Understanding Hospital Billing and Coding

By

  • 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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Book information

  • Published: February 2013
  • Imprint: SAUNDERS
  • ISBN: 978-1-4557-2363-8


Table of Contents

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