Physician Coding and Reimbursement
Physician reimbursement and the coding to support it are
critically important to the sustained health of any physician's practice.
Physicians
can bill or code for a number of different types of patient encounters. The most
common non-procedural encounters are evaluation and management services, or E
& M, codes and include outpatient activities such as office/outpatient
visits, outpatient consultations, inpatient hospital visits, inpatient
consultations, and management of patients in observation or critical case
status.
Once a
procedure or service receives a code, it needs to be valued for reimbursement
purposes. Prior to 1992, physicians were reimbursed based on “usual, customary,
and reasonable charges” (UCR). UCRs were based on the physician's most frequent
charge for the service (usual), the average charge for that service in the area
(customary), and the actual charge for the service (reasonable).
Today,
physicians are faced with additional guidelines and regulations. Again,
affecting how a provider is reimbursed. Today’s physician must
understand :
·
HEDIS
·
Meaningful Use
·
Quality Measures
·
P4P – PQRS
Additional
changes : ICD-10 and Changes to CPT to
accommodate the ICD-10
How does a
physician keep up with all the changes in Coding and Reimbursement ?
The AccuChecker
OnLine is a comprehensive database with:
Procedures – CPT, Category II and HCPCS codes.
Diagnoses codes (ICD-9-CM, ICD-10-CM and ICD-10-PCS).
Converter of ICD9 to ICD10.
Medicare fee schedules including OPPS rates in
radiology.
Coding techniques like:
Corrective Coding Initiative (CCI)
Medical
Necessity - procedures matching diagnoses.
Medicare’s
LCD and NCD.
Surgical
modifiers outlining coding guidelines.
Global
period for surgical services.
AccuChecker OnLine is available in two (2) versions:
·
State Version - Fee Schedules for the State ONLY.
·
National Version - Fee Schedules for the entire nation
–for each zip code.
The annual subscription for AccuChecker OnLine
:
·
State Version - $299.00
·
National Version - $399.00
AccuChecker the ONE tool to manage your
Coding and Reimbursement
www.accuchecker.com
Call for more details :
305-227-2383 or 1-877-938-9311
Call for your Free Trial
or Webinar
Our Social Sites - Please feel free to Join:
No comments:
Post a Comment