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Contents: WHAT ARE THE RULES * Provider Responsibility for Accuracy of Coding * Official Coding Guidelines for Physician Services * Diagnosis Coding * Procedure Coding * Coding Rules for Non-HGFA Payers * Why You Need Written Policies and Procedures * PATIENT RECORDS - THE BASIC OF CODING * Improving the Record * Organization/Format * Forms * Improving the Documentation * Content * Legibility * Other Improvements * TRANSLATING THE RECORD INTO CODES - DIAGNOSIS * Primary Diagnosis * Rule/Out * V Codes * Payable Diagnosis * Cheatsheets/Superbills *
Diagnosis for Procedures * TRANSLATING THE RECORDS INTO CODES - PROCEDURES * Site of Service * Bundled Procedures * Global Package * Modifiers * Evaluation and Management Services * WHAT WENT WRONG? * Payment Denials * Prior Approvals * Non-Covered vs. Not Medically Necessary * How to Appeal Denials * RESOURCES FOR YOU AND YOUR STAFF * Training/Credentially * References/Software * Payer Newsletters and Manuals * Internet Resources * Consultants * Professional Organizations * APPENDIX A.* Diagnostic Coding and Reporting Guidelines for Outpatient Services (Hospital-Based and Physician Office) * APPENDIX B. * Data Elements for Adequate Documentation * APPENDIX C. * Bibliography
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