Understanding Hospital Billing and Coding

Debra Ferenc, BS, CPC, CPC-I, CPC-H, CMSCS, PCS, FCS

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.

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Paperback, 624 Pages

Published: February 2013

Imprint: Saunders

ISBN: 978-1-4557-2363-8

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

Understanding Hospital Billing and Coding

Contents