Tremendous advances have been made in healthcare during pregnancy and child birth. From basic check-ups to advanced screenings, obstetrical procedures strive to ensure the safety and health of both the mother and the baby. Women planning to have a baby can start their medical check-ups pre conception and continue with regular check-ups right through the course of their pregnancy and after.
Clinical documentation has been around for centuries. There are records from the 18th and 19th centuries that show the detailed observation and findings recorded by doctors of that time. However, clinical documentation has undergone drastic changes over the years. In the early days, clinical documentation was used as a record of the patient’s diagnosis and treatment for future reference.
ICD 9 codes were replaced by ICD 10 on October 01, 2015 as they had some inherent issues which were addressed and rectified in ICD 10.
However, it is important to understand that ICD 10 codes are not merely ICD 9 codes that have been increased in numbers or volume; ICD 10 codes with changes in terminology and providing far more details are definitely more complex than ICD 9 codes.
One of the most important considerations during the medical billing and coding process is to choose whether the patient is an inpatient or an outpatient. Based on the choice, the medical codes associated differ.
At times, inexperienced medical coders may unintentionally misrepresent the patient status which could result in denied claims and even accusations of fraud.
HCC scores have been used since 2004 by Medicare to adjust payments based on the risk level of the enrollee. This has resulted in Medicare paying a higher monthly capitation fee for patients with higher HCC scores as these require more resources and disease intervention.
So, what is HCC in medical terms and what is HCC healthcare?
HCPCS Stands for
HCPCS stands for Healthcare common Procedure Coding System, and is a standardized set of code that is used extensively by healthcare professionals and insurance providers in order to chalk up the insurance claims. The codes and resources provided by HCPCS offers and orderly method to assimilate and calculate the insurance,
Medicine has transcended from being a profession that focuses solely on curing patients to multi-billion dollar commerce. Physicians and hospitals have been forced to amend their means of operation in order to accommodate the magnanimous paper work and related bureaucracy. Medical coding standards have steeply risen in complexity and size, thus risking overworking your current staff in billing and applying for claims and reimbursements.
The Hierarchical Condition Categories (HCC) was developed and implemented by The Centers for Medicate and Medicaid (CMS) in order to create a risk adjustment methodology to provide adequate payment plans for patients opting for private health care. These codes are primarily based on the health expenditure risk profiles of the Medicare Advantage (MA) plan members;
Dealing with medical bills is one of the leading concerns of physicians and health care professionals. Attempting to deal with such complex and ever changing medical billing and coding practices by themselves is a tedious process indeed. This measure is increased manifold when dealing with cardiology billing. This is a highly specific area of medical billing and requires specialized training and experience that helps maintain a fair degree of accuracy and reliability.
CPT is short for Current Procedural Terminology, and is a set of medical codes that defines a slew of medical related procedures and services to physicians, health insurance companies and accreditation agencies. CPT procedures operate closely with ICD-9 and ICD-10 diagnostic coding, except it defines the services rendered, while the ICD coding focuses more in the diagnosis on the claim.