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2017 Emergency Department Revenue Cycle Handbook

Emergency Department Revenue Cycle Handbook
Re-created for 2017, this essential book includes full guidance on the ED revenue spectrum, medical necessity essentials, and help with common areas of confusion.

Price: $167.00



Expanded & improved: ED best practices, from admission to billing.

Perhaps no other area of the hospital has experienced more upheaval in recent years than the emergency department. Among the major challenges& a surge in admissions through the ED, bottlenecks in patient flow to other care settings and, of course, rising costs coupled with growing pressures from value-based pricing. Now, more than ever, it's crucial that you get a firm grip on the entire spectrum of patient care, from ED admission through billing and payment.

What's in this essential guide?

  • Introduction
  • Chapter 1: Defining Your Emergency Department's Business
    • Type A and B ED
    • Stand-Alone EDs
  • Chapter 2: Basics of Emergency Department Coding
    • CPT® and HCPCS Level II Codes
    • Modifiers
    • ICD-10-CM Diagnosis and ICD-10-PCS Codes
    • Revenue Center Codes
  • Chapter 3: ED Revenue Cycle—Front End: Patient Registration and Triage
    • EMTALA
    • Registration
    • National Coverage Determinations
    • Local Coverage Determinations
    • Not Reasonable and Necessary
  • Chapter 4: ED Revenue Cycle—Middle: Patient Experience and Documentation
    • The Registration Process
    • Patient Care
    • Discharge
    • Electronic Health Records
    • Valid Physician Orders
    • Protocols
    • Standing Orders
    • Symptoms vs. Diagnoses
  • Chapter 5: ED Revenue Cycle—Back End: Charging, Coding, Billing and Reimbursement
    • Example of an Emergency Department Chargemaster
    • Facility Component
    • Example of Partial Point/Acuity Systems
    • Professional Services
    • Payer Reporting Requirements
    • Overview of OPPS and APCs
    • OPPS Status Indicators
    • Packaging, Bundling, and Discounting
    • Comprehensive and Composite APCs
    • Transitional Pass-Through Payment
    • Inpatient-Only List
    • Outlier Payments
    • Copayment Changes
    • Condition Code 44
    • Outpatient Code Editor
    • National Correct Coding Initiative
    • Non-Covered Service
    • Remittance Advice
    • Rejections and Denials
  • Chapter 6: The Move To Value-Based (Quality) Reporting and Payment
    • Hospital VBP Program
    • Changes for Future Payment Determinations
    • First Option: Test the QPP
    • Second Option: Participate for part of the calendar year
    • Third Option: Participate for the full calendar year
    • Fourth Option: Participate in an Advanced APM in 2017
  • Chapter 7: Observation Services
    • Counting Observation Time
    • Condition Code 44
  • Chapter 8: Urgent-Care and Fast-Track Departments
  • Chapter 9: Emergency Department Professional Services
    • Charge Description Master
    • Charge Strategy
    • Trauma Activation
    • Presence and Absence of the Teaching Physician
    • Type of History
    • Chief Complaint (CC)
    • History of Present Illness (HPI)
    • Review of Systems (ROS)
    • Marshfield E/M Tool: Scoring Number of Diagnoses/ Treatment Options
    • Marshfield E/M Tool: Scoring for Amount and/or Complexity of Data to Be Reviewed
    • Table of Risk
    • Place of Service (POS) Code
  • Appendix 1: OPPS Visit Codes—Frequently Asked Questions
  • Appendix 2: Medicare Fee For Service Program: Shifts to Value-Based Purchasing
  • Appendix 3: Glossary

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    For certain MedLearn Publishing publications, you will see an 'AMA Royalty Fee' in your shopping cart. This charge covers the licensing fee MedLearn Publishing pays to the American Medical Association (AMA) for references to CPT® codes. The AMA owns the copyright for CPT codes.