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University of Alabama *

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203

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Mechanical Engineering

Date

Apr 3, 2024

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docx

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Uploaded by Robinson0323

This week's article is found online in Revcycle Intelligence by xtelligent Healthcare Media: https://revcycleintelligence.com/features/exploring-the- fundamentals-of-medical-billing-and-coding Read the article and provide a 250-word (minimum) response to it (not a summary of the whole article). Include in your response something you learned that you felt was interesting about how ICD-CM Coding classification system and other coding systems are currently used in the delivery of healthcare in the United States. Think critically about the topics presented and discuss your thoughts in your reflection. After reading the article by Revcycle Intelligence covers the fundamentals of medical coding and billing, emphasizing how these processes play a vital role in the healthcare industry's revenue cycle. It also highlights how crucial a complete clinical record is during a patient's visit to a healthcare facility. One of the most critical steps in avoiding potential legal issues and claim denials is to ensure that medical records are appropriately documented; this can be done by preventing code words and billing for undocumented services. The complexity of the medical coding systems, such as the diagnosis and procedure codes for HCPCS and CPT, is explained in

detail. The system's vast number of unique identifiers makes interpreting the data difficult. I find the use of modifiers in CPT codes particularly interesting. These help in ensuring that providers are reimbursed accurately, taking into account various factors such as the procedure, the patient's location, and the reason for the service. This article also covers the requirement for using HCPCS codes in certain circumstances, which adds to the complexity of the coding process; this affects providers who deal with government and private payers. The article discusses the CMS Hospital PriceTransparency rule and how hospitals can publicize their chargemasters. This rule aims to promote transparency in the healthcare industry. In addition, it talks about how facility and professional codes can be integrated, which highlights how technology can improve the efficiency and accuracy of medical coding. The use of standardized codes such as ICD-CM helps in the accuracy of the information presented in medical records. They help in ensuring that the services and procedures that are provided are correct and are reimbursed. The extensive use of these sets also enables communication between different groups within the healthcare industry. The article discusses the intricate relationship between coding and medical billing, emphasizing how these processes are vital in

the healthcare industry's revenue cycle. It also covers the various documentation requirements and coding systems that must be understood to improve efficiency. The article highlights how the industry is working to make these processes more accurate and efficient.

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