Understanding Hospital Billing and Coding - Elsevier eBook on VitalSource (Retail Access Card), 3rd Edition
Elsevier eBook on VitalSource - Access Card
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A basic guide to hospital billing and reimbursement, Understanding Hospital Billing and Coding, 3rd Edition helps you understand, complete, and submit the UB-04 claim form that is used for all Medicare and privately insured patients. It describes how hospitals are reimbursed for patient care and services, showing how the UB-04 claim form reflects the flow of patient data from the time of admission to the time of discharge. Written by coding expert Debra P. Ferenc, this book also ensures that you understand the essentials of ICD-10-CM and develop skills in both inpatient coding and outpatient/ambulatory surgery coding.
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- Over 300 illustrations and graphics bring important concepts to life.
- Practice hospital cases let you apply concepts to real-life scenarios.
- A department-by-department overview of hospital structure shows how hospitals really work.
- Detailed chapter objectives highlight what you are expected to learn.
- Key terms, acronyms, and abbreviations with definitions are included in each chapter.
- Key Points boxes reinforce key concepts.
- Test Your Knowledge exercises reinforce lessons as you progress through the material.Comprehensive presentation of the UB-04 includes section-by-section explanations and a comparison between the CMS-1500 and UB-04.
- Detailed explanations of HIPAA, hospital coding, and various payer systems prepare you to enter the field of hospital billing and coding.
- Chapter summaries review key concepts.
- Review exercises in each chapter reinforce your understanding and improve your retention of important concepts.
- Exercises on the companion Evolve website simulate a hospital billing and coding environment and provide another method of learning procedures by drawing from source documents – such as application of registration, Charge Description Master (CDM), and the patient invoice.
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- Updated Claim Forms chapter covers the UB-04 claim form.
- Updated information covers diagnosis and procedural coding, with guidelines and applications.
- Updated claim forms and names are used throughout.
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Section 1: Hospital Overview
1. Hospital Introduction
2. Hospital Regulatory Environment
3. HIPAA
Section 2: Hospital Billing and Coding Process
4. Patient Accounts Data Flow
5. Hospital Billing Process
Section 3: Coding
6. ICD-9-CM Diagnosis and Procedure Coding
7. ICD-10-CM Diagnosis Coding
8. Procedure Coding (HCPCS and ICD-10-PCS)
9. Coding Guidelines and Applications (HCPCS and ICD-10-CM/PCS)
Section 4: Claim Forms
10. Claim Forms
Section 5: Health Care Payers and Reimbursement
11. Payers
12. Prospective Payment Systems
13. Accounts Receivable Management
Section 6: Appendixes
A: Cases
B: Claim Form Data
C: Web Resources
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