Iikhowudi ze-HCPCS ziinombolo zamagciwane azinikezela kuwo wonke umsebenzi kunye nenkonzo ugqirha unokunika isiguli. Kukho iikhowudi nganye kwinkonzo yezobugqirha, ukuhlinzwa kunye nokuxilonga. I-HCPCS imele iNkqubo yeCoding System yeCandelo leMpilo.
Ekubeni bonke abantu basebenzisa iikhowudi ezifanayo ukuthetha into efanayo, baqinisekisa ukulingana. Ngokomzekelo, kungakhathaliseki ukuba ugqirha ogqirha kwi-Medicare uvakatye ntoni kwi-injection ye-allergies (i-HCPCS ikhowudi 95115) ugqirha uya kuhlawulwa ngu-Medicare umlinganiselo ofanayo omnye ugqirha kuloo ndawo iya kuba yinto enjalo.
Iikhowudi zokuhlawula i-HCPCS zilawulwa yi-CMS, amaziko e-Medicare kunye neeNkonzo zeMedicaid. Zisekelwe kwiikhowudi ze-CPT ( iikhowudi zeNkcazo zeNkqubo zeNkqubo zangoku) eziphuhliswe yi-American Medical Association. Iikhowudi ze-HCPCS zilawulwa yi-HIPAA, efuna yonke imibutho yokunakekelwa kwezempilo isebenzise iikhowudi eziqhelekileyo zokuthengiselana ezibandakanya ulwazi lwezempilo.
Amanqanaba eikhowudi zeHCPCS kunye nabaguqula
I-HCPCS ifaka amanqanaba amabini eikhowudi.
- Inqanaba ndiqukethe iikhowudi ze-CPT. Iikhowudi ze-CPT okanye i-Current Procedural Terminology zenziwe ngamanani anama-5 kwaye zilawulwa yi-American Medical Association (AMA). Iikhowudi ze-CPT zisetyenziselwa ukuchonga iinkonzo zonyango kunye neenkqubo eziyalelwe ngamagqirha okanye nabanye abaqeqeshi abanelayisenisi.
- Inqanaba II le-HCPCS yiinkcukacha zee-alphanumeric eziqulethwe yileta enye ye-alfabhethi elandelwa ngamanani amane kwaye ilawulwa yi-Centres ye-Medicare ne-Medicaid Services (CMS). Ezi khowudi zichonga iinkonzo ezingezizo ugqirha ezifana neenkonzo ze-ambulensi, izixhobo zonyango ezizinzileyo kunye nekhemisi. Ezi ngokuqhelekileyo azikho iindleko ezigqityiweyo kwiofisi yonyango ukuze zijongane ne-Medicare okanye iMedicaid ngokwahlukileyo kwindlela inkampani ye-inshorensi yempilo eya kubaphatha ngayo.
Ezinye iikhowudi ze-HCPCS zifuna ukusetyenziswa kweenguqulelo. Ziqukethe inombolo yeenombini ezimbini, iileta ezimbini okanye iilwimi ze-alphanumeric. I-modifier code ye-HCPCS inikezela ngolwazi olongezelelweyo malunga nenkonzo okanye inkqubo eyenziwa. Izilungiso zisetyenziselwa ukuchonga indawo yomzimba apho kwenziwa inkqubo, iinkqubo ezininzi kwiseseshoni efanayo, okanye zibonisa ukuba inkqubo yaqalwa kodwa yavalwa.
Ngamanye amaxesha iinkonzo zihlala ziqokelelene kunye, apho apho iikhowudi zabo zingabalwa. Ezi zibizwa ngokuba yi "khowudi" .
Kubaluleka kwabasebenzi bezeMpilo kunye nababoneleli
Ababoneleli kufuneka baqaphele iikhowudi zekhowudi ze-HCPCS kwi-inshurensi nganye ngakumbi xa i-Medicare ne-Medicaid zibiza. I-Medicare kunye neMedicaid bafumana izikhokelo ezingaphezulu kunezinye i-insurers.
Ababoneleli kunye nabaphathi beeofisi zezobugcisa kufuneka baqinisekise ukuba amakhowudi abo ezokwelapha ahlale efikelele kwiikhowudi ze-HCPCS. Iikhowudi ze-HCPCS zihlaziywa rhoqo ngenxa yamakhowudi amatsha aphuhliswayo kwinkqubo entsha kunye neendlela ezikhoyo zihlaziywa okanye zilahlwa.
Apho izigulane zinokufumana iikhowudi ze-HCPCS / CPT
Izigulane zifumana iikhowudi ze-HCPCS / CPT kwiindawo ezininzi. Njengoko ushiya iofisi yegqirha, unikezelwa ukuhlaziywa kokuqeshwa kwakho okungekho uluhlu olude lweenkonzo ezinokuthi ugqirha wakho unikezele, ezinye zazo zijikeleze. Amanani anxulumene, ngokuqhelekileyo amadijithi amahlanu, iikhowudi.
Ukuba ukuqeshwa kwakho kudinga ukuhlawulwa kokulandelwa ngugqirha wakho kwiipayili okanye i-inshurensi ye-co-ordinates, ke iikhowudi zingase zibekwe kuloo mabhili.
Isigulane esisilumko kunye nabathengi abanonophelo lwezempilo baya kusebenzisa ezi khowudi ukuphonononga ukuhlawulwa kwezonyango kwizonyango , amaziko okuvavanya, izibhedlele okanye ezinye izibonelelo.
Yindlela efanelekileyo yokuqinisekisa ukuba i-inshurensi yakho (kunye ne-co-co-insurance kunye ne-inshurensi yakho) ihlawula kuphela ezo nkonzo ozifumene.
Ukuba ufumana ingxelo evela kumgqirha okanye kwi- inshurensi yempilo kwaye ikhowudi ye-HCPCS / CPT ayibonakali, qhagamshelana neqela elibathumeleyo kwaye ucele isitatimende esitsha esibandakanya iikhowudi.