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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


  

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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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