Cover image for Step-by-step medical coding
Title:
Step-by-step medical coding
Author:
Buck, Carol J.
Personal Author:
Edition:
Third edition.
Publication Information:
Philadelphia : W.B. Saunders, [2000]

©2000
Physical Description:
xv, 622 pages : illustrations ; 28 cm
Language:
English
ISBN:
9780721684581
Format :
Book

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RB115 .B83 2000 Adult Non-Fiction Central Closed Stacks-Oversize
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Summary

Summary

Provides students with the skills required to correctly identify the right codes for the diagnoses or services provided, and to use those codes to obtain reimbursement correctly the first time an insurance claim is filed. This third edition paces the student through the three major coding classifications - ICD-9 Diagnostic Codes, CPT Procedural Codes and HCPCS Level 3 Codes for non-CPT services and supplies - before refocusing on reimbursment.


Table of Contents

Unit I Current Procedural Terminology (CPT)p. 1
Chapter 1 Introduction to the CPTp. 2
The Purpose of the CPT Manualp. 4
Updating the CPT Manualp. 4
The CPT Manual Formatp. 6
Starting With the Indexp. 17
Chapter 2 Evaluation and Management (E/M) Sectionp. 26
Contents of the E/M Sectionp. 28
Three Factors of E/M Codesp. 28
Various Levels of E/M Servicep. 30
An E/M Code Examplep. 48
Using the E/M Codesp. 49
Documentation Guidelinesp. 75
Chapter 3 Anesthesia Section and Modifiersp. 80
Part I Learning About the Anesthesia Sectionp. 82
Types of Anesthesiap. 82
Anesthesia Section Formatp. 84
Formula for Anesthesia Paymentp. 85
Unlisted Anesthesia Codep. 92
Part II Modifiersp. 94
The CPT Modifiersp. 94
Chapter 4 Introduction to the Surgery Section and Integumentary Systemp. 120
Part I Introduction to the Surgery Sectionp. 122
Formatp. 122
Separate Proceduresp. 126
Surgical Packagep. 127
Part II General and Integumentary System Subsectionsp. 130
General Subsectionsp. 130
Formatp. 131
Skin, Subcutaneous and Accessory Structuresp. 131
Nailsp. 139
Repair (Closure)p. 143
Burnsp. 154
Destructionp. 156
Breast Proceduresp. 157
Chapter 5 Musculoskeletal Systemp. 162
Formatp. 164
Coding Highlightsp. 164
Generalp. 170
Application of Casts and Strappingp. 178
Endoscopy/Arthroscopyp. 181
Chapter 6 Respiratory Systemp. 186
Formatp. 188
Coding Highlightsp. 189
Nosep. 190
Accessory Sinusesp. 196
Larynxp. 197
Trachea and Bronchip. 199
Lungs and Pleurap. 201
Chapter 7 Cardiovascular Systemp. 208
Coding Highlightsp. 210
Cardiovascular Coding in the Surgery Sectionp. 212
Cardiovascular Coding in the Medicine Sectionp. 228
Cardiovascular Coding in the Radiology Sectionp. 241
Chapter 8 Female Genital System and Maternity Care and Deliveryp. 248
Part I Female Genital Systemp. 250
Formatp. 250
Coding Highlightsp. 250
Part II Maternity Care and Deliveryp. 261
Formatp. 261
Coding Highlightsp. 261
Chapter 9 General Surgery Ip. 268
Male Genital Systemp. 270
Intersex Surgeryp. 271
Urinary Systemp. 271
Digestive Systemp. 274
Mediastinum and Diaphragmp. 280
Chapter 10 General Surgery IIp. 286
Hemic and Lymphatic Systemsp. 288
Endocrine Systemp. 290
Nervous Systemp. 292
Eye and Ocular Adnexap. 298
Auditory Systemp. 301
Chapter 11 Radiology Sectionp. 306
Formatp. 308
Radiology Terminologyp. 308
Proceduresp. 309
Planesp. 309
Guidelinesp. 316
The Four Radiology Subsectionsp. 319
Chapter 12 Pathology/Laboratory Sectionp. 336
Formatp. 338
Subsectionsp. 338
Chapter 13 The Medicine Section and Level II National Codesp. 350
Diagnostic and Therapeutic Servicesp. 352
History of National Level Codingp. 374
Unit II International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)p. 389
Chapter 14 An Overview of the ICD-9-CMp. 390
What is the ICD-9-CM?p. 392
ICD-9-CM Format and Conventionsp. 394
Alphabetic Index, Volume 2p. 402
Tabular List, Volume 1p. 413
The Five Appendices in the Tabular List, Volume 1p. 423
Procedures, Volume 3p. 426
Chapter 15 Using the ICD-9-CMp. 440
Some General Information About the Offical Guidelines for Coding and Reportingp. 442
V Codes and Late Effectsp. 464
Chapter-Specific Guidelinesp. 469
More General Guidelinesp. 517
Diagnostic Coding and Reporting Guidelines for Outpatient Servicesp. 519
Overview of ICD-10-CM and ICD-10-PCSp. 522
Unit II An Overview of Reimbursementp. 541
Chapter 16 Third-Party Reimbursement Issuesp. 542
Introductionp. 544
The Basic Structure of the Medicare Programp. 544
The Importance of the Federal Registerp. 547
Understanding Inpatient Diagnosis-Related Groups (DRGs)p. 550
The Purpose of Peer Review Organizations (PROs)p. 565
What Is the Outpatient Resource-Based Relative Value Scale (RBRVS)?p. 567
The Prospective Payment System for the Skilled Nursing Facilityp. 573
Outpatient Medicare Reimbursement System--APCp. 573
Medicare Fraud and Abusep. 576
The Managed Health Care Conceptp. 584
Appendix A ICD-9-CM Official Guidelines for Coding and Reportingp. 591
Appendix B Exercise Answersp. 633
Appendix C Documentation Guidelines for Evaluation and Management Servicesp. 663
Glossaryp. 689