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ADVANCED ICD-10 FOR PHYSICIANS INCLUDING WORKER'S COMPENSATION AND PERSONAL INJURY | 9781138032903 | Portada

ADVANCED ICD-10 FOR PHYSICIANS INCLUDING WORKER'S COMPENSATION AND PERSONAL INJURY

Fukumoto, E.

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Datos técnicos

  • ISBN 9781138032903
  • Año Edición 2017
  • Páginas 276
  • Encuadernación Rústica
  • Idioma Inglés
 

Sinopsis

ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization. It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury of diseases. The code set allows more than 14,000 different codes and permits the tracking of many new diagnoses.

The U.S. has used ICD-10-CM (Clinical Modification) since October, 2015. This national variant of ICD-10 was provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics, and the use of ICD-10-CM codes are nowmandated for all inpatient medical reporting requirements.

This book is for physicians, practice managers and all others who need learn ICD-10. It’s designed for the clinician to learn how to put their diagnosis into a code and not rely on staff or computer software programs to decide it form them.

ICD-10 is a complex system of coding and Medicare and third party insurers have been lenient giving providers a year to get used to the coding system. As a result, physicians and their staff have become very complacent regarding proper coding. However, Medicare and third party insurers will soon begin to deny claims which are not coded correctly, which in turn will cost physician groups time and money.

This book focuses on Worker’s Compensation and Personal Injury, a very large segment of the healthcare industry and is a new area to ICD-10. The diagnosis coding for injuries is much different than for Medicare or group insurance and unless the physicians and their staff learn how to use it properly, they risk losing income for themselves and worse, they risk losing the case for the patient.

Features

The first book in the US on ICD-10 as it relates to Worker’s Compensation and Personal Injury.
Provides a step-by-stepprocessforphysicians to makesurethey are givingtherightcodeforthe diagnosis givenforthepatientforanyinsurancetype.
Provides a sixcategoryprocess to handleeverythingneededforallinjury cases.
Includesexpertguidanceneededfortheinjurycoding as theindustryevolves to createthecorrectcodingalongtheway as thisallevolves.
Includesworksheets and case studies to illustratetheprocess.

Contents

1: Introduction to Worker’s Compensation and Personal Injury in ICD-10

2: Structure Overview of the "2015 ICD-10-CM"

Codestructurebasics
Using ICD-10 Overview

3: Components of ICD-10 and Their Usage

‘Z’ codes and theirimportance in Worker’sCompensation/Personal Injury
A basic 7-Step processforDiagnosticcoding
A basic 7-step process case example
6-category processforinjurycoding

4: Provider Requirements

Combinationcodes
7th charactercodes
Greaterlevel of detailrequired
External cause codes
External causes of morbidity (transport and other)

5: Worker’s Compensation, Personal Injury and Drug or Chemically Induced Diabetes

Diabetes Mellitus discussion
Use of flow charts for diabetes
Diabetes flow charts
2015 ICD-10-CM draftreleaseexpertedition – diabetes mellitus section

6: Worker’s Compensation and Personal Injury Billing Guide

Personal injuryexample – case #1
Worker’scompensationexample – case #2
Worker’scompensationexample – case #3
Billingforphysicaltherapy
Billingforinjections
Billingfor x-rays
Billingforminorsurgicalprocedures

7: Commonly Used Diagnosis Codes

Abdominal pain – ICD-10 category R10
CarpalTunnelSyndrome in Worker’sCompensation and Personal Injury
Psychosocialdiscussion

8: Complex Examples and Worksheet section

Example of whiplash case
Exampleonpainmanagement
Exampleoncarpaltunnelsyndromewithmultipleother injuries
ExampleonAgreed Medical re-evaluationfromanInternal Medical or Cardiovascular standpoint
Exampleon medical sleepdisorderevaluation
ExampleonOrthopaedicAgreed Medical evaluation – complicatedbyStraphInfectionfollowingsurgery
ExampleonPsychiatricAgreed Medical re-examination

9: Causation and Apportionment in Worker’s Compensation and Personal Injury

10: Dilemma of the Independent Medical Evaluator

TheLaw of UnintendedConsequences
OverviewforIndependent Medical Evaluators

Appendices:

Appendix 1: Medicare coverage, diagnosis requirements and coding edits

CorrectCodingInitiative (CCI) Edits
ICD-9 Diagnosis Codes are used in CurrentLCD’s

Appendix 2: Worker’s Compensation and Medicare Set asides

Appendix 3: Implementation Guide for ICD-10

Appendix 4: Discussion of ICD-10 Crosswalks

Appendix 5: Crosswalk from ICD-9 to ICD-10 of common diagnosis codes used in Worker’s Compensation and Personal Injury with notes on potential problem areas

Appendix 6: Glossary

Appendix 7: General Sample Fee Slip

Appendix 8: New California Worker’s Compensation Forms

Appendix 9: Web Links for additional information

Author(s) Bio

Eugene Fukumoto is President and General Manager of Health Claims Services, Inc., a consulting firm that manages the billing and collection for sole proprietors and medical groups including provider disputes with Insurance Companies. He is an authorized billingvendor for the Regents of the University of California, and has contracted with the USC School of Medicine and UCLA. He previously was General Manager for Health Computer Systems, a referenced Hewlett-Packard software vendor of medical billing systems whichdeveloped the first electronic billing software for medical practices. He is the author of numerous publications including Conquering ICD-10 for Chiropractors and Conquering ICD-10 for Family Physicians and General Practice.

 

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