ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization. It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury of diseases. The code set allows more than 14,000 different codes and permits the tracking of many new diagnoses.
The U.S. has used ICD-10-CM (Clinical Modification) since October, 2015. This national variant of ICD-10 was provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics, and the use of ICD-10-CM codes are now mandated for all inpatient medical reporting requirements.
This book is for physicians, practice managers and all others who need learn ICD-10. It's designed for the clinician to learn how to put their diagnosis into a code and not rely on staff or computer software programs to decide it form them.
ICD-10 is a complex system of coding and Medicare and third party insurers have been lenient giving providers a year to get used to the coding system. As a result, physicians and their staff have become very complacent regarding proper coding. However, Medicare and third party insurers will soon begin to deny claims which are not coded correctly, which in turn will cost physician groups time and money.
This book focuses on Worker's Compensation and Personal Injury, a very large segment of the healthcare industry and is a new area to ICD-10. The diagnosis coding for injuries is much different than for Medicare or group insurance and unless the physicians and their staff learn how to use it properly, they risk losing income for themselves and worse, they risk losing the case for the patient.
Sprache
Verlagsort
Verlagsgruppe
Zielgruppe
Für höhere Schule und Studium
Professional Practice & Development
Illustrationen
25 s/w Abbildungen, 1 s/w Photographie bzw. Rasterbild, 24 s/w Zeichnungen
24 Line drawings, black and white; 1 Halftones, black and white; 25 Illustrations, black and white
Maße
Höhe: 276 mm
Breite: 219 mm
Gewicht
ISBN-13
978-1-138-03290-3 (9781138032903)
Copyright in bibliographic data and cover images is held by Nielsen Book Services Limited or by the publishers or by their respective licensors: all rights reserved.
Schweitzer Klassifikation
Eugene Fukumoto is President and General Manager of Health Claims Services, Inc., a consulting firm that manages the billing and collection for sole proprietors and medical groups including provider disputes with Insurance Companies. He is an authorized billing vendor for the Regents of the University of California, and has contracted with the USC School of Medicine and UCLA. He previously was General Manager for Health Computer Systems, a referenced Hewlett-Packard software vendor of medical billing systems which developed the first electronic billing software for medical practices. He is the author of numerous publications including Conquering ICD-10 for Chiropractors and Conquering ICD-10 for Family Physicians and General Practice.
1: Introduction to Worker's Compensation and Personal Injury in ICD-10
2: Structure Overview of the "2015 ICD-10-CM"
Code structure basics
Using ICD-10 Overview
3: Components of ICD-10 and Their Usage
'Z' codes and their importance in Worker's Compensation/Personal Injury
A basic 7-Step process for Diagnostic coding
A basic 7-step process case example
6-category process for injury coding
4: Provider Requirements
Combination codes
7th character codes
Greater level of detail required
External cause codes
External causes of morbidity (transport and other)
5: Worker's Compensation, Personal Injury and Drug or Chemically Induced Diabetes
Diabetes Mellitus discussion
Use of flow charts for diabetes
Diabetes flow charts
2015 ICD-10-CM draft release expert edition - diabetes mellitus section
6: Worker's Compensation and Personal Injury Billing Guide
Personal injury example - case #1
Worker's compensation example - case #2
Worker's compensation example - case #3
Billing for physical therapy
Billing for injections
Billing for x-rays
Billing for minor surgical procedures
7: Commonly Used Diagnosis Codes
Abdominal pain - ICD-10 category R10
Carpal Tunnel Syndrome in Worker's Compensation and Personal Injury
Psychosocial discussion
8: Complex Examples and Worksheet section
Example of whiplash case
Example on pain management
Example on carpal tunnel syndrome with multiple other injuries
Example on Agreed Medical re-evaluation from an Internal Medical or Cardiovascular standpoint
Example on medical sleep disorder evaluation
Example on Orthopaedic Agreed Medical evaluation - complicated by Straph Infection following surgery
Example on Psychiatric Agreed Medical re-examination
9: Causation and Apportionment in Worker's Compensation and Personal Injury
10: Dilemma of the Independent Medical Evaluator
The Law of Unintended Consequences
Overview for Independent Medical Evaluators
Appendices:
Appendix 1: Medicare coverage, diagnosis requirements and coding edits
Correct Coding Initiative (CCI) Edits
ICD-9 Diagnosis Codes are used in Current LCD's
Appendix 2: Worker's Compensation and Medicare Set asides
Appendix 3: Implementation Guide for ICD-10
Appendix 4: Discussion of ICD-10 Crosswalks
Appendix 5: Crosswalk from ICD-9 to ICD-10 of common diagnosis codes used in Worker's Compensation and Personal Injury with notes on potential problem areas
Appendix 6: Glossary
Appendix 7: General Sample Fee Slip
Appendix 8: New California Worker's Compensation Forms
Appendix 9: Web Links for additional information
