Kukanganisa mukuKodha Kunogona Kukupa Mari
Inishuwarenzi inoshandiswa neurongwa hwehutano hwako hwekuita zvisarudzo pamusoro pekubhadhara zvakadini chiremba wako nevamwe vatapi vezvoutano. Kazhinji, iwe uchaona mazano aya pane Tsanangudzo yeBatsiro uye mabhidharo emishonga.
Tsanangudzo yeZvibatsiro (EOB) isimboti kana chirongwa chinogona kutumirwa kwauri neinishuwarenzi yako mavhiki mashoma kana mwedzi mushure mekunge uine rubatsiro rweutano rwakabhadharwa nekambani ye inshuwarisi.
EOB yako inofanirwa muzvenhau yako yekubhadhara yezvechiremba. Chiongororai zvakanyatsoita kuti uone kuti iwe wakagamuchira basa iri kurikweretwa, mari iyo chiremba wako akagamuchira uye mugove wako wakarurama, uye kuti kuongororwa kwako uye nzira yako yakanyorwa uye yakanyorwa.
Kukosha KweInishuwarenzi Mapeji
EOBs, mafomu emishuwarenzi, uye mishonga yezvechiremba kubva kuchiremba wako kana kuchipatara zvinogona kuva zvakaoma kunzwisisa nekuda kwekushandiswa kwemitemo kurondedzera maitiro anowanikwa uye kuongorora kwako. Aya mazwi anowanzoshandiswa panzvimbo peChirungu Chinyorwa uye zvinogona kukubatsira iwe kuti udzidze pamusoro pematare aya, kunyanya kana une imwe kana zvimwe zvinetso zvoutano zvisingaperi.
Semuenzaniso, mamiriyoni eAmerica ane chirwere cheshuga chechipiri pamwe nekuderedzwa kweropa uye nepamusoro chetiestarol. Iri boka revanhu rinogona kunge rine hutano hwehutano kupfuura huwandu hweAmerica uye, saka, huchada kuongorora mamwe EOB uye mabhizimisi ekurapa.
Coding Systems
Zvirongwa zvehutano, makambani ekubhadhara kurapwa, uye vashandi vehutano vanoshandisa zvitatu zvakasiyana-siyana zvekodhi. Idzi nheyo dzakagadzirwa kuti dzive nechokwadi chokuti kune nzira isingagumi uye yakavimbika yemakambani emishuwarenzi ehutano kugadzirisa zvikwereti kubva kune vashandi vehutano uye kubhadharira mahutano ehutano.
Current Procedural Terminology
Nhasi Maitiro Ezvakanyorwa Purogiramu (CPT) nheyo dzinoshandiswa navanachiremba kurondedzera mabasa avo anopa. Chiremba wako haazobhadharwe hurongwa hwako hwehutano kunze kwekuti ikhodi yeCPT yakanyorwa pane fomu yekubvunza.
Nhamba dze CPT dzakagadzirwa uye dzinovandudzwa neAmerican Medical Association (AMA). Zvinosuruvarisa, iyo AMA haina kupa rusununguko rwakasununguka kumataipi eCPT. Vashandi vezvechiremba vanoshandisa mabhizimusi vanofanira kutenga mabhuku ekunyora kana kuwanika paIndaneti kumitemo kubva kuAA.
I AMA site inokubvumira kutsvaga kode kana zita rekuita. Zvisinei, sangano rinoita kuti iwe usapfuure zvinopfuura 5 kutsvaga pazuva (iwe unofanirwa kugadzira ereji uye ungopinda kuti ukwanise kushandisa sarudzo yekutsvaga). Uyewo, chiremba wako angave ane pepa (inonzi chiitiko chekuchingana kana "kukwirira") iyo inonyanya kushandisa yakawanda iyo CPT uye zviratidzo zvekuongorora zvinoshandiswa muhofisi yake. Hofisi yechiremba wako inogona kugovera iyi fomu newe.
Mimwe mienzaniso yeCP codes ndeyokuti:
- 99201 - hofisi kana mumwe munhu kunze kwekushanyira kutarisa nekutariswa kwechirwere chitsva
- 93000 - electrocardiogram
- 36415 - kuunganidza ropa rakawanda nekuputika (kuteura ropa)
Utano Hwakagadziriswa Kurongeka Coding System
IHealthcare Common Procedure Coding System (HCPCS) ndiyo nzira yekunyoresa inoshandiswa ne Medicare.
Nhamba I HCPCS nheyo dzakangofanana neCPT nhamba kubva kuAmerican Medical Association.
Medicare inochengetedzawo mahedheni emitemo inozivikanwa seHCPCS Level II. Aya mazano anoshandiswa kugadzira michina, zvigadzirwa, uye maitirwo asina kuiswa mumitemo yeCPT, yakadai semamulensiki nemishonga inogara kwenguva refu yezvokurapa (maguruvhesi nemibhedha yezvipatara), prosthetics, maitiro, uye zvinhu zvinoshandiswa kunze kwehofisi yechiremba.
Mimwe mienzaniso yeChikamu II HCPCS nhete ndeiyi:
- L4386 - kufamba-famba
- E0605 - vaporizer
- E0455 - okisijeni mutende
ICenter for Medicare neMedicaid Services inochengetedza webhusaiti iyo yakagadziridzwa HCPCS kodhi yemashoko inowanika kuvanhu vose.
Kurongeka Kwepasi rose kwezvirwere
Nzira yechitatu yekunyoresa ndeyekutsvaga kwepasi rose kwezvirwere, kana maIndaneti. Aya mazano, yakagadzirwa neWorld Health Organization (WHO), inofanidza hutano hwako, kana kuongororwa. ICD codes inowanzoshandiswa pamwe chete neCPT codes kuti uone kuti hutano hwako uye hutano hwawakagamuchira hwakafanana.
Semuenzaniso, kana iwe uchitaridzika uri bronchitis uye chiremba wako akarayira chikwata che X-ray, zvichida kuti X-ray haingabhadharwi nokuti haina kufambidzana nebronchitis. Zvisinei, chifukidzo che X-ray chakakodzera uye chinogona kubhadharwa.
Mimwe mienzaniso yeCI-10 codes ndeyokuti:
- E66.0 - kuora muviri kunokonzerwa nemakori akawanda
- F32.0 - kuora mwoyo
- S93.4 - yakakonzerwa nemakumbo
Nyaya yakazara yekuongorora zviratidzo (inozivikanwa seCI-10) inowanikwa kuti idziwe kubva pawebsite yeCMS, uye ICD10data.com inoita zvakananga kutsvaga mhando dzakasiyana-siyana.
IUnited States yakashandura kubva kuIndaneti-9 kusvika kuIndaneti-10 muna 2015, asi dzimwe nyika dzemazuva ano zvirongwa zvekuchengetedza utano hwakange dzashandisa ICD-10 makore mazhinji apfuura. Nhamba dzePCT dzinoramba dzichishandiswa pamwe chete ne ICD-10 nhamba (ivo vose vanozviratidza pamashoko ekurapa), nokuti CPT codes ndeyekubhadhara, asi ma ICD-10 nhamba ndeyekunyora kuongorora zvirwere.
Coding Errors
Kushandisa zvitatu zvekunyoresa zvingave zvinoremedza kune chiremba anoshanda uye chipatara vashandi vezvipatara uye zviri nyore kunzwisisa kuti sei kukanganiswa kwekukanganisa kuchiitika. Nokuti hurongwa hwehutano hwako hunoshandisa zviratidzo kuti uite zvisarudzo pamusoro pekubhadhara zvakadini chiremba wako nevamwe vanopa utano hwehutano, zvikanganiso zvinogona kukudhura mari.
Nhamba isina kururama inogona kukuratidza iwe nehutano hune hutano hwausina huri (pane huchiri kunetseka kuti mamiriro ezvinhu akagara akambovapo anogona zvakare kuva chipingamupinyi chokuwana hutano hwehutano pasi peGOP yehutano hwekugadzirisa kushandiswa kwezvinhu), zvikonzerei kuwedzerwa kune chiremba wako uye inogona kuwedzera yako kunze kwe-podhadha yemari , kana urongwa hwako hwehutano hunogona kuramba kuda kwako uye kusabhadhara chero chinhu. Zvingaita kuti chiremba wako, mukana wekukurumidzira, kana chipatara kuti usanyora pasi mavhisi wamakagamuchira, kana kunyora zvisiri izvo kuongorora kana kusakanganisika. Kunyange nyore nyore typographical zvikanganiso zvinogona kuva nemigumisiro inokosha.
Semuenzaniso: Doug M. akawira paaifamba. Nemhaka yekutambudzika mumakumbo ake, akaenda kunzvimbo yake yepamhanho yepamhanho. Mushure mekunge aine X-ray yechidzitiro chake, chirwere cheE ER chakaonekwa kuti chakakonzerwa nemakumbo uye chakatumira Doug kumba kuti agare. Mavhiki mashomanana gare gare Doug akawana bhadharo kubva kuchipatara kune zvinodarika madhora mazana mashanu emakumbo eX-ray. Apo EOB yake yakauya, akaona kuti chirongwa chake chehutano chakanga chakaramba kudai X-ray.
Doug akadana hurongwa hwake hwehutano. Zvakatora nguva yekugadzirisa kukanganisa kwakaitwa nebhadhiro yekubhadhara muimba yekutambudzika. Akangoerekana aisa nhamba isiri iyo muDoug's diagnostic code, achichinja S93.4 (yakagadziriswa ngaravo) ku S53.4 (yakagadziriswa). Chirongwa chehutano hwaDoug chakaramba kubvuma nokuti X-ray yemakumbo haisi muedzo unoitwa kana mumwe munhu ane chirongo chegorosi.
Kune matanho akawanda mukutora kuzadza uye kuendesa chiremba chekurapa. Vari munzira, vanhu uye makombiyuta anobatanidzwa mukugadzirisa zvinogona kuita zvikanganiso. Kana kuda kwako kwakarambidzwa, usanyara kudana hofisi yako yechiremba uye chirongwa chako cheutano.
> Sources:
> American Medical Association. Kuwana Coding Resources.
> Bohnett, Charlotte. WebPT. 8 Zvinhu Zvaunoda Kuziva Zvino Pamusoro peCI-10. July 2013.
> Centers for Medicare neMedicaid Services. HCPCS Quarterly Update.
> ICD10data.com. IWeb Web's Free 2018 ICD-10-CM / PCS Medical Coding Reference.