Principles of coding and reimbursement for surgeons / Mark Savarise, Christopher Senkowski, editors.
Savarise, Mark, editor.; Senkowski, Christopher, editor.
2017
RD16
Available Online

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Title Principles of coding and reimbursement for surgeons / Mark Savarise, Christopher Senkowski, editors.
ISBN 9783319435954 (electronic book)
3319435957 (electronic book)
9783319435930
3319435930
DOI https://doi.org/10.1007/978-3-319-43595-4
Publication Details Cham, Switzerland : Springer, 2017.
Language English
Description 1 online resource
Item Number 10.1007/978-3-319-43595-4 doi
Call Number RD16
Dewey Decimal Classification 617.001/2
Summary This text provides the in-depth understanding of the mechanisms that guide coding and reimbursement. The text is meant to be useful to surgeons in practice, both in general surgery and in surgical subspecialties; practice management teams of surgical practices and to resident physicians in surgery. Part 1 of the text addresses the CPT coding process, the relative valuation system (RVU), the ICD-9 and ICD-10 systems of classification, Medicare Part B payment rules for physicians, the DRG system and Medicare Part A payment for hospitals, alternative payment models, and the myriad of quality measures of importance to surgeons. Part 2 of the text addresses specific coding in areas where surgeons historically have had the most difficulty. This is not meant to substitute for the available texts, software or courses on coding, but to provide the historical background and rationale for the specific coding rules. Principles of Coding and Reimbursement for Surgeons will be of great value to general surgeons and surgical subspecialists in private practice, academic institutions, and employed positions. It will provide direction to management teams from practice and institutional levels. It is also of use to surgical trainees and to researchers in health policy issues.
Access Note Access limited to authorized users.
Digital File Characteristics text file PDF
Source of Description Description based on print version record.
Added Author Savarise, Mark, editor.
Senkowski, Christopher, editor.
Available in Other Form Principles of coding and reimbursement for surgeons.
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Foreword; Introduction; Contents; Contributors; Part I: Coding and Valuation; Chapter 1: Medical Coding inßtheßUnited States: Introduction andßHistorical Overview; References; Suggested Reading; Chapter 2: ICD-10; ICD-10-CM; History; ICD-10-CM Code System; ICD-10-CM Chapters; Using ICD-10; Conventions Used Throughout theßCoding System; Coding Diseases andßTheir Manifestations; Level ofßDetail andßCoding; The Seventh Character; External Causes ofßMorbidity; Factors Influencing Health Status; Office or Ambulatory Coding; Future Directions; Procedure Codes ICD-10-PCS.

Organization of ICD-10-PCS First Character Section ofßtheßCoding System; Second Character: Body System; Third Character: Root Operation; Root Operations That Take Out Some or All ofßaßBody Part; Root Operations That Take Out Solids/Fluids/Gases fromßaßBody Part; Root Operations That Involve Cutting or Separation Only; Root Operations That Put In/Put Back or Move Some/All ofßaßBody Part; Root Operations That Alter theßDiameter/Route ofßaßTubular Body Part; Root Operations That Always Involve aßDevice; Root Operations Involving Examination Only.

Root Operations That Define Other Repairs Root Operations That Define Other Objectives; PCS Charts; So Why Does This Matter toßMe?; Suggested Reading; Chapter 3: The CPT Code; History ofßtheßCPT Code; Current Status ofßCPT Code; Category 1 Codes; Category 2 Codes; Category 3 Codes; CPT Modifiers; CPT Panel; CPT Process/Application; Category 1 andß3 Application; Category 1 Literature Requirements; Category 2 Code Application andßProcess; Reconsideration ofßRejected Proposal; Clinical Examples ofßCPT Coding; Example 1; Example 2; References.

Chapter 4: A Resource-Based Relative Value Scale (RBRVS) System Legislation Mandating anßRBRVS System; Developing anßRBRVS System; Implementing theßMedicare RBRVS; Revising andßMaintaining theßMedicare RBRVS: Formation ofßtheßAMA RUC; Advising theßRUC: Role ofßtheßAdvisory Committee; Assigning New RVUs or Updating RVUs inßanßRBRVS System; References; Part II: Reimbursement; Chapter 5: CMS, theßSGR, andßMACRA; Introduction; OBRA; MVPS; SGR; MACRA; References; Chapter 6: Global Period; Overview; History; Classification; Services inßtheßGlobal Period; Current Practice.

Future ofßtheßGlobal PeriodReferences; Chapter 7: Medicare Part AßandßDRG's; Hospital andßOutpatient Facility Reimbursement forßMedicare Patients; Medicare; The Development ofßDiagnosis-Related Groups (DRGs) andßtheßPolitics ofßHealthcare; Diagnosis-Related Groups: Connecticut andßNew Jersey Studies; DRGs Become anßIssue ofßPolitical andßFinancial Urgency; DRGs Today; Outpatient Prospective Payment System (OPPS) andßtheßAmbulatory Payment Classification (APC) [17,18]; Facility andßNon-facility CPT Reimbursement; CPT Code Detail-38500: Biopsy ofßLymph Node; Facility Fees.

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