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Medical Coding in the United States: Introduction and Historical Overview
Pages 3-11
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.
Medical Coding in the United States: Introduction and Historical Overview
Pages 3-11
ICD-10
Pages 13-34
The CPT Code
Pages 35-44
A Resource-Based Relative Value Scale (RBRVS) System
Pages 45-56
CMS, the SGR, and MACRA
Pages 59-67
Global Period
Pages 69-80
Medicare Part A and DRG’s
Pages 81-93
Acute Care Surgical Bundled Payment Models
Pages 95-113
Accountable Care Organizations
Pages 115-131
Pay for Performance and Value-Based Care
Pages 133-143
Coding and Reimbursement of Evaluation and Management Services
Pages 147-160
Skin and Soft Tissue
Pages 161-175
Breast Coding
Pages 177-185
Gastrointestinal Endoscopy
Pages 187-206
Coding for Laparoscopic Surgery
Pages 207-214
Coding for GI Tract and Hepatopancreaticobiliary Procedures
Pages 215-221
Coding for Colon and Rectal Surgery
Pages 223-236
Hernia and Abdominal Wall Coding
Pages 237-243
Bariatric Coding
Pages 245-268
Trauma, Critical Care, and Emergency General Surgery Coding
Pages 269-277
Surgical Oncology Coding
Pages 279-287
Intricacies of Transplant Physician/Surgeon Coding, Billing, and Reimbursement
Pages 289-296
Coding for Vascular and Endovascular Surgery
Pages 297-310
General Thoracic and Esophageal Surgery Coding
Pages 311-323
Head and Neck Coding
Pages 325-334
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