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| Preface | |
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| Introduction to Coding | |
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| Introduction | |
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| A Career as a Medical Coder | |
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| What Skills are Required in Medical Coding? | |
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| What Is Fraud and Abuse? | |
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| Tools of the Trade | |
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| Types of Coding | |
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| ICD-10-CM | |
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| ICD-9-CM | |
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| Introduction | |
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| History and Usage of ICD-9-CM | |
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| How to Look Up a Term | |
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| Tubular List | |
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| V Codes and E Codes | |
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| M Codes | |
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| Categories, Subcategories, and Subclassifications | |
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| Coding Conventions | |
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| Review of the Basic Steps in Coding | |
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| Procedural Coding with ICD-9-CM | |
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| Infections | |
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| HIV Infections | |
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| Circulatory System Coding | |
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| Diabetes Mellitus | |
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| Using V Codes | |
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| Obstetrical Coding | |
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| Neoplasms | |
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| E Coding | |
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| Injuries | |
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| Fractures | |
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| Burns | |
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| Poisoning Versus Adverse Effects | |
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| Complications | |
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| Late Effects | |
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| Official Coding Guidelines | |
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| ICD-10-CM | |
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| Procedures in ICD-10-CM | |
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| Implementation of ICD-10-CM | |
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| Web Sites Related to ICD-10-CM | |
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| HCPCS Level II | |
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| Introduction | |
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| History | |
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| Format | |
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| HCPCSII Hierarchy | |
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| Code Revisions | |
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| Index | |
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| HCPCSII Chapter Details | |
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| Accuracy Tips | |
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| HCPCSII Medication Flow Chart | |
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| Current Procedural Terminology (CPT) Basics | |
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| Introduction | |
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| AMA/CPT Code Book | |
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| Symbols | |
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| Unlisted Codes | |
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| Sending Copies of Notes | |
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| Illustrations | |
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| Anesthesia | |
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| CPT Surgical Guidelines | |
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| Radiology and Pathology Guidelines | |
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| Category II Codes | |
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| Category III Codes | |
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| CPT Errata | |
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| Modifiers | |
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| Appendix B | |
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| Clinical Examples | |
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| Appendix D | |
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| Appendix E | |
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| Appendix F | |
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| Appendix G | |
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| Appendix H | |
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| Appendix I | |
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| Index | |
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| Tips for Selecting a CPT Code | |
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| Evaluation and Management | |
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| Introduction | |
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| AMA/CPT Evaluation and Management (E/M) Guidelines | |
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| Criteria of Documentation and E/M Code Selection per AMA/CPT | |
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| More Details | |
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| Time | |
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| How to Select the E/M Code for the Most Common Encounters | |
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| CMS 1995 Evaluation and Management Guidelines | |
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| CMS 1997 Evaluation and Management Guidelines | |
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| CPT Code Book | |
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| Anesthesia/General Surgery | |
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| Introduction | |
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| Anesthesia | |
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| Types of Anesthesia | |
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| Anesthesia Coding | |
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| General Surgery | |
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| The Respiratory System | |
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| The Cardiovascular System | |
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| The Hemic and Lymphatic Systems | |
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| The Mediastinum and Diaphragm | |
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| The Digestive System | |
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| The Urinary System | |
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| The Male Genital System | |
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| Laparoscopy/Hysteroscopy | |
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| The Nervous System | |
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| The Eye and Ocular Adnexa | |
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| The Auditory System | |
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| Integumentary System | |
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| Introduction | |
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| ICD-9-CM Code Selection | |
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| Evaluation and Management Services for Integumentary/Skin | |
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| Surgical Guidelines for Integumentary | |
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| Incision and Drainage | |
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| Debridement | |
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| Paring or Cutting | |
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| Biopsy | |
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| Removal of Skin Tags | |
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| Lesion Removal or Destruction | |
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| Nails | |
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| Intralesional Injections and Tissue Expanders | |
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| Repair (Closures) | |
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| Graft Concepts and Tips | |
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| Adjacent Tissue Transfer of Rearrangement | |
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| Free Skin Grafts | |
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| Flaps (Skin and/or Deep Tissues) | |
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| Other Procedures | |
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| Pressure Ulcers (Decubitus Ulcers) | |
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| Burns, Local Treatment | |
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| Destruction | |
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| Moh's Micrographic Surgery | |
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| Breast Procedures | |
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| Repair and/or Reconstruction | |
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| Orthopedics | |
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| Introduction | |
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| Fractures | |
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| Dislocations | |
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| Arthropathy | |
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| Vertebral Disorders | |
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| Sprains and Strains | |
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| Other Conditions and Procedures | |
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| Cardiology and the Cardiovascular System | |
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| Introduction | |
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| Cardiac and Vascular Anatomy and Physiology | |
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| ICD-9-CM Code Selection | |
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| CPT | |
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| 90000 Series of CPT | |
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| Intracardiac Electrophysiological Procedures/Studies | |
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| Other Vascular Studies | |
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| Noninvasive Vascular Diagnostic Studies | |
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| 30000 Series of CPT | |
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| Radiology | |
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| Using Modifiers Effectively | |
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| Considering an Unlisted Code? Category II | |
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| Category II Codes | |
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| OB/GYN | |
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| Introduction | |
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| Unique Aspects of Coding OB/GYN | |
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| Subspecialties of OB/GYN | |
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| Anatomy and Physiology of the Female Reproductive System | |
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| Obstetrics and Gynecology (OB/GYN) | |
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| Obstetrics (OB) | |
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| Radiology, Pathology, and Laboratory | |
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| Introduction | |
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| Radiology | |
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| CPT-Radiology | |
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| Radiology Modifiers | |
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| Dignostic Radiology (Diagnostic Imaging) | |
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| Diagnostic Ultrasound | |
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| Radiation Oncology | |
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| Nuclear Medicine | |
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| CPT-Pathology and Laboratory | |
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| Organ or Disease Oriented Panels | |
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| Evocative/Suppression Testing | |
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| Chemistry | |
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| Hematology and Coagulation | |
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| Immunology | |
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| Transfusion Medicine | |
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| Microbiology | |
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| Anatomic Pathology | |
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| Cytopathology | |
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| Surgical Pathology | |
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| Medicine | |
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| Introduction | |
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| Medicine Guidelines | |
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| Immune Globulins | |
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| Immunization Administration | |
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| Vaccines and Toxoids | |
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| Therapeutic Infusions | |
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| Injections | |
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| Psychiatry | |
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| Psychiatric Therapeutic Care | |
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| Biofeedback | |
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| Dialysis | |
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| Gastroenterology | |
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| Ophthalmology | |
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| Otorhinolaryngology Services | |
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| Cardiology | |
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| Pulmonary | |
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| Allergy and Clinical Immunology | |
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| Endocrinology | |
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| Neurology and Neuromuscular Procedures | |
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| Central Nervous System Assessments/Tests | |
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| Health and Behavior Assessment | |
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| Chemotherapy Administration | |
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| Photodynamic Therapy and Dermatological Procedures | |
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| Physical Medicine and Rehabilitation | |
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| Medical Nutrition Therapy | |
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| Acupuncture | |
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| Osteopathic Manipulation | |
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| Chiropractic Manipulative Treatment | |
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| Special Services | |
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| Qualifying Circumstances for Anesthesia | |
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| Home Health Procedures | |
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| Billings and Collections | |
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| Introduction | |
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| Patient Registration | |
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| Ambulatory Patient Groups | |
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| Payment and Billing Processes | |
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| Billing | |
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| The Billing Process | |
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| The Collections Process | |
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| Collection Techniques | |
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| Professional Courtesy | |
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| Filing the Claim Form | |
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| Introduction | |
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| The Health Insurance Claim Form | |
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| Medicaid | |
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| Medicare | |
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| Medicare as Secondary Payer | |
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| Submitting a Claim for a Deceased Patient | |
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| Health Maintenance Organizations (HMOS) | |
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| Champus/Tricare/Champva | |
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| Workers' Compensation | |
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| Blue Cross/Blue Shield | |
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| Electronic Claim Processing | |
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| Insurance Claims Follow-Up | |
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| Payment for Professional Health Care Services, Auditing, and Appeals | |
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| Introduction | |
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| Payment Cycle | |
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| Encounter Forms, Superbills, Fee Slips, or Charge Tickets | |
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| Step-By-Step Completion of a Paper CMS 1500 Form | |
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| Payer Receipt of the Claim | |
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| Follow-Up | |
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| Accuracy of Payment on Arrival | |
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| Appealing the Claim | |
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| Insurance Participation Agreements (Contracts) | |
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| Denials and Rejections | |
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| Appeals | |
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| Mirrored Image of the Documentation | |
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| Risky Behavior | |
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| Auditing | |
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| The Office of Inspector General | |
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| Steps to Take When an Investigator Arrives | |
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| Fraud Risk Prevention | |
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| Penalties | |
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| Health Insurance Portability and Accountability Act (HIPAA) | |
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| Inpatient Coding | |
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| Introduction | |
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| Hospital Based ICD-9-CM Coding | |
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| Unconfirmed Conditions | |
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| Code Assignment | |
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| Coding Guidelines | |
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| Hospital Reimbursement Environment | |
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| Glossary | |
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| Index | |