MEDICAL CODING INTRODUCTION FOR A CAREER Presented by Lyn
Olsen,Ph.D., MPA, RHIT, CCS, CPC-H, CCS-P, CPC
www.tseas.wordpress.com
Slide 3
WHAT IS MEDICAL CODING AND BILLING? MEDICAL CODING &
BILLING ARE THE CORE OF ADMINISTRATIVE MEANS BY WHICH HEALTHCARE
PROVIDERS ARE PAID INVOLVES ABUNDANT REGULATIONS BY A MULTITUDE OF
GOVERNMENT AGENCIES WITH SERIOUS FINES FOR FRAUD AND/OR ABUSE
(check websites www.cms.gov and www.oig.hhs.gov for more
information) IF CODERS AND BILLERS FAIL TO DO THEIR JOB WELL,
HOSPITALS AND DOCTORS MAY BE UNABLE TO PRACTICE AND PATIENTS MAY
NOT BE ABLE TO RECEIVE PROPER SERVICES
Slide 4
ICD-9 ICD IS THE INTERNATIONAL CLASSIFICATION OF DISEASES AS
DEVELOPED BY THE WORLD HEALTH ORGANIZATION TO TRACK THE OCCURRENCES
OF DISEASES SO THAT PATIENTS CAN BE MORE EFFECTIVELY TREATED UNITED
STATES USES THIS SYSTEM TO SELECT DIAGNOSTIC CODES AS PART OF THE
PAYMENT PROCESS TO ENSURE MEDICAL NECESSITY ICD CODES ARE NUMERIC
AND CAN VARY FROM 3 DIGITS TO 5 DIGITS WITH THE 4 TH AND 5 TH
DIGITS LOCATED TO THE RIGHT OF THE PERIOD AND THE REST OF THE
DIGITS ARE LOCATED TO THE LEFT THERE ARE TWO ADDITIONAL SECTIONS
FOR E (EXTERNAL INFLUENCES) CODES AND V CODES (SUPPLEMENTAL CODES)
THERE ARE THREE VOLUMES CONTAINED WITHIN ONE BOOK: VOLUME 1 IS THE
TABULAR INDEX OR CODES VOLUME 2 IS THE ALPHABETICAL INDEX VOLUME 3
IS THE TABULAR INDEX OF HOSPITAL PROCEDURES AND IS NOT USED BY
PHYSICIANS OR HEALTHCARE PROVIDERS BECAUSE THEY USE THE CPT
CODES
Slide 5
CPT CPT IS THE CURRENT PROCEDURAL TERMINOLOGY WHICH IS
DEVELOPED BY THE AMERICAN MEDICAL ASSOCIATION CPT PROVDES CODES FOR
VARIOUS SERVICES PROVIDED BY HEALTHCARE PROVIDERS, SUCH AS DOCTORS
AND TECHNICIANS CPT BOOK IS COMPOSED OF CODES AND AN ALPHABETICAL
INDEX CPT BOOK ALSO HAS APPENDICES WHICH ARE IMPORTANT WITH USE OF
CODES, SUCH AS THE MODIFIERS CPT CODES ARE 5 DIGITS NUMERIC AND
MODIFIERS CAN BE ATTACHED MARKED BY A HYPHEN BETWEEN THE CPT CODE
AND THE MODIFIER SECTIONS OF THE CPT BOOK INCLUDE EVALUATION &
MANAGEMENT FOR VISITS, ANESTHESIOLOGY, SURGERY, RADIOLOGY,
LABORATORY/PATHOLOGY AND MEDICINE.
Slide 6
HCPCS HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) HCPCS
LEVEL I ARE THE CPT CODES LEVEL II ARE ALPHANUMERIC AND DEVELOPED
BY THE CENTERS FOR MEDICAID AND MEDICARE SERVICES (CMS), A PART OF
THE HEALTH AND HUMAN SERVICES FEDERAL DEPARTMENT. LEVEL II CODES
ARE USED TO CODE FOR PAYMENT OF NON- PHYSICIAN SERVICES INCLUDING
AMBULANCE SERVICES, PROSTHETIC DEVICES, AND SUPPLIES AND MATERIALS
INCLUDING DRUGS AND MEDICATIONS. HCPCS ALSO HAVE MODIFIERS
Slide 7
MEDICAL CODING AS A CAREER CHOICE AS A CAREER, MEDICAL CODING
AND BILLING JOBS ARE EXAGGERATED TOO OFTEN BY TOO MANY WITH FEW
PROMISES FULFILLED QUALITY IS CRITICAL AND YOU NEED TO MAKE YOUR
DECISION TO START THIS CAREER WITH A QUALITY COMPREHENSIVE
EDUCATION CREDIBLE TRAINING INVOLVES MANY HOURS OF INSTRUCTION BY
QUALIFIED INSTRUCTORS FOR THERE IS MUCH TO KNOW TRAINING SHOULD
INCLUDE MEDICAL BILLING, TERMINOLOGY, AND HEALTH
ADMINISTRATION
Slide 8
MEDICAL CODING CERTIFICATION CERTIFIED CODERS ARE HIGHLY VALUED
WITH HIGHER SALARIES AND GOOD JOB SECURITY IT IS RECOMMENDED THAT
CODERS BE CERTIFIED AS PHYSICIAN CODERS FIRST AND THEN ADVANCE TO
HOSPITAL CODING IF DESIRED PHYSICIAN CODING INVOLVES CODING FOR
HEALTHCARE PROVIDER SERVICES WITHIN DOCTOR OFFICES, CLINICS, URGENT
CARE AND EMERGENCY ROOM HOSPITAL CODING IS DISTINGUISHED AS
OUTPATIENT AND INPATIENT OUTPATIENT HOSPITAL CODING IS FOR SERVICES
WHEN THE PATIENT IS NOT ADMITTED TO THE HOSPITAL SUCH AS OUTPATIENT
SURGERY CENTERS INPATIENT HOSPITAL CODING IS FOR SERVICES PROVIDED
BY THE HOSPITAL, SUCH AS ROOM AND BOARD, SUPPLIES, NURSING
STAFF
Slide 9
LEGITIMATE HEALTH ADMINISTRATIVE CERTIFYING AGENCIES AHIMA:
AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION (ahima.org)
OFFERS CERTIFICATION AS CERTIFIED CODING SPECIALIST FOR THE
PHYSICIAN (CCS-P) AND CERTIFIED CODING SPECIALIST (CCS) FOR
INPATIENT AND OUTPATIENT HOSPITAL OFFERS CODING CERTIFICATION AS AN
APPRENTICE (CCA) OFFERS CERTIFICATION AS REGISTERED HEALTH
INFORMATION TECHNICIAN (RHIT) AND ADMINISTRATORS (RHIA) WHO MANAGE
CLINICS AND HOSPITAL DEPARTMENTS AS WELL AS MANY OTHER JOBS AHIMA
HAS BEEN INVOLVED IN MANY HEALTH ADMINISTRATION PROJECTS WITH
MEDICAL AND GOVERNMENTAL AGENCIES FOR OVER 75 YEARS
Slide 10
LEGITIMATE HEALTH ADMINISTRATIVE CERTIFYING AGENCIES AAPC:
AMERICAN ACADEMY OF PROFESSIONAL CODERS (aapc.com) OFFERS
CERTIFICATION AS CERTIFIED PROFESSIONAL CODER (CPC) AND CERTIFIED
PROFESSIONAL CODER (CPC-H) FOR OUTPATIENT HOSPITAL CODING PROVIDES
TRAINING AND CONTINUING EDUCATION UNITS WITHIN THE CODING
FIELD
Slide 11
ONLINE COMPREHENSIVE MEDICAL CODING COURSE Three Sisters
M&E Services offer high quality and comprehensive training in
medical coding Derived from 15 years experience teaching, writing,
consulting, and presenting in the health administration including
preparation of students for coding exams Experience enhanced by the
instructors five national certifications in healthcare
administration (RHIT, CCS, CPC-H, CCS-P & CPC) Online courses
developed by instructor so no cost for books Course consists of 30
packets for ICD-9 and 30 packets for CPT/HCPCS. Cost is $500 per
course for a total of $1000 for both courses.
Slide 12
FOR MORE INFORMATION CONTACT www.tseas.wordpress.com