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CPT® 2021 Professional Edition is the definitive AMA-authored resource to help health care professionals correctly report and bill medical procedures and services. Providers want accurate reimbursement. Payers want efficient claims processing. Since the CPT® code set is a dynamic, everchanging standard, an outdated codebook does not suffice. Correct reporting and billing of medical procedures and services begins with CPT® 2021 Professional Edition. Only the AMA, with the help of physicians and other experts in the health care community, creates and maintains the CPT code set. No other publisher can claim that. No other codebook can provide the official guidelines to code medical services and procedures properly. FEATURES AND BENEFITS The CPT® 2021 Professional Edition codebook covers hundreds of code, guideline and text changes and features: CPT® Changes, CPT® Assistant, and Clinical Examples in Radiology citations -- provides cross-referenced information in popular AMA resources that can enhance your understanding of the CPT code set E/M 2021 code changes - gives guidelines on the updated codes for office or other outpatient and prolonged services section incorporated A comprehensive index -- aids you in locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym or abbreviation to allow for a clearer, quicker search Anatomical and procedural illustrations -- help improve coding accuracy and understanding of the anatomy and procedures being discussed Coding tips throughout each section -- improve your understanding of the nuances of the code set Enhanced codebook table of contents -- allows users to perform a quick search of the codebook's entire content without being in a specific section Section-specific table of contents -- provides users with a tool to navigate more effectively through each section's codes Summary of additions, deletions and revisions -- provides a quick reference to 2020 changes without having to refer to previous editions Multiple appendices -- offer quick reference to additional information and resources that cover such topics as modifiers, clinical examples, add-on codes, vascular families, multianalyte assays and telemedicine services Comprehensive E/M code selection tables -- aid physicians and coders in assigning the most appropriate evaluation and management codes Adhesive section tabs -- allow you to flag those sections and pages most relevant to your work More full color procedural illustrations Notes pages at the end of every code set section and subsection
While the vast majority of providers never intend to commit fraud or file false claims, complex procedures, changing regulations, and evolving technology make it nearly impossible to avoid billing errors. For example, if you play by HIPAA’s rules, a physician is a provider; however, Medicare requires that the same physician must be referred to as a supplier. Even more troubling is the need to alter claims to meet specific requirements that may conflict with national standards. Far from being a benign issue, differing guidelines can lead to false claims with financial and even criminal implications. Compliance for Coding, Billing & Reimbursement, Second Edition: A Systematic Approach to Developing a Comprehensive Program provides an organized way to deal with the complex coding, billing, and reimbursement (CBR) processes that seem to force providers to choose between being paid and being compliant. Fully revised to account for recent changes and evolving terminology, this unique and accessible resource covers statutorily based programs and contract-based relationships, as well as ways to efficiently handle those situations that do not involve formal relationships. Based on 25 years of direct client consultation and drawing on teaching techniques developed in highly successful workshops, Duane Abbey offers a logical approach to CBR compliance. Designed to facilitate efficient reimbursements that don’t run afoul of laws and regulations, this resource – Addresses the seven key elements promulgated by the OIG for any compliance program Discusses numerous types of compliance issues for all type of healthcare providers Offers access to online resources that provide continually updated information Cuts through the morass of terminology and acronyms with a comprehensive glossary Includes downloadable resources packed with regulations and information In addition to offering salient information illustrated by case studies, Dr, Abbey provides healthcare providers and administrators, as well as consultants and attorneys, with the mindset and attitude required to meet this very real challenge with savvy, humor, and perseverance.
This unique workbook features coding exercises referencing each section of the current annual CPT-4 and ICD-9-CM, and HCPCS Level II coding manuals. with interactive exercises focusing on condition and procedure statements, learners will expand their medical vocabulary and enhance their coding skills for the physician's office. Included in the workbook are the Centers for Medicare and Medicaid Services (CMS) guidelines for diagnosis coding and reporting by physicians. Learners need current CPT-4, ICD-9-CM, and HCPCS coding manuals to complete the exercises.
The newest edition of this best-selling educational resource contains the essential information needed to understand all sections of the CPT codebook but now boasts inclusion of multiple new chapters and a significant redesign. The ninth edition of Principles of CPT(R) Coding is now arranged into two parts: - CPT and HCPCS coding - An overview of documentation, insurance, and reimbursement principles Part 1 provides a comprehensive and in-depth guide for proper application of service and procedure codes and modifiers for which this book is known and trusted. A staple of each edition of this book, these revised chapters detail the latest updates and nuances particular to individual code sections and proper code selection. Part 2 consists of new chapters that explain the connection between and application of accurate coding, NCCI edits, and HIPAA regulations to documentation, payment, insurance, and fraud and abuse avoidance. The new full-color design offers readers of the illustrated ninth edition a more engaging and far better educational experience. Features and Benefits - New content! New chapters covering documentation, NCCI edits, HIPAA, payment, insurance, and fraud and abuse principles build the reader's awareness of these inter-related and interconnected concepts with coding. - New learning and design features -- Vocabulary terms highlighted within the text and defined within the margins that conveniently aid readers in strengthening their understanding of medical terminology -- "Advice/Alert Notes" that highlight important information, exceptions, salient advice, cautionary advice regarding CMS, NCCI edits, and/or payer practices -- Call outs to "Clinical Examples" that are reminiscent of what is found in the AMA publications CPT(R) Assistant, CPT(R) Changes, and CPT(R) Case Studies -- "Case Examples" peppered throughout the chapters that can lead to valuable class discussions and help build understanding of critical concepts -- Code call outs within the margins that detail a code description -- Full-color photos and illustrations that orient readers to the concepts being discussed -- Single-column layout for ease of reading and note-taking within the margins -- Exercises that are Internet-based or linked to use of the AMA CPT(R) QuickRef app that encourage active participation and develop coding skills -- Hands-on coding exercises that are based on real-life case studies
- Features completely updated information that reflects the many changes in the insurance industry. - Contains a new chapter on UB-92 insurance billing for hospitals and outpatient facilities. - Includes a new appendix, Quick Guide to HIPAA for the Physician's Office, to provide a basic overview of the important HIPAA-related information necessary on the job.
With the expert insight of leading coding educator Carol J. Buck, this complete exam review highlights the content you'll need to master to pass the AHIMA CCS certification exam and take your coding career to the next step. CCS Coding Exam Review 2013: The Certification Step with ICD-9-CM features an easy-to-follow outline format that guides you through the anatomy, terminology, and pathophysiology for each organ system; reimbursement concepts; an overview of CPT, ICD-9-CM, and HCPCS coding; and more. Two full practice exams and a final exam modeled on the actual CCS exam simulate the testing experience and help prepare you for success. Companion Evolve website includes electronic practice exams that simulate the actual AHIMA exam experience to help you overcome test anxiety. Pre-, post-, and final exams allow you to track your learning. Answers and rationales reinforce your understanding of coding concepts. Updates, study tips, and helpful web links aid your understanding. Comprehensive CCS coverage highlights essential information for passing the AHIMA CCS exam, accompanied by detailed figures, for the most efficient exam review. Concise outline format gives you quick and easy access to content and helps you make the most of your study time. NEW! Facility-based coding activities challenge you to apply your knowledge to 35 realistic inpatient case scenarios, providing valuable practice and preparation for the CCS exam.