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Medical Billing and Coding For Dummies, 2nd Edition



Medical Billing and Coding For Dummies, 2nd Edition

Karen Smiley

ISBN: 978-1-118-98254-9 April 2015 368 Pages


Your complete guide to a career in medical billing and coding, updated with the latest changes in the ICD-10 and PPS

This fully updated second edition of Medical Billing & Coding For Dummies provides readers with a complete overview of what to expect and how to succeed in a career in medical billing and coding. With healthcare providers moving more rapidly to electronic record systems, data accuracy and efficient data processing is more important than ever. Medical Billing & Coding For Dummies gives you everything you need to know to get started in medical billing and coding.

This updated resource includes details on the most current industry changes in ICD-10 (10th revision of the International Statistical Classification of Diseases and Related Health Problems) and PPS (Prospective Payment Systems), expanded coverage on the differences between EHRs and MHRs, the latest certification requirements and standard industry practices, and updated tips and advice for dealing with government agencies and insurance companies.

  • Prepare for a successful career in medical billing and coding
  • Get the latest updates on changes in the ICD-10 and PPS
  • Understand how the industry is changing and learn how to stay ahead of the curve
  • Learn about flexible employment options in this rapidly growing industry

Medical Billing & Coding For Dummies, 2nd Edition provides aspiring professionals with detailed information and advice on what to expect in a billing and coding career, ways to find a training program, certification options, and ways to stay competitive in the field.

Introduction 1

Part I: Getting to Know Medical Billing and Coding 5

Chapter 1: Dipping Your Toes into Medical Billing and Coding 7

Chapter 2: Exploring the Billing and Coding Professions 17

Chapter 3: Weighing Your Employment Options 31

Part II: Boning Up on the Need]to]Knows of Your Profession 43

Chapter 4: Compliance: Understanding the Rules 45

Chapter 5: Not]So]Strange Bedfellows: Medical Terminology and Medical Necessity 61

Chapter 6: Getting to Know the Payers 85

Part III: Becoming a Professional: Getting Certified 101

Chapter 7: Your Basic Certification Options, Courtesy of the AAPC and AHIMA 103

Chapter 8: The Path to Certification: Finding a Study Program 117

Chapter 9: Signing Up and Preparing for the Certification Exam 137

Chapter 10: Adding Street Cred: Specialty Certifications and Continuing Ed 155

Part IV: Dealing and Succeeding with Nitty]Gritty On]the]Job Details 167

Chapter 11: Processing a Run]of]the]Mill Claim: An Overview 169

Chapter 12: Homing In on How to Prepare an Error]free Claim 187

Chapter 13: From Clearinghouse to Accounts Receivable to Money in the Pocket 203

Chapter 14: Handling Disputes and Appeals 215

Chapter 15: Keeping Up with the Rest of the World 235

Part V: Working with Stakeholders 247

Chapter 16: Dealing with Commercial Insurance Claims 249

Chapter 17: Caring about Medicare 261

Chapter 18: Client Relations and Coding Ethics: Being an Advocate for Your Employer 275

Part VI: The Part of Tens 291

Chapter 19: Ten Common Billing and Coding Mistakes and How to Avoid Them 293

Chapter 20: Ten Acronyms to Burn into Your Brain 299

Chapter 21: Ten (Plus One) Tips from Billing and Coding Pros 303

Glossary 309

Index 319