Principles of Coding and Reimbursement for Surgeons / edited by Mark Savarise, Christopher Senkowski.

Format:

Book

Contributor:

Savarise, Mark., Editor.

Senkowski, Christopher., Editor.

Language:

English

Subjects (All):

Surgery.

General Surgery.

Local Subjects:

General Surgery.

Physical Description:

1 online resource (XVII, 343 p. 9 illus., 4 illus. in color.)

Edition:

1st ed. 2017.

Place of Publication:

Cham : Springer International Publishing : Imprint: Springer, 2017.

Summary:

This text provides the in-depth understanding of the mechanisms that guide coding and reimbursement. The text is meant to be useful to surgeons in practice, both in general surgery and in surgical subspecialties; practice management teams of surgical practices and to resident physicians in surgery. Part 1 of the text addresses the CPT coding process, the relative valuation system (RVU), the ICD-9 and ICD-10 systems of classification, Medicare Part B payment rules for physicians, the DRG system and Medicare Part A payment for hospitals, alternative payment models, and the myriad of quality measures of importance to surgeons. Part 2 of the text addresses specific coding in areas where surgeons historically have had the most difficulty. This is not meant to substitute for the available texts, software or courses on coding, but to provide the historical background and rationale for the specific coding rules. Principles of Coding and Reimbursement for Surgeons will be of great value to general surgeons and surgical subspecialists in private practice, academic institutions, and employed positions. It will provide direction to management teams from practice and institutional levels. It is also of use to surgical trainees and to researchers in health policy issues.

Contents:

Section I: History

Section II: ICD Coding

ICD-9 Coding

ICD-10 Coding

Section III: CPT

The CPT Process and Panel

CPT Application

Section IV: The RUC

Harvard Study and the Evolution of the RVU

History of the RUC

RVU Valuation Process

How RVU have been Used for Physician Benchmarking

Section V: Reimbursement

CMS and the SGR

Copays, Deductibles, Out of Pocket

Billing and Collections

Section VI: APC, DRGs and Hospital Reimbursement

Medicare Part A

DRG-Based Payment, CCs and MCCs and APCs

How ASCs are Reimbursed Differently

Durable Medical Equipment

Section VII: Alternative Payment Schemes

Bundled Payment Models

Accountable Care Organizations

Pay for Performance

Section VIII: Quality Measures

PQRS, SCIP and Other Existing Measures

Section IX: Specific Coding Issues

Evaluation and Management

Skin and Soft Tissue Procedures

Breast

Vascular

GI

Laparoscopy

Bariatric

Colon and Rectal

Abdominal Wall

Oncology

Transplant

Trauma and Critical Care

Endoscopy.

Notes:

Includes bibliographical references at the end of each chapters and index.

ISBN:

3-319-43595-7