MEDICAL CODING

MEDICAL CODINGINTRODUCTION FOR A CAREER Presented by Lyn Olsen,Ph.D., MPA, RHIT, CCS, CPC-H, CCS-P, CPCwww.tseas.wordpress.com

1WHAT IS MEDICAL CODING AND BILLING?MEDICAL CODING & BILLING ARE THE CORE OF ADMINISTRATIVE MEANS BY WHICH HEALTHCARE PROVIDERS ARE PAID

INVOLVES ABUNDANT REGULATIONS BY A MULTITUDE OF GOVERNMENT AGENCIES WITH SERIOUS FINES FOR FRAUD AND/OR ABUSE (check websites www.cms.gov and www.oig.hhs.gov for more information)

IF CODERS AND BILLERS FAIL TO DO THEIR JOB WELL, HOSPITALS AND DOCTORS MAY BE UNABLE TO PRACTICE AND PATIENTS MAY NOT BE ABLE TO RECEIVE PROPER SERVICES

2ICD-9ICD IS THE INTERNATIONAL CLASSIFICATION OF DISEASES AS DEVELOPED BY THE WORLD HEALTH ORGANIZATION TO TRACK THE OCCURRENCES OF DISEASES SO THAT PATIENTS CAN BE MORE EFFECTIVELY TREATEDUNITED STATES USES THIS SYSTEM TO SELECT DIAGNOSTIC CODES AS PART OF THE PAYMENT PROCESS TO ENSURE MEDICAL NECESSITY ICD CODES ARE NUMERIC AND CAN VARY FROM 3 DIGITS TO 5 DIGITS WITH THE 4TH AND 5TH DIGITS LOCATED TO THE RIGHT OF THE PERIOD AND THE REST OF THE DIGITS ARE LOCATED TO THE LEFTTHERE ARE TWO ADDITIONAL SECTIONS FOR E (EXTERNAL INFLUENCES) CODES AND V CODES (SUPPLEMENTAL CODES)THERE ARE THREE VOLUMES CONTAINED WITHIN ONE BOOK: VOLUME 1 IS THE TABULAR INDEX OR CODESVOLUME 2 IS THE ALPHABETICAL INDEXVOLUME 3 IS THE TABULAR INDEX OF HOSPITAL PROCEDURES AND IS NOT USED BY PHYSICIANS OR HEALTHCARE PROVIDERS BECAUSE THEY USE THE CPT CODES

3CPTCPT IS THE CURRENT PROCEDURAL TERMINOLOGY WHICH IS DEVELOPED BY THE AMERICAN MEDICAL ASSOCIATION CPT PROVDES CODES FOR VARIOUS SERVICES PROVIDED BY HEALTHCARE PROVIDERS, SUCH AS DOCTORS AND TECHNICIANSCPT BOOK IS COMPOSED OF CODES AND AN ALPHABETICAL INDEXCPT BOOK ALSO HAS APPENDICES WHICH ARE IMPORTANT WITH USE OF CODES, SUCH AS THE MODIFIERSCPT CODES ARE 5 DIGITS NUMERIC AND MODIFIERS CAN BE ATTACHED MARKED BY A HYPHEN BETWEEN THE CPT CODE AND THE MODIFIERSECTIONS OF THE CPT BOOK INCLUDE EVALUATION & MANAGEMENT FOR VISITS, ANESTHESIOLOGY, SURGERY, RADIOLOGY, LABORATORY/PATHOLOGY AND MEDICINE.

4HCPCSHEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) HCPCS LEVEL I ARE THE CPT CODESLEVEL II ARE ALPHANUMERIC AND DEVELOPED BY THE CENTERS FOR MEDICAID AND MEDICARE SERVICES (CMS), A PART OF THE HEALTH AND HUMAN SERVICES FEDERAL DEPARTMENT. LEVEL II CODES ARE USED TO CODE FOR PAYMENT OF NON-PHYSICIAN SERVICES INCLUDING AMBULANCE SERVICES, PROSTHETIC DEVICES, AND SUPPLIES AND MATERIALS INCLUDING DRUGS AND MEDICATIONS.HCPCS ALSO HAVE MODIFIERS 5MEDICAL CODING AS A CAREER CHOICEAS A CAREER, MEDICAL CODING AND BILLING JOBS ARE EXAGGERATED TOO OFTEN BY TOO MANY WITH FEW PROMISES FULFILLED

QUALITY IS CRITICAL AND YOU NEED TO MAKE YOUR DECISION TO START THIS CAREER WITH A QUALITY COMPREHENSIVE EDUCATION

CREDIBLE TRAINING INVOLVES MANY HOURS OF INSTRUCTION BY QUALIFIED INSTRUCTORS FOR THERE IS MUCH TO KNOW TRAINING SHOULD INCLUDE MEDICAL BILLING, TERMINOLOGY, AND HEALTH ADMINISTRATION

6MEDICAL CODING CERTIFICATIONCERTIFIED CODERS ARE HIGHLY VALUED WITH HIGHER SALARIES AND GOOD JOB SECURITYIT IS RECOMMENDED THAT CODERS BE CERTIFIED AS PHYSICIAN CODERS FIRST AND THEN ADVANCE TO HOSPITAL CODING IF DESIREDPHYSICIAN CODING INVOLVES CODING FOR HEALTHCARE PROVIDER SERVICES WITHIN DOCTOR OFFICES, CLINICS, URGENT CARE AND EMERGENCY ROOMHOSPITAL CODING IS DISTINGUISHED AS OUTPATIENT AND INPATIENTOUTPATIENT HOSPITAL CODING IS FOR SERVICES WHEN THE PATIENT IS NOT ADMITTED TO THE HOSPITAL SUCH AS OUTPATIENT SURGERY CENTERSINPATIENT HOSPITAL CODING IS FOR SERVICES PROVIDED BY THE HOSPITAL, SUCH AS ROOM AND BOARD, SUPPLIES, NURSING STAFF7LEGITIMATE HEALTH ADMINISTRATIVE CERTIFYING AGENCIES AHIMA: AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION (ahima.org)OFFERS CERTIFICATION AS CERTIFIED CODING SPECIALIST FOR THE PHYSICIAN (CCS-P) AND CERTIFIED CODING SPECIALIST (CCS) FOR INPATIENT AND OUTPATIENT HOSPITALOFFERS CODING CERTIFICATION AS AN APPRENTICE (CCA) OFFERS CERTIFICATION AS REGISTERED HEALTH INFORMATION TECHNICIAN (RHIT) AND ADMINISTRATORS (RHIA) WHO MANAGE CLINICS AND HOSPITAL DEPARTMENTS AS WELL AS MANY OTHER JOBSAHIMA HAS BEEN INVOLVED IN MANY HEALTH ADMINISTRATION PROJECTS WITH MEDICAL AND GOVERNMENTAL AGENCIES FOR OVER 75 YEARS

8LEGITIMATE HEALTH ADMINISTRATIVE CERTIFYING AGENCIES AAPC: AMERICAN ACADEMY OF PROFESSIONAL CODERS (aapc.com)OFFERS CERTIFICATION AS CERTIFIED PROFESSIONAL CODER (CPC) AND CERTIFIED PROFESSIONAL CODER (CPC-H) FOR OUTPATIENT HOSPITAL CODINGPROVIDES TRAINING AND CONTINUING EDUCATION UNITS WITHIN THE CODING FIELD

9ONLINE COMPREHENSIVE MEDICAL CODING COURSEThree Sisters M&E Services offer high quality and comprehensive training in medical coding Derived from 15 years experience teaching, writing, consulting, and presenting in the health administration including preparation of students for coding examsExperience enhanced by the instructors five national certifications in healthcare administration (RHIT, CCS, CPC-H, CCS-P & CPC)Online courses developed by instructor so no cost for booksCourse consists of 30 packets for ICD-9 and 30 packets for CPT/HCPCS.Cost is $500 per course for a total of $1000 for both courses. 10FOR MORE INFORMATION CONTACTwww.tseas.wordpress.com

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