Practice Management & Reimbursement

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CPT 2012 (Cpt / Current Procedural Terminology (Professional Edition))

Michelle Abraham, Jay T. Ahlman, Caryn Anderson, Angela J. Boudreau, Judy Connelly

Correctly interpreting and reporting medical procedures and services begins with CPT® 2012 Professional Edition. Straight from the American Medical Association (AMA), this is the only CPT codebook with the official CPT coding rules and guidelines developed by the CPT Editorial Panel. Covers hundreds of code, guideline and text changes.

The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care

Eric Topol

Until very recently, if you were to ask most doctors, they would tell you there were only two kinds of medicine: the quack kind, and the evidence-based kind. The former is baseless, and the latter based on the best information human effort could buy, with carefully controlled double-blind trials, hundreds of patients, and clear indicators of success.Well, Eric Topol isn't most doctors, and he suggests you entertain the notion of a third kind of medicine, one that will make the evidence-based state-of-the-art stuff look scarcely better than an alchemist trying to animate a homunculus in a jar. It turns out plenty of new medicines-although tested with what seem like large trials-actually end up revealing most of their problems only once they get out in the real world, with millions of people with all kinds of conditions mixing them with everything in the pharmacopeia. The unexpected interactions of drugs, patients, and diseases can be devastating. And the clear indicators of success often turn out to be minimal, often as small as one fewer person dying out of a hundred (or even a thousand), and often at exorbitant cost. How can we avoid these dangerous interactions and side-effects? How can we predict which person out of a hundred will be helped by a new drug, and which fatally harmed? And how can we avoid having to need costly drugs in the first place?It sure isn't by doing another four hundred-person trial. As Topol argues in The Creative Destruction of Medicine, it's by bringing the era of big data to the clinic, laboratory, and hospital, with wearable sensors, smartphone apps, and whole-genome scans providing the raw materials for a revolution. Combining all the data those tools can provide will give us a complete and continuously updated picture of every patient, changing everything from the treatment of disease, to the prolonging of health, to the development of new treatments. As revolutionary as the past twenty years in personal technology and medicine have been-remember phones the sizes of bricks that only made calls, or when the most advanced "genotyping" we could do involved discerning blood types and Rh-factors?-Topol makes it clear that we haven't seen a thing yet. With an optimism matched only by a realism gained through twenty-five years in a tough job, Topol proves the ideal guide to the medicine of the future-medicine he himself is deeply involved in creating.

CPT 2012: Standard Edition (Cpt / Current Procedural Terminology (Standard Edition))

Michelle Abraham, Jay T. Ahlman, Caryn Anderson, Angela J. Boudreau, Judy Connelly

Understanding Health Policy

Thomas S. Bodenheimer, Kevin Grumbach

"This highly readable text gives a broad but detailed picture of how health care is organized and dispensed in the United States." -Annals of Internal Medicine, on the First Edition

The #1 text on health policy, this well-known book provides a short introduction to U.S. health care policy by two leading experts who are themselves practicing physicians. The Fourth Edition features the latest information on cost containment, health insurance, managed care, hospital payment, and the new two-tier model of physician reimbursement.

2012 ICD-9-CM for Hospitals, Volumes 1, 2 and 3 Professional Edition (Spiral bound), 1e (Saunders Icd 9 Cm)

Carol J. Buck MS CPC CPC-H CCS-P

Elsevier and the American Medical Association have partnered to co-publish this ICD-9-CM reference by Carol J. Buck!

Code efficiently and effectively with Carol J. Buck's 2012 ICD-9-CM for Hospitals, Volumes 1, 2, & 3, Professional Edition. Combining Netter's Anatomy artwork and the 2011 Official Guidelines for Coding and Reporting (OCGR) with a format designed by coders for coders, this handy, spiral-bound reference helps you easily access the information you need to stay up to date and ensure the most accurate billing and maximum reimbursement in physician-based and inpatient coding. Plus, you can take this resource into your certification exams for enhanced testing support!

  • Coverage of all three ICD-9-CM volumes fulfills all of your coding needs with one comprehensive guide.
  • Convenient spiral binding makes it easy to access the information you need.
  • UNIQUE! Full-color Netter's Anatomy artwork clarifies complex anatomic information to help you appropriately code related procedures.
  • Use Additional Digit(s) symbol in the index identifies codes that require an additional digit to remind you to check the tabular.
  • Full-color design incorporates color-coded symbols to help you quickly find the information you need.
  • More than 150 full-color illustrations enhance your understanding of difficult terminology, diseases/conditions, and specific coding situations.
  • The 2011 Official Guidelines for Coding and Reporting (OGCR) are listed within the lists of codes and in a separate index for fast, easy access to the coding rules when you need them.
  • Items provide detailed information on common diseases and conditions, helping you code more effectively.
  • Symbols throughout the text alert you to new, revised, and deleted codes and clearly identify codes that require special consideration before assigning symbols, including use additional, includes and excludes, code first, and codes that cannot be assigned as principal diagnoses.
  • Present on Admission symbol highlights particular diseases that will always be coded as present on admission.
  • Hospital Acquired Condition symbol notes specific conditions that will always be coded as hospital acquired for easier recognition.
  • Complications & Comorbidities (CC) and Major Complications & Comorbidities (MCC) symbols help you instantly recognize codes associated with the presence of secondary diagnoses from MS-DRGs.
  • CC and MCC Exclusion lists instantly alert you to CC and MCC exceptions.
  • Additional hints, tips and definitions within specific codes provide extra guidance in coding anatomy, pathophysiology, or other coding directions.
  • Guide to the Updates enables you to reference all annual coding changes at a glance.
  • References to the American Hospital Association's Coding Clinics help you find expanded information about specific codes and their usage.
  • Age and Sex edits alert you to codes that are used only with patients of a specific age or sex, helping to ensure accurate reporting.
  • Manifestation code helps you identify certain conditions where it is important to record both the etiology (cause) and the manifestation (symptom) of the disease.
  • Omit and Code Also codes highlight government text needing special attention.
  • Valid OR Procedure symbols help you recognize procedures affected by DRG.
  • Coding updates on the companion codingupdates.com website keep you informed of changes to ICD codes.
  • Authorized support you can take into certification exams to enhance your testing experience and help you ensure certification success.

Health Care USA: Understanding Its Organization and Delivery

Harry A. Sultz, Kristina M. Young

An essential text for providing an overview of the professional, political, social, and economic forces that shape the U.S. health care system. Health Care USA, Third Edition offers a clear overview of the health care industry and the issues confronting it. The Third Edition will discuss how economic disincentives or reimbursement limitations are changing treatment priorities; includes a new chapter entitled "Hospitals: Origin, Organization and Future"; explore the impact of the Balanced Budget Act and the prospective payment system on long term care; highlight the issue of ethics in public health, and much more. Web based instructional support materials will be available.

CPT 2011: Standard Edition (Cpt / Current Procedural Terminology (Standard Edition))

Michelle Abraham, Jay T. Ahlman, Angela J. Boudreau, Judy L. Connelly, Desiree D. Evans

Understanding Health Insurance: A Guide to Professional Billing

Jo Ann C. Rowell, Michelle A. Green

Understanding Health Insurance: A Guide to Professional Billing, 7th edition, is a comprehensive guide for those learning about health insurance claims processing and reimbursement issues. The text utilizes a step-by-step approach to successful completion of health insurance claims. The objectives of this edition are to 1) introduce information about major third party payers, 2) provide up-to-date information about federal health care regulations, 3) clarify coding guidelines and provide application exercises for each coding system, 4) introduce reimbursement issues, 5) emphasize the importance of coding for medical necessity, and 6) help users develop the skill to complete claims accurately. Numerous examples help clarify key concepts. Case studies and review exercises provide users with numerous opportunities to apply knowledge and develop skills in completing CMS-1500 claims accurately. The textbook CD-ROM and accompanying workbook provide additional exercises and practice in completing CMS-1500 claims electronically. Current information is provided on CPT-5 and ICD-10-CM coding systems. The appendices include information about processing UB-92 (CMS-1450) claims and dental claims.

2012 HCPCS Level II Standard Edition, 1e (Saunders Hcpcs Level II)

Carol J. Buck MS CPC CPC-H CCS-P

Elsevier and the American Medical Association have partnered to co-publish this HCPCS Level II reference by Carol J. Buck!

Code more quickly, accurately, and efficiently, and optimize reimbursement with 2012 HCPCS Level II (Standard Edition). In an easy-to-use format, this practical reference presents the latest Healthcare Common Procedure Coding System (HCPCS) codes to help you comply with coding regulations and confidently locate information on specific codes, manage supply reimbursement, report patient data, and more. Keep current with HCPCS codes with this essential medical billing reference from Carol J. Buck!

  • At-a-glance code listings highlight all new, revised, and deleted codes for 2012.
  • UNIQUE! Color-coded Table of Drugs similar to the ICD-9-CM drug table makes it easier to find specific drug information.
  • Distinctive symbols identify new, revised, reinstated, and deleted codes.
  • Drug code annotations help you quickly and easily identify brand name drugs as well as drugs that appear on the National Drug Class (NDC) directory and other Food and Drug Administration (FDA) approved drugs.
  • Updated Internet Only Manual (IOM) provides essential information on carrier-specific and Medicare-specific regulations to ensure coding accuracy.
  • Companion website (codingupdates.com) keeps you informed of changes to ICD codes, and provides the opportunity to sign up for automatic e-mail notifications.
  • Affordable pricing provides unparalleled value at a reasonable cost.
  • The latest codes help you maintain compliance with current Healthcare Common Procedure Coding System (HCPCS) standards.

ICD-9-CM 2012 Expert for Physicians (ICD-9-CM Expert for Physicians, Vol. 1 & 2)

Ingenix

Now enhanced with a new, bolder font to improve readability, the Ingenix ICD-9-CM Expert for Physicians continues to provide accurate and comprehensive coverage for diagnosis coding and reimbursement. Loaded with innovative features and content to address regulatory changes and coding challenges, Ingenix experts study industry changes and trends while seeking feedback from coding professionals to ensure your code book provides accurate and up-to-date information in an easy-to-use, intuitive format. Remain a step ahead with a resource thats designed to enhance performance in your daily work.

Features include:

Highlighted coding instructional and informational notes. Recognize important code usage guidance for specific sections more easily with highlighted notes.

Intuitive color-coded symbols and alerts. Identify critical coding and reimbursement issues quickly with alerts on the same page as the code you need.

Instructional and informational note alerts. Find coding notes clearly designated for enhanced emphasis and coding accuracy.

Additional digit required symbols. Know when an additional fourth or fifth digit is required for code specificity and validity to avoid invalid code submissions (provided in Index and Tabular Section).

V-code symbols.

Manifestation code alert.

Unspecified and Other Specified code alerts.

Age and sex edits.

New and revised code alerts with dated pages.

Synopsis of code changes.

Hallmark page design and features. Locate information quickly with a user-friendly page design, including dictionary-style headers, QuickflipTM color bleed tabs, and legend keys.

HIPAA compliance.

ICD-10 Spotlight. Preview ICD-10 codes with the most frequently reported ICD-9-CM codes to learn as you work.

AHAs Coding Clinic and official coding guideline tips. Use citations to link to the official coding advice every coder in every health care setting must follow for ICD-9-CM and find official coding tips with the codes.

Illustrations and definitions.

More value with the Expert edition:

ICD-9-CM Code Changes. An Insiders View. Find detailed, chapter-by-chapter clinical and coding tips for all the new 2012 codes in a single resource.

Coding tables.Reduce time spent on code selection for complex diagnoses that typically require additional research and steps.

10 Steps to Correct Coding.Receive step-by-step instruction to improve coding accuracy and more effectively use ICD-9-CM conventions.

Valid three-digit code list.See at a glance whether a code is valid for claim submission to prevent denied claims due to invalid code usage.

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