Understanding Hospital Billing and Coding
Understanding Hospital Billing and Coding,
Edition 3
By Debra P. Ferenc, BS, CPC, CPC-I, CPC-H, CMSCS, PCS, FCS

Publication Date: 29 May 2013

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A comprehensive, approachable guide to hospital insurance billing and coding, Understanding Hospital Billing and Coding, 2nd Edition covers everything hospital billers need to know, from patient admission to accounts receivable management and HIPAA. It builds on your knowledge so that you can make a successful transition from the physician/outpatient environment to the hospital setting. Written by coding expert Debra P. Ferenc, this book covers the hospital regulatory setting, the structure and functions of hospital departments, patient accounts and data flow, the billing process, coding, claim forms, reimbursement, accounts receivable management, HIPAA requirements, and much more.

Key Features

  • UB-04 Claim Simulation on the companion Evolve website lets you practice entering information from source documents into the claim form.
  • Over 300 illustrations and graphics bring important concepts to life.
  • Detailed chapter objectives highlight what you are expected to learn.
  • Key terms, acronyms, and abbreviations with definitions are included in each chapter.
  • Concept Review boxes reinforce key concepts.
  • Test Your Knowledge exercises reinforce lessons as you progress through the material.
  • Chapter summaries review key concepts.
  • Practice hospital cases let you apply concepts to real-life scenarios.

New Features

      • UPDATED content reflects the most current industry changes in ICD-10, MR-DRGs, PPS Systems, and the Electronic Health Record.
      • NEW Hospital Introduction chapter includes a department-by-department overview showing how today’s hospitals really work
      • NEW Health Care Payers and Reimbursement section follows the workflow of the hospital claim by including successive chapters on payers, prospect payment systems, and accounts receivable management.
      About the author
      By Debra P. Ferenc, BS, CPC, CPC-I, CPC-H, CMSCS, PCS, FCS
      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

      Book details
      ISBN: 9781455723638
      Page Count: 600
      Illustrations: Approx. 300 illustrations (130 in full color)
      Retail Price: £58.99