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.
This is the first contemporary, comprehensive reference for neurosurgeons and radiation oncologists using Gamma Knife and Linear Accelerator technology. Each chapter includes specific case presentations representative of the most commonly treated conditions, including applications for spinal disorders. Chapters conclude with counterpoint experiences, oriented to treatment options other than radiosurgery. These counterpoint discussions are written by noted experts and address in greater detail the indications, results and complications of their approach and enable readers to improve decision making with regard to their own patients.
Combining the basics of coding, insurance, and reimbursement in one concise text, this reader-friendly resource is your key to understanding the fundamentals of medical billing and coding. Clearly organized, full-color chapters guide you through the entire coding and claims process, detailing coding rules and applications, insurance guidelines, and the reimbursement system, all accompanied by real-world practice to help you apply what you’ve learned in the field! Highlighted examples illustrate concepts in realistic medical office settings to enhance your understanding. Coding exercises teach you how to correctly code using the ICD-9-CM and CPT-4 manuals. Test Your Knowledge questions within each chapter help you assess your strengths and weaknesses and prepare for exams. Critical thinking problems challenge you to apply chapter concepts to common coding scenarios. Code It and Claim It! software familiarizes you with a professional coding claim interface similar to programs you’ll use on the job and provides real-world practice with actual patient cases. Key term lists and an extensive glossary reinforce your understanding of important coding and insurance terminology. NEW application exercises help you put your knowledge of coding and reimbursement into practice.
Today, multidisciplinary approaches to treatment are at the heart of cancer care. They offer improved clinical outcomes, new possibilities in patient quality of life, and enable the development of true innovation in individualized treatment. To accurately reflect this modern day approach to cancer care, the content of the 6th edition of Principles and Practice of Gynecologic Oncology was written entirely by surgeons, medical oncologists, radiation oncologists, and pathologists. New to the editorial team, Dr. Andrew Berchuck has made significant contributions to the understanding of the molecular pathogenesis of ovarian and endometrial cancer in the book’s content. Every chapter of this book has been either completely rewritten or extensively updated to ensure that everyone involved in treating women with gynecologic cancer will have the most comprehensive and up-to-date information on the subject.
This issue of Surgical Clinics of North America, guest edited by Drs. Ronald Martin and Paul Schenarts, is devoted to Development of a Surgeon: Medical School through Retirement. They have assembled expert authors to review the following topics: Residency Surgical Training at a University Academic Medical Center; Fellowship Training: Need and Contributions; Evolving Educational Techniques in Surgical Training; Transition to Practice: From Trainee to Staff Surgeon; The Value of the Surgeon Emeritus; Alternative Methods and Funding for Surgical Training; Medical School Training for the Surgeon; Residency Surgical Training at an Independent Academic Medical Center; Assessment of Competence: The ACGME/RRC Perspective; Assessment of Competence: The American Board of Surgery Perspective; The Impaired Surgeon; Continuing Medical Education: The American College of Surgeons Perspective; Workforce Needs and Demands in Surgery, and more!
Immediately Sequential Bilateral Cataract Surgery (ISBCS): Global History and Methodology is a comprehensive guide for the safe and efficient performance of ISBCS. It provides an overview of the history, recommended protocols, necessary precautions, exclusion criteria, benefits and risks associated with this procedure, organizational standards, and more. Written by the most prominent ISBCS surgeons in the world, chapters recount the arguments for and against bilateral surgery that have been made throughout the ages, up to the present, and deliver achieved and proposed resolutions to all problems discussed. Topics such as ethics and medico-legal issues surrounding ISBCS are also discussed, and a chapter on the global evolution of bilateral cataract surgery provides readers with a complete overview of the development of ISBCS practices in countries from all continents. Provides a comprehensive history and current status of ISBCS globally Provides step-by-step recommendations and precautions necessary to perform ISBCS safely, including detailed discussion of surgical infection prophylaxis with antibiotics delivered into the eye at surgery Reviews and explains the patient benefits associated with ISBCS Covers development of ISBCS practices worldwide
In recent years the approach towards rib fractures has evolved. Abandoned in the past, due to inadequate instrumentation and lack of evidence, rib fixation has recently re-emerged as a treatment option for trauma patients. There have been a number of advances over the last 25 years that now allow surgeons to internally fix rib fractures that otherwise may have not had other options. However, as a result there has been a rapid increase in literature and many institutions interested in initiating rib fixation programs. Due to a variety of practitioners involved namely, trauma surgeons, orthopedic surgeons, and thoracic surgeons there has been no comprehensive guide to patient selection, technique, and post-operative care. The purpose of this text is to fill the educational gap for those trauma, orthopedic, and thoracic surgeons interested in learning the cutting edge evidence-based approaches to treatment of rib fractures. This topic has caught the interest of many and has been a recurrent theme at surgical meetings over the last two years. Although there has been ever increasing levels of interest and experience nationally there are many questions which remain. This text will provide not only the theoretical background for improving outcomes in those with rib fractures but also serve as a practical guide to those interested in starting new programs. The text will include tips and tricks that can be used in the OR or at the bedside to improve patient care. Therefore, the focus will be on a comprehensive review but also including tips and tricks from the most experienced surgeons around the country who are performing internal fixation for rib fractures.
Today’s fast-paced and constantly changing health-care environment demands that you find the answers you need quickly and easily. This brand-new approach to billing and coding teaches you the who, what, why, when, and how of proper diagnostic and procedural coding, claim form completion, and medical recordkeeping.
This combination textbook and workbook, explains each phase of the medical claim cycle, from the time the patient calls for an appointment until the financial transaction for the encounter is completed. Coverage includes types of insurance payers, basic coding and billing rules, and standard requirements for outpatient billing using the CMS-1500 claim form. It also emphasizes legal aspects related to each level of the medical claim cycle and the importance of the medical office employee, showing their responsibility for and impact on successful reimbursement. 3 separate chapters offer coverage of the basic concepts of medical coding. A comprehensive overview of the CMS-1500 claim form with step-by-step guidelines and illustrations thoroughly covers reimbursement issues and explains the billing process. Includes detailed information on various insurance payers and plans including Medicare, government medical plans, disability plans, private indemnity plans, and managed care. Stop & Review sections illustrate how the concepts presented in each chapter relate to real-life billing situations. Sidebars and Examples highlight key concepts and information related to the core text lesson. A companion CD-ROM contains sample patient and insurance information that readers can use to practice completing the accompanying CMS-1500 claim form, as well as a demonstration of Altapoint practice management software. 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.
The leading textbook of hospital medicine – completely updated to reflect today’s challenges A Doody’s Core Title for 2021! Since its publication in 2012, Principles and Practice of Hospital Medicine, Second Edition has become the field’s premier resource. Comprehensive, authoritative, and practical, this landmark text provides a solid grounding in clinical, organizational, and administrative areas central to the practice of hospital medicine. The Second Edition has been completely updated to reflect the evolving practice responsibilities of hospitalists. Examples include value-based medicine, expanded surgical content, bedside clinical reasoning, and a new segment devoted to rehabilitation and skilled nursing care. This edition also features a more accessible and streamlined full-color design enriched by more than 600 illustrations. Each clinical chapter opens with boxed Key Clinical Questions that are addressed in the text and summarized in hundreds of tables. Case studies demonstrate how to apply this information specifically to the management of hospitalized patients. Representing the expertise of more than two hundred renowned contributors, Principles and Practice of Hospital Medicine, Second Edition is logically divided into six sections: The Specialty of Hospital Medicine and Systems of Care Medical Consultation Rehabilitation and Skilled Nursing Care The Approach to the Patient at the Bedside Diagnostic Testing and Procedures Clinical Conditions in the Inpatient Setting Principles and Practice of Hospital Medicine, Second Edition is essential reading for clinicians who strive to optimize inpatient care and sharpen their leadership skills.
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 a CD-ROM 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.