Kuchengetedza kwechiremba chikamu chinokosha chekubhadhara kuchipatara nekukurukurirana pakati pevashandi vehutano uye vatsigiri. Dzidza zvinyorwa zvezvinorevei uye kuti mazwi acho anoshandiswa sei.
Chii Chiri Kurapa Coding?
Coding yezvechiremba inzira yehuwandu uye mavara mabhii ayo akasiyana pane imwe neimwe kuongororwa, chiratidzo kana chiratidzo chinogadziriswa, uye chinokonzera rufu muvanhu.
Uyezve, nheyo dzinoshandiswa pakukurukurirana kwakakwana kwezvipo uye nzira dzinoshandiswa mukurapa kwemamiriro evanhu. Kururamiswa kwekodhi yakarurama kwakakosha pakubhadhara uye mumatanho ekutsvaga kwezvirwere uye kurapwa.
Kunyora coding inonyanya kukosha pakuwana inshuwarheni yekubhadhara pamwe nekuchengetedza zvinyorwa zvevarwere. Kunyora kwekodhi kunonyatsobvumira mubhadharo wehushuga kuziva chirwere kana kukuvadzwa kwemurwere uye nzira yekurapa.
Coding yezvechiremba inogona kusanganisira imwe kana akawanda emhando dzemhando idzi: ICD codes, CPT codes, HCPCS codes, DRG codes, uye modifiers. Zvose izvi zvinyorwa zvekunyoresa zvakakosha pakukurukurirana uye zvinangwa zvekubhadhara. Haisi kungoita coding chete inokosha mune zvekurapa, zvinokosha nokuti vatengesi vemabhizimisi vakaita semakambani einishuwarenzi, Medicare neMedicaid havazobhadhara kudai kana isingatenderwi zvakanaka nematare anogamuchirwa.
ICD Codes
Iro International Statistical Classification of Diseases kana maIndaneti maitiro eimwe nzira yemitemo. Izvi zvakanyatsoratidza kuenzaniswa kwezvirwere, zviratidzo, uye zvinokonzera rufu muvanhu. IWorld Health Organization inogadzira, zvinyorwa zvitsva, uye inotarisira zvinhu izvi zvakasarudzwa uye zvinowirirana uye zvichidaro zvinogamuchirwa nedzimba dzose dzezvechiremba uye vashandi munyika yose.
MuUnited States the National Center for Health Statistics, iyo inhengo yeCenter for Medicare neMedicaid Services inogadzirisa chero zvigadziriswa kumaiyo eCI pamwe neW WHO.
HCPCS Codes
HCPCS (Healthcare Common Procedure Coding System) mazinga I uye II ndeimwe nzira yekunyora. Nhamba I ine maPCT, uye Nhamba II inosanganisira alphanumeric nheyo dzinoshandiswa kugadzira zvigadzirwa, zvigadzirwa, uye mabasa asina kuiswa mumitemo yeCPT paanoshandiswa kunze kwehofisi yechiremba.
HCPCS nheyo dzinotsanangurwa muzvikamu zvitatu:
- Nhamba I CPT (Current Procedural Terminology) nhamba dzakagadzirwa nhamba nhamba dzishanu uye dzinotungamirirwa neAmerican Medical Association (AMA). Nhamba dzePCT dzinoshandiswa kuzivisa zvirongwa zvezvechiremba uye maitiro anorayirwa navanachiremba kana vamwe vadzidzisi vane mvumo.
- Nhamba II HCPCS ndeye alphanumeric mitsara ine imwe yerefabheti iyo yakateverwa nenhamba ina uye inotarisirwa neCenter for Medicare neMedicaid Services (CMS). Aya mazita anoratidza kusingabatsiri kwemashoko akadai semakambani mazano, zvipatara zvinogara kwenguva refu, uye pharmacy.
- Nhamba III nheyo ndeye alphanumeric nheyo W, X, Y, kana Z inoteverwa nechina-digit digit code. Zvimwe zvisingazivikanwe sehutano hwemunharaunda, idzi nheyo dzinoshandiswa sekhodi imwechete apo pasina ruyero I kana kuti yechipiri chechipiri kuti ione iyo.
Zvinoshandura: Dzimwe nheyo dzeHCPCS dzinoda kushandiswa kwema modifiers. Zvinosanganisira nhamba mbiri, nhamba mbiri kana alphanumeric characters. HCPCS code code modifiers inopa humwe ruzivo pamusoro pebasa kana nzira yakagadzirwa. Kuchinja kunoshandiswa kureva nzvimbo yemuviri umo maitiro akaitwa, maitiro akawanda muchitsauko chakafanana, kana kuratidza kuti nzira yakatangwa asi inorega.
CPT Codes
Nhamba dzeCPT dzinowanzoita maitiro ehurumende uye dzakagadziridzwa uye dzinozivikanwa neAmerican Medical Association muna 1966. Idzi inzira yezvishanu zvinyorwa zvinyorwa zvinyorwa zvinyorwa zvinotsanangurwa mune nzira yakarongeka yezvechiremba, yekuvhiya, uye yekuongorora zvirongwa.
DRG Codes
DGG codes , diagnostic-related related grouping codes, zvinongoshandiswa kuparidzira muchengeti wepatient claim. Vatsigiri vakawanda vanobhadhara maererano neDGG, naizvozvo, kunyatsoratidzwa kwezvinhu zvose kunokosha pakureva kubhadhara mari.
Kunyorwa Kwokurapa Kwechiremba Kunoshandiswa
Izvi zvinogadzirisa zvigaro zvakakosha pakukurukurirana uye zvinangwa zvekubhadhara. Haisi kungoita coding chete inokosha mune zvekurapa, iyo inonyanya kukoshesa mari kune vashandi vezvokurapa nokuti vatengi vemabhizimisi vakaita semakambani einishuwarenzi, Medicare neMedicaid havangabhadhara kubhadhara kana isingatenderwi zvakanaka nemitemo yakagamuchirwa.
Uyezve, kuongororwa kwemashoko kunoshandiswa kuongorora zvirwere zvezvirwere mumasangano uye kuhuwandu hwehutano nehutano nehutachiwana. Dzimwe nhengo dzeWorld Health Organization dzinogona kubatsirwa kubva pane zvigadziro zvinoda kurwisa nyaya dzakapararira dzehutano, kudzidzisa vanhu mukudzivirira uye kurapwa, uye kuve nechokwadi chehutano hwakanaka mune ramangwana uye hupenyu hwevanhu vayo.
Dzidzo muCoding Coding
Makoroji akawanda uye zvikoro zvekutengeserana zvinopa zvidzidzo, zvidzidzo, kunyange kushamwaridzana kweApplied Science degrees mubhadharo yezvechiremba uye coding. Idzi idzi dzakadzika dzidzo kana chirongwa chechidimbu chinodzidzisa vadzidzi pamagumo ekurapa, kukodha kwakakodzera uye maitiro ekubhadhara, mahofisi akakodzera ehurumende, uye huwandu hwakawanda hwekambani. Mimwe yeiyi yakagamuchirwa uye vamwe haisi, saka mumwe nomumwe angave mudzidzi anofanira kuita basa ravo rechikoro asati asarudza purogiramu yekudzidza.
Kukosha kwekutanga dzidzo nekuenderera mberi dzidzo muhofisi yekliniki kana kuti chiremba haigoni kudarika. Kuramba uchienzanisa nekushandurwa kwekodhi uye maitiro ekubhadhara, uyewo kutonga mitemo inokosha mune iyi dhidhijiti inotenderera iyo yatinoshanda tose uye tinorarama.
Coding uye Billing
Kuchengetedza uye kubhadhara kunowanzotaurwa pamwe chete nokuti izvi zvikamu zviviri zvehofisi yezvokurapa iyo yakabatana zvikuru. Mushandi (s) anozadzisa coding yako yezvechiremba uye kubhadhara kunofanira kushanda pamwe chete kuti vaone kubhadhara kwakarurama nekukurumidza kwezvose zvinodhaka zvekurapa uye kururamisa uye kukwana zvikwereti zvezvokurapa.
Zvishandiso zvakadai sepamusoro pezvinyorwa zvemitemo mabhuku zvakanyora mhando dzakasiyana-siyana kana purogiramu yezvino yekukodhidza kana kubhadhara inokosha kune kubhadhara uye kukodhidzira vashandi kuitira kuti vave nechokwadi chekunyora zvakakwana kumakambani einishuwarenzi kana Medicare neMedicaid , uye kubhadhara nokukurumidza kubva kune dzimwe nhengo, pamwe chete sezvinyorwa zvakajeka uye zvinyorwa zvemishonga. Pamusoro pekutanga kwekutsvaga kwezvirwere, mutsara uye kana biller angave ane mhosva yekutevera zvirevo zvisirizvo kuburikidza nekuongorora bhidhiyo yemurwere, kudzorera zvakare kudai, kukumbira kudai, kana kutora mamwe matanho kuti ave nechokwadi chokuti kudai.
Zvichipa kuti vashandi vezvechiremba uye vanobhadhara ndivo vane mhosva yekururamisa kwezvinyorwa zvezvokurapa maererano nehurumende uye yehurumende mitemo zvakare, kukosha kwevanokwanisa kubhadhara mari uye makodhi hazvigone kudzvinyirirwa. Imwe nyanzvi yekurapa yakabudirira inofanira kunge yakave yakadzidziswa, yakarongeka, uye inyanzvi yezvokurapa zvikwereti uye makodhi ezvokurapa.