Inpatient and Outpatient Hospital stays
Medical Coding 1, Lesson 8
1. The three goals of the Physician Payment Reform are as follows: Decrease Medicare expenditures, Re-Distribute physicians payments more equitably and ensure quality health care at a reason rate.
2. You would use modifier 57 for the hospital visit.
3. 1. Physician Work – the relative level of time, skill, training and intensity to provide a given service.
2. Practice Expense – this component addresses the costs of maintaining a practice including, rent, equipment, supplies and the nonphysician staff costs.
3. Malpractice – These represent payment for the professional liability expenses.
4. The three types of persons eligible for Medicare are: People 65 and older, People with disabilities who have been receiving Social Security or Railroad Disability payments for 24 months, except for persons with Lou Gehrig’s disease (ALS)—they are eligible for Medicare in the sixth month of disability and People with end-stage renal disease (ESRD), that is, kidney Thdisease that requires dialysis or transplant.
5. The six basic methods to locate main terms in the index of CPT are procedure/service, synonym, eponymous, anatomic site, condition of disease, and abbreviations.
6. The E/M code would be 99253.
7. Chief complaint (CC), history or present illness (HPI), review of systems (ROS), past present family and/or social history (PFSH)
8. 1. # of diagnoses or management options (minimal, limited, multiple, or extensive)
2. Amount or complexity of data to review (minimal, none, limited, moderate, or extensive)
3. Risk of complication or death if the condition goes untreated (minimal, low, moderate, or high).
9. CPT code would be 99214.
10. The three key components are: History, Exam and Medical Decision Making
11. The CPT code would be 99396.
12. The CPT code would be 99341
13. The four levels of history type are: Problem focused, expanded problem focused, detailed and comprehensive.
14. The CPT code would be 99281 and ICD9 would
1. The three goals of the Physician Payment Reform are as follows: Decrease Medicare expenditures, Re-Distribute physicians payments more equitably and ensure quality health care at a reason rate.
2. You would use modifier 57 for the hospital visit.
3. 1. Physician Work – the relative level of time, skill, training and intensity to provide a given service.
2. Practice Expense – this component addresses the costs of maintaining a practice including, rent, equipment, supplies and the nonphysician staff costs.
3. Malpractice – These represent payment for the professional liability expenses.
4. The three types of persons eligible for Medicare are: People 65 and older, People with disabilities who have been receiving Social Security or Railroad Disability payments for 24 months, except for persons with Lou Gehrig’s disease (ALS)—they are eligible for Medicare in the sixth month of disability and People with end-stage renal disease (ESRD), that is, kidney Thdisease that requires dialysis or transplant.
5. The six basic methods to locate main terms in the index of CPT are procedure/service, synonym, eponymous, anatomic site, condition of disease, and abbreviations.
6. The E/M code would be 99253.
7. Chief complaint (CC), history or present illness (HPI), review of systems (ROS), past present family and/or social history (PFSH)
8. 1. # of diagnoses or management options (minimal, limited, multiple, or extensive)
2. Amount or complexity of data to review (minimal, none, limited, moderate, or extensive)
3. Risk of complication or death if the condition goes untreated (minimal, low, moderate, or high).
9. CPT code would be 99214.
10. The three key components are: History, Exam and Medical Decision Making
11. The CPT code would be 99396.
12. The CPT code would be 99341
13. The four levels of history type are: Problem focused, expanded problem focused, detailed and comprehensive.
14. The CPT code would be 99281 and ICD9 would