overall.”
The Continuing Education Units (CEUs) are assigned after each course and successful completion of the post test. CEUs are approved by American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), Association of Clinical Documentation Improvement Specialists (ACDIS), the Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation, and Radiology Coding Certification Board (RCCB).
Source:
3M Health Information SystemsÂ
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Weston Coder III Job – FL, 33326 – Jobs at Cleveland Clinic
Coder III
Reference Title
HR Use Only:
Hospital: Florida Hospital Non-Exempt
Facility: CC Florida Hospital Weston
Department: Medical Records
Job Code: 000884
Pay Grade: 14
Schedule: Full Time
Shift: Day/Evening
Hours: FLEXIBLE
Job Details: – 2 years experience required
GENERAL SUMMARY
Participates daily, in coding and abstracting activities. Identifies, reviews, interprets, abstracts and codes clinical information from Inpatient records with some back up in area of outpatient surgeries and observation records for the purpose of research, reimbursement and compliance with federal regulations and other agencies utilizing established coding principles and protocols. A Coder 3 must meet productivity and quality standards and must meet coding/abstracting goals to expedite the billing process, as well as, expedite the retrieval for physician access and ongoing patient care.
MINIMUM QUALIFICATIONS:
A. Education, Knowledge, Skills and Abilities
Graduation from accredited Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) program or Certified Coding Specialist (CCS) certified or two years of college education in science related field including anatomy/physiology, basic disease process, medical terminology. Requires strong verbal skills in interpersonal situations.
B. Required Length and Type of Experience
Minimum of 2 or more years experience in the application of ICD-9-CM and CPT-4 coding, recording of and interpreting clinical data from medical records of inpatients in acute care facility. After selection and placement into this position, at least 3 months of on-the-job training with attendance at comprehensive training sessions in order to code clinical data with a high degree of accuracy.
C. Required Licensure, Certification or Registry
CCS or RHIT or RHIA required.
Category: Clerical/Administrative Support
Medical Coding And Billing Starting Salary | Medical Transcription …
Medical Coding And Billing Starting Salary – Everything you need to know about Medical Transcription Training, Medical Transcription Programs, Medical. … Inpatient/Outpatient Medical Coding & Billing 35,000 new jobs, through 2018. outpatient coding. Medical Billing and Coding Dental Assistant. Title: AlliedHealthAds[6-2-11] Created Date: 6/2/2011 9:46:39 AM. The Medical Billing Specialist certificate training program begins with an overview of the medical billing practice, body's …
Reimbursement for Pain Management in the Coming Years
At the 12th Annual Spine, Orthopedic and Pain Management Driven ASC Conference in Chicago on June 13, Amy Mowles, president and CEO of Mowles Medical Practice Management, spoke about reimbursement for pain management in the coming years.
Ms. Mowles began the presentation by comparing reimbursement for certain pain management procedures over the years. She started with sacroiliac joint injections, which have really seen a decrease in reimbursement.
From 2000 through 2005, the average office rate payment for an SI joint injection was $480. From 2006 through 2011, that rate fell to roughly $200. Part of the issue here is that physicians were learning how to perform the procedure from one another via telecast and other informal communication methods rather than licensed, approved educational forums.
That’s still happening today, said Ms. Mowles. “What you will find, thank goodness, is insurance companies are starting to ask: ‘If you want to be a participating provider in our network, where did you learn to do SI joint injections?'”
Reimbursement for SI joint injections really fell from 2012 through the present, though. Payments now average $170, said Ms. Mowles.
Speaking of the present, Ms. Mowles said CMS’ cuts for pain reimbursement in 2014 were drastic. “They are saying pain is overutilized, and it is,” she said. “There is a lot of money being spent in pain management.”
She emphasized the need for education about pain management, and how clinicians should not approach these procedures as quick nor easy. “From what I’ve seen, that simply is not true,” she said. “I do not take it lightly at all.” She also said an official from one state health department told her pain management was “provocative and invasive,” and he questioned the validity of its provision in the ambulatory or outpatient setting.
Ms. Mowles said she thinks states will have more authority if pain management continues to shift to “less sophisticated platforms.” State health departments will exercise more jurisdiction about what can safely be done in their states. She advised stakeholders to stay informed, get involved and understand what Medicare is planning next and how it will affect their bottom lines. Any ASC with adequate pain management procedure volume that is enough to keep providers and staff productive and equipment busy will be profitable, Ms. Mowles noted in her presentation.
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