Understanding Hospital Billing and Coding - Elsevier eBook on VitalSource, 3rd Edition
Elsevier eBook on VitalSource
A basic guide to hospital billing and reimbursement, Understanding Hospital Billing and Coding, 3rd Edition helps students 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. With this text, students will also learn the essentials of ICD-10-CM and develop skills in both inpatient coding and outpatient/ambulatory surgery coding.
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- UPDATED content reflects the most current industry changes in ICD-10, MR-DRGs, PPS Systems, and the Electronic Health Record.
- NEW Hospital Introduction chapter includes a department-by-department overview showing how today’s hospitals really work.
- NEW Health Care Payers and Reimbursement section follows the workflow of the hospital claim by including successive chapters on payers, prospect payment systems, and accounts receivable management.
- UB-04 Claim Simulation on the companion Evolve website lets students practice entering information from source documents into the claim form.
- Over 300 illustrations and graphics bring important concepts to life.
- Detailed chapter objectives highlight what students are expected to learn.
- Key terms, acronyms, and abbreviations with definitions are included in each chapter.
- Concept Review boxes reinforce key concepts.
- Test Your Knowledge exercises reinforce lessons as students progress through the material.
- Chapter summaries review key concepts.
- Practice hospital cases let students apply concepts to real-life scenarios.
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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
as described in our 