Coding for Medical Necessity Reference Guide - First Edition
Coding for Medical Necessity Reference Guide - First Edition

Author: AAPC

Publisher: AAPC

Published: 2020-03-18

Total Pages: 17

ISBN-13: 1626889805

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Master coding concepts related to medical necessity and report compliant codes for your services. Revenue loss, rework, payback demands—how much are medical necessity errors costing your practice? And that’s to say nothing of potential civil penalties. Get medical necessity wrong and it’s considered a “knowingly false” act punishable under the FCA. Stay liability-free and get reimbursed for your services with reliable medical necessity know-how. AAPC’s Coding for Medical Necessity Reference Guide provides you with step-by-step tutorials to remedy the range of documentation and coding issues at the crux of medical necessity claim errors. Learn how to integrate best practices within your clinical processes—including spot-checks and self-audits to identify problems. Benefit from real-world reporting examples, Q&A, and expert guidance across specialties to master coding for medical necessity. Learn how to lock in medical necessity and keep your practice safe and profitable: Avoid Medical Necessity Errors with CERT Smarts Rules to Improve Provider Documentation Denials? Pay Attention to Procedure/Diagnosis Linkage Nail Down the Ins and Outs of Time-based Coding Expert Guidance to Fend Off RAC Audits and Denials Beat E/M Coding Confusion with Payer Advice Improve Your ABN Know How with This FAQ

Clinical Documentation Reference Guide - First Edition
Clinical Documentation Reference Guide - First Edition

Author: AAPC

Publisher: AAPC

Published: 2020-03-12

Total Pages: 13

ISBN-13: 1626889791

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It's not the quantity of clinical documentation that matters—it's the quality. Is your clinical documentation improvement (CDI) program identifying your outliers? Does your documentation capture the level of ICD-10 coding specificity required to achieve optimal reimbursement? Are you clear on how to fix your coding and documentation shortfalls? Providing the most complete and accurate coding of diagnoses and site-specific procedures will vastly improve your practice’s bottom line. Get the help you need with the Clinical Documentation Reference Guide. This start-to-finish CDI primer covers medical necessity, joint/shared visits, incident-to billing, preventative care visits, the global surgical package, complications and comorbidities, and CDI for EMRs. Learn the all-important steps to ensure your records capture what your physicians perform during each encounter. Benefit from methods to effectively communicate CDI concerns and protocols to your providers. Leverage the practical and effective guidance in AAPC’s Clinical Documentation Reference Guide to triumph over your toughest documentation challenges. Prevent documentation deficiencies and keep your claims on track for optimal reimbursement: Understand the legal aspects of documentation Anticipate and avoid documentation trouble spots Keep compliance issues at bay Learn proactive measures to eliminate documentation problems Work the coding mantra—specificity, specificity, specificity Avoid common documentation errors identified by CERT and RACs Know the facts about EMR templates—and the pitfalls of auto-populate features Master documentation in the EMR with guidelines and tips Conquer CDI time-based coding for E/M The Clinical Documentation Reference Guide is approved for use during the CDEO® certification exam.

Denials Management & Appeals Reference Guide - First Edition
Denials Management & Appeals Reference Guide - First Edition

Author: AAPC

Publisher: AAPC

Published: 2020-03-17

Total Pages: 16

ISBN-13: 1626889821

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Recoup lost time and revenue with denials management and appeals know-how. Claim denials can sink a profit margin. And given the cost of appeals, roughly $118 per claim, not all denials can be reworked. A practice submitting 50 claims a day at an average reimbursement rate of $200 per claim should bring in $10,000 in daily revenue. But if 10% of those claims are denied, and the practice can only appeal one, they lose $800 per day—upwards of $200K annually. Your medical claims are the lifeblood of operations. Don’t compromise your financial health. Learn how to preempt denials with the Denials Management & Appeals Reference Guide. This vital resource will equip you to get ahead of payers by simplifying the leading causes of denials and showing you how to address insufficient documentation, failing to establish medical necessity, coding and billing errors, coverage stipulations, and untimely filing. Rely on AAPC to walk you through the appeal process. We’ll help you establish protocols to avoid an appeals backlog and teach you how to identify and prioritize denials likely to win an appeal. What’s more, you’ll learn when a claim can be “reopened” to fix a problem. Collect the revenue your practice deserves with effective denials and appeals solutions: Know how to analyze your denials Defeat documentation and compliance issues for successful claims success Utilize payer policy for coverage clues Lock in revenue with face-to-face reimbursement guidance Refine efforts to avoid E/M claim denials Ace ICD-10 coding for optimum reimbursement Put an end to modifier confusion Stave off denials with CCI edits advice Navigate the appeals process like a pro And much more!

Evaluation and Management Coding Reference Guide - First Edition
Evaluation and Management Coding Reference Guide - First Edition

Author: AAPC

Publisher: AAPC

Published: 2020-06-30

Total Pages: 14

ISBN-13: 162688983X

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Defeat the challenges that threaten your E/M claims and compliance success. Evaluation and management (E/M) services are the lifeblood of your revenue stream, and yet they’re the most problematic to report. Claim denials remain high. E/M coding errors, in fact, rose from 11.9% in 2018 to account for 12.8% of CMS’s overall 2019 improper payment rate. How much E/M revenue are you losing? Safeguard your organization from claim denials and audit scrutiny with the Evaluation & Management Coding Reference Guide. Our experts break down E/M coding rules and requirements into simple, manageable steps written in everyday language to boost your E/M reporting skills. Learn how to capture the key components of medical history, physical exam, and medical decision-making—and capitalize on real-world clinical scenarios to prevent over- or under-coding. The Evaluation & Management Coding Reference Guide will help you prep for 2021 E/M guideline changes overhauling new and established office and outpatient services, and walk you through online digital E/M services, remote physiologic monitoring, and more. Master the ins and outs of E/M coding—CPT® guidelines, level of service, modifiers, regulations, and documentation guidelines. Put an end to avoidable denials and optimize your E/M claims for full and prompt reimbursement. Benefit from expert tutorials covering the spectrum of E/M reporting concepts and challenges: Prep for 2021 guideline changes and their impact on your organization Master the ins and outs of E/M guidelines in CPT® Capture the seven components of E/M services Sort out medical decision-making coding Avoid the pitfalls of time-based coding Nail down specifics for critical care E/M services Clear up modifier confusion Understand NPPs rules for same-day E/M services Take the guesswork out of complexity determinations Get the details on coding surgery and E/M together Learn the principles of E/M documentation

Coders' Dictionary & Reference Guide - First Edition
Coders' Dictionary & Reference Guide - First Edition

Author: AAPC

Publisher: AAPC

Published: 2020-06-30

Total Pages: 18

ISBN-13: 1626889813

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Finding the coding and billing information you need just got easier. The Coders’ Dictionary & Reference Guide is the perfect companion for coding and billing students and busy professionals. This unique resource, designed for your everyday use, provides a complete reference library in one convenient and affordable volume. Now you can clear the pile of books from your desk and find all the supporting information you need for medical billing and coding. Boost your productivity with fingertip-access to medical terms and industry acronyms. Double-check your modifier usage. Find quick answers to your E/M, anesthesia, and surgery coding questions. Refer to educational illustrations and solidify your reporting know-how with essential lay terms. Speed up your workflow with these beneficial features: Exhaustive list of thousands of medical terms with definitions in an easy-to-understand language Billing, coding and reimbursement terms defined to familiarize you with current regulations, requirements, processes, and agencies How-to guidance for coding procedures from the Surgery section, with explanations of common terms Evaluation and Management (E/M) Survival Guideto help you identify the right choice for E/M service levels Anesthesia primer to distinguish between various types of anesthesia Modifiers and lay descriptions for CPT®and HCPCS modifiers in plain English to eliminate your confusion as to when and how to apply modifiers Lists of prefixes, suffixes, abbreviations, and eponyms frequently used in coding Anatomical illustrations to enhance your understanding of services and procedures Place of service(POS) and type of service (TOS) lists And much more!

Medical Billing & Coding For Dummies
Medical Billing & Coding For Dummies

Author: Karen Smiley

Publisher: John Wiley & Sons

Published: 2019-12-05

Total Pages: 355

ISBN-13: 1119625440

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The definitive guide to starting a successful career in medical billing and coding With the healthcare sector growing at breakneck speed—it’s currently the largest employment sector in the U.S. and expanding fast—medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered. This updated edition provides everything you need to begin—and then excel in—your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered. Find out about the flexible employment options available and how to qualify Understand the latest updates to the ICD-10 Get familiar with ethical and legal issues Discover ways to stay competitive and get ahead The prognosis is good—get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!

Practice Management Reference Guide - First Edition
Practice Management Reference Guide - First Edition

Author: AAPC

Publisher: AAPC

Published: 2020-03-16

Total Pages: 14

ISBN-13: 1626889856

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Effectively manage the business side of medicine. Profit margin, collections, cash flow, compliance, human resources, health information, efficient business processes—the broad responsibilities and complex requirements of practice management are endless. Drop one ball in the daily juggle and the fallout can be costly. There’s never enough time, which makes it tough to stay on top of regulations and best practices. That’s where AAPC’s Practice Management Reference Guide becomes vital to your organization, providing you with one-stop access to the latest and best in practice management. From office operations to financial oversight, the Practice Management Reference Guide lays out essential guidance to help you optimize efficiency, security, and profitability. Benefit from actionable steps to streamline accounts receivable. Discover how to bring in new patients and keep the ones you have happy. Leverage real-world strategies to command payer relations, recruitment, training, employee evaluations, HIPAA, MACRA, Medicare, CDI, EHR … everything you need to ensure bountiful operations in 2020 and beyond. With the Practice Management Reference Guide, you’ll gain working knowledge covering the spectrum of practice management issues, including: Negotiating favorable payer contracts Preventing an appeals backlog Remaining audit-ready Correctly applying incident-to billing rules to maximize reimbursement Using assessment tools to evaluate your risk Preparing a risk plan and know what questions to ask Knowing how and why you should implement policies and protocols Complying with state and federal patient privacy rules

Code Complete
Code Complete

Author: Steve McConnell

Publisher: Pearson Education

Published: 2004-06-09

Total Pages: 952

ISBN-13: 0735636974

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Widely considered one of the best practical guides to programming, Steve McConnell’s original CODE COMPLETE has been helping developers write better software for more than a decade. Now this classic book has been fully updated and revised with leading-edge practices—and hundreds of new code samples—illustrating the art and science of software construction. Capturing the body of knowledge available from research, academia, and everyday commercial practice, McConnell synthesizes the most effective techniques and must-know principles into clear, pragmatic guidance. No matter what your experience level, development environment, or project size, this book will inform and stimulate your thinking—and help you build the highest quality code. Discover the timeless techniques and strategies that help you: Design for minimum complexity and maximum creativity Reap the benefits of collaborative development Apply defensive programming techniques to reduce and flush out errors Exploit opportunities to refactor—or evolve—code, and do it safely Use construction practices that are right-weight for your project Debug problems quickly and effectively Resolve critical construction issues early and correctly Build quality into the beginning, middle, and end of your project

Beautiful Code
Beautiful Code

Author: Greg Wilson

Publisher: "O'Reilly Media, Inc."

Published: 2007-06-26

Total Pages: 621

ISBN-13: 0596554672

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How do the experts solve difficult problems in software development? In this unique and insightful book, leading computer scientists offer case studies that reveal how they found unusual, carefully designed solutions to high-profile projects. You will be able to look over the shoulder of major coding and design experts to see problems through their eyes. This is not simply another design patterns book, or another software engineering treatise on the right and wrong way to do things. The authors think aloud as they work through their project's architecture, the tradeoffs made in its construction, and when it was important to break rules. This book contains 33 chapters contributed by Brian Kernighan, KarlFogel, Jon Bentley, Tim Bray, Elliotte Rusty Harold, Michael Feathers,Alberto Savoia, Charles Petzold, Douglas Crockford, Henry S. Warren,Jr., Ashish Gulhati, Lincoln Stein, Jim Kent, Jack Dongarra and PiotrLuszczek, Adam Kolawa, Greg Kroah-Hartman, Diomidis Spinellis, AndrewKuchling, Travis E. Oliphant, Ronald Mak, Rogerio Atem de Carvalho andRafael Monnerat, Bryan Cantrill, Jeff Dean and Sanjay Ghemawat, SimonPeyton Jones, Kent Dybvig, William Otte and Douglas C. Schmidt, AndrewPatzer, Andreas Zeller, Yukihiro Matsumoto, Arun Mehta, TV Raman,Laura Wingerd and Christopher Seiwald, and Brian Hayes. Beautiful Code is an opportunity for master coders to tell their story. All author royalties will be donated to Amnesty International.

CPT Professional 2022
CPT Professional 2022

Author: American Medical Association

Publisher:

Published: 2021-09-17

Total Pages: 1200

ISBN-13: 9781640160873

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CPT(R) 2022 Professional Edition is the definitive AMA-authored resource to help healthcare professionals correctly report and bill medical procedures and services.