Iikhowudi ze-ICD-10 zichaphazela njani ukunakekelwa kwakho kunye ne-Wallet yakho
Kuthatha iminyaka yemfundo noqeqesho ukufundisa oogqirha izakhono ezifunekayo ukuvavanya isigulane, ukuxilonga, nokunyanga loo mntu ngokomgangatho wokunyamekela. Ngo-2015, ungcoliseko olutsha lwenkcenkceshelo lwongeziweyo oluchaphazelayo okanye ingaba isicwangciso sakho se-inshorensi siya kuhlawula ukunyamekela kwakho - utshintsho kwiikhowudi zokuxilonga.
Indlela yokuYilwa kweeMali
Unokuthatha ikhosi ukuqonda iingxaki zeentlawulo zezokwelapha , kodwa oko ufuna ngokwenene ukuba yimiba yenkcitho echaphazela wena kwiqondo lakho.
Ngendlela elula, ugqirha wakho uvavanya wena, ukhetha ikhowudi yokuxilonga ukufanisa imeko yakho, kwaye ukhetha ikhowudi yokukhokha ngokusekelwe kwintloni yokutyelela kwakho. Nawuphi na uvavanyo oluyalelwe ukuba ludibaniswe nekhowudi yokuxilongwa. Olu lwazi luya kubhekiswa kwinkampani yakho yomshuwalense, i- Medicare ifakiwe, ngoko ugqirha wakho uhlawula inkonzo yakhe.
Ukuba ugqirha wakho akayi kukhetha ikhowudi yokuchonga, kufanelekile ukuba isicwangciso sakho se-inshurensi asiyi kuhlawula ukunyamekela kwakho. Okukushiya ukuhlawula kuphela i- copay okanye i-coinsurance yovavanyo okanye ukutyelela kodwa inani elipheleleyo leedola.
Utshintsho kwi-ICD-9 ukuya kwiikhowudi ze-ICD-10
Ulwahlulo lwaMazwe ngamazwe lweZifo libhokisi leethuluzi lokuxilongwa. Kwiphepha le-10 (i-ICD-10) ukususela ngo-1990, olu luhlu lokuxilongwa lusetyenziswa emhlabeni jikelele ukulandelela izifo nokufa kwabantu. Iikhowudi zokuxilongwa ngokuzimeleyo ziphucula nokukwazi ukulandelela amanyathelo ezempilo, ukubeka esweni iimeko zempilo, nokuphendula kwimingcipheko yempilo.
I-United States, nangona kunjalo, yayicotha ukufumana iikhowudi zakutshanje kwaye ayizange ishintshe ukusuka kwi-ICD-9 ukuya kwi-ICD-10 ukuya ku-Oktobha 2015.
Kukho iikhowudi zokuxilonga ezingakumbi kunokuba unokucinga. Inani leendlela zokuncedisa unonophelo lwezempilo kufuneka ukhethe ngokunyuka ngokukhawuleza ngo-Oktobha 2015. Kukho iikhowudi ezingama-155 000 ezifumaneka kwikhompyutheni ka-2015 ye-ICD-10 xa kuthelekiswa neikhowudi ezili-17 000 kwi-ICD-9.
Ngo-2018, kuya kubakho iikhowudi ezintsha ezingama-363, ii-142 ezingenakwenziwa, kunye ne-226 iikhowudi ezihlaziyiweyo.
Olu lwazi olwandisiwe lwenza kube nzima oogqirha ukuba bafumane iikhowudi abayidingayo ukuze bafumane i-inshorensi yokuhlawula. Uphononongo olwenziwa yi-Healthcare Management Management Systems Society lubonisa ukuba kuphela iipesenti ezingama-63 zekhowudi ze-ICD-10 ezichanileyo. Iimpazamo ezingaphezulu zokukhokha zingakhokelela kuwe ukuhlawula ngaphezu kwesabelo sakho esilungileyo.
Ukukhetha i-Code efanelekileyo
Ukufumana ingcamango yinkimbinkimbi ye-ICD-10, jonga kwizikhalazo eziphezulu zokuphefumula. I-rhinitis ye-allergen (i-pitny runner kwi-allergies) ine-ncinane iikhowudi ezi-6 ezahlukileyo zokukhetha, iikhompyliya ezingama-20, iikhompsi ze-asthma ezili-15, i- influenza 5 ikhowudi, iikhowudi ze- sinusitis ezingama-21, kunye neenkohlakalo ezi- 7 zomlomo . Ezi zilula.
Iimeko ezinzima ezifana nexinzelelo lwentliziyo zineendlela ezininzi zokuxilongwa ezibonisa indlela imeko ehambelana ngayo nesifo senhliziyo, isifo sesifo, ukukhulelwa, kunye nokunye. Isifo sikashukela sinamakhodi amaninzi. Kukho iikhowudi ezintathu zokubethwa ngento ewayo kwisikhephe! Unokuzihlaziya kwaye ufune iikhowudi kumaziko e-Medicare ne-Medicaid (CMS) iwebhusayithi.
Umzekelo: I-Medicare ihlawulisa kuphela ukuxinwa kweethambo ukuhlola ukunyuka kwe-osteoporosis ukuba kukho iikhowudi ezithile ze-ICD-10. I-Medicare iya kukhanyela ukukhutshwa kwekhowudi ye-ICD-10 M85.80, "nezinye izinto ezichaziweyo zethambo kunye nesakhiwo, indawo engachazwanga", kodwa iya kuvuma ukubuyisela i-M85.81x-M85.89x, iikhowudi ezichaza indawo (iinyawo, unyawo, ingxube, isandla, umlenze ophantsi, umxhwele, intamo, ingalo engaphezulu, okanye izingosi ezininzi) kunye ne-laterality (kwesobunxele okanye kwesokudla) yesifo se-bone, oko kukuthi, i-M85.822, "ezinye izifo ezichaziweyo zethambo kunye nesakhiwo, .
Oku kukugqithisa njengokuba kukho ezinye iikhowudi eziza kubandakanya ukuxilongwa kwethambo. Nangona kunjalo, kulula ukubona indlela enye idijithi enye inokugqiba isigqibo sokuba ubani ohlawula unyamekeleyo, wena okanye wakho umshwalense.
Ukubhena Kwimeko Yakho
Emva kokutshintshwa kwe-ICD-10 ngo-2015, amaziko e-Medicare kunye neeNkonzo zeMedicaid (i-CMS) avunyelwe unyaka owodwa wenceba yeenjongo zokuhlawula. Ukubeka nje, i-CMS inike oogqirha ukuba banike iinyanga ezili-12. Ngethuba nje loogqirha babhala kwisigqibo esifanelekileyo kwisifo, nokuba ngaba bekungekho ikhowudi ekhethiweyo, abayi kuhlawulwa yi-CMS kwaye kufuneka unyamekele. Oko akusona kunjalo.
Ukuba naliphi na ixesha ufumana ibhajethi engacingi ukuba kufuneka uhlawule, qhagamshelana neofisi yakho yegqirha. Kungenzeka ukuba baye basebenzisa ikhowudi ye-ICD-10 engalunganga. Ugqirha wakho unokukwazi ukutshintsha ikhowudi yokuxilongwa kumntu onika i-inshorensi oyifunayo.
ILizwi
Oogqirha besazi kakuhle kulondolozo lwezonyango kunokuba ityala lonyango. Ngamaxwebhu angaphezu kwe-155 000 ICD-10 ekhoyo, kungenzeka ukuba ugqirha wakho angakhetha into engalunganga. Ukuba i-Medicare yenqaba ukuhlawulwa kweenkonzo ngenxa yephutha lokubhala, ushiywe ukuhlawula ephaketheni. Yazi amalungelo akho. Finyelela kwi-ofisi yakho yokuhlawula i-ofisi yeenkonzo zokunikwa iinkonzo zempilo xa ufumanisa nayiphi na ukungqinelani kwintlawulo yakho.
> Imithombo:
> 2018 ICM-10 CM kunye nee-GEMs. Amasebe e-Medicare ne-Medicaid Services website. https://www.cms.gov/Medicare/Coding/ICD10/2018-ICD-10-CM-and-GEMs.html. Ukuhlaziywa nge- 8/11/2017.
> I-Bone Mass Measurement ICD-10 IiNkonzo eziNgciniweyo zibuyekeziwe. Ikholeji yase-American College of Radiology. https://www.acr.org/Advocacy/Economics-Impilo-Inqubomgomo/UkuCelwa-Coding/Coding-Source-List/2016/March-April-2016/Bone-Mass-Measing-ICD-10-Ukukhutshwa- Iinkonzo- Ukuhlaziywa.
> Herman, B. Ngu-63% kuphela we-ICD-10 Documentation echanekileyo ngokuCoded. Iwebhusayithi yeNgxelo ye-Hospital ye-Hospital ye-Becker. http://www.beckershospitalreview.com/finance/report-only-63-of- > icd > -10-amaxwebhu-echanekileyo-coded.html. Ipapashwe ngo-Oktobha 24, 2013.
> I-ICD-10 Code Khangela. Amasebe e-Medicare ne-Medicaid Services website. https://www.cms.gov/medicare-coverage-database/staticpages/icd-10-code-lookup.aspx.
> Ukwahlulelwa kweZizwe ngezizwe (ICD). Iwebhusayithi Yempilo Yehlabathi. http://www.who.int/classifications/icd/en/.