Chapter 1: Medical Coding in History
The Black Death
William Farr and the Cholera Studies
International List of Causes of Death
Beyond Death
Modern Times
Reflection of Society
What About ICD-10?
Chapter 2: Diagnosis Coding
What is a Diagnosis?
Deducing the Diagnosis – History
Deducing the Diagnosis – Exam
Reality Check
Deducing the Diagnosis – Medical Decision-Making
Documenting the Diagnosis
What Number is My Diagnosis?
How Hard Can This Be?
What are the Rules?
General Coding Guidelines
What is the Structure of the Diagnosis Codes?
Which Diagnosis is Listed First?
Outpatient and Physician Office
What’s in Each Diagnosis Chapter?
Infectious and Parasitic Diseases
Neoplasms
Endocrine, Nutritional and Metabolic
Blood and Blood-Forming Organs
Mental Disorders
Nervous System and Sense Organs
Circulatory System
Respiratory System
Digestive System
Genitourinary System
Complications of Pregnancy, Childbirth and the Puerperium
Skin and Subcutaneous Tissue
Musculoskeletal System and Connective Tissue
Congenital Anomalies
Perinatal Period
Symptoms, Signs and Ill-Defined Conditions
Injury and Poisoning
External Causes of Injury and Poisoning
Factors Influencing Health Status
How Can You Code Your Conditions?
Misdiagnosis: the Wrong Path
Chapter 3: Procedure Coding
Coding Paths Diverge
Hospital Procedures vs. Doctor’s Procedures
Why the Difference?
Hospital Procedure Coding
Physician Procedure Coding
What About HCPCS?
Where It’s At
ICD-9-CM Procedure Coding Guidelines
Principal Procedure
Other Procedures
How to Locate a Procedure
CPT Procedure Coding
CPT Modifiers
Additional CPT Guidelines
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Evaluation and Management
Procedure Coding Summarized
Chapter 4: How Codes are Used for Reimbursement
The Price is Right
Staking a Claim
CMS-1500
UB-92
Claims Submission
Claims Processing and Adjudication
The Rejection Puzzle
Medical Necessity
Payment Methodologies
Fee for Service
Cost-Based
Prospective Payment – Inpatient
Prospective Payment –ASC
Prospective Payment – SNF
Prospective Payment –HHA
Prospective Payment –Outpatient
The Effect of Payment Methods on Coding
Chapter 5: Coding for Dollars
Healthcare Fraud and Abuse
OIG Compliance Guidance
What Does This Have to Do With Coding?
Preventive Measures
Chapter 6: Solving Your Healthcare Coding Problems
Get a Life
For the Record
How do Coding Errors Occur?
When EOB = No
Chapter 7: Coding as a Career
Is it Right for You?
Where to Start?
Appendix A: ICD-9-CM
3-Digit Diagnosis Categories
Appendix B: ICD-9-CM
2-Digit Procedure Categories
Appendix C: AHIMA Code of Ethics
Appendix D: Uniform Billing Revenue Codes
Appendix E: Remittance Advice Remarks Codes
Appendix F: Payment System Reference
Appendix G: Useful Websites
Appendix H: Uniform Hospital Discharge Data Set
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