Understanding Hospital Billing and Coding

A basic guide to hospital billing and reimbursement, Understanding Hospital Billing and Coding, 3rd Edition helps you understand, complete, and submit the UB-04 claim form that is used for all Medicare and privately insured patients. It describes how hospitals are reimbursed for patient care and services, showing how the UB-04 claim form reflects the flow of patient data from the time of admission to the time of discharge. Written by coding expert Debra P. Ferenc, this book also ensures that you understand the essentials of ICD-10-CM and develop skills in both inpatient coding and outpatient/ambulatory surgery coding.
- Updated Claim Forms chapter covers the UB-04 claim form.
- Updated information covers diagnosis and procedural coding, with guidelines and applications.
- Updated claim forms and names are used throughout.

Section 1: Hospital Overview 1. Hospital Introduction 2. Hospital Regulatory Environment 3. HIPAA Section 2: Hospital Billing and Coding Process 4. Patient Accounts Data Flow 5. Hospital Billing Process Section 3: Coding 6. ICD-9-CM Diagnosis and Procedure Coding 7. ICD-10-CM Diagnosis Coding 8. Procedure Coding (HCPCS and ICD-10-PCS) 9. Coding Guidelines and Applications (HCPCS and ICD-10-CM/PCS) Section 4: Claim Forms 10. Claim Forms Section 5: Health Care Payers and Reimbursement 11. Payers 12. Prospective Payment Systems 13. Accounts Receivable Management Section 6: Appendixes A: Cases B: Claim Form Data C: Web Resources