Ukwenza i-coding yezokwelapha kuyona nto ibalulekileyo ekufumaneni i-inshuwalansi kunye nokugcina iirekhodi zesigulane. Amabango okuqhafaza ngokuchanekileyo avumele ukuba umntu ohlawula i-inshorensi azi ukugula okanye ukulimala kwesigulane kunye nendlela yokonyango. Izigulana ziyakwazi ukubona ezi khowudi kwiirekhodi zabo zonyango okanye kwiibhili.
Iinkqubo eziqhelekileyo zeeNkcukacha zoLonyango
Iikhowudi ze-CPT ziphuhliswe yi-American Medical Association ukuchonga iikhowudi ezisetyenziswa rhoqo ngabagqirha ababonelela ngeenkonzo kwiofisi yezokwelapha.
Ezi khowudi zihlaziywa ngonyaka. Zine-copyright ze-AMA kwaye iiofisi zonyango zifaka imali kwi-software ezibandakanya utshintsho oluqhubekayo okanye ukuthenga iikhowudi ezihlaziyiweyo rhoqo ngonyaka. Abo bangathengi ezi zixhobo banokujonga iikhowudi ezili-12 ngaphandle kwentlawulo ngokubhalisa kwiwebhusayithi ye-AMA.
Iikhowudi ze-HCPCS ziphuhliswe yi-CMS (amaziko e-Medicare kunye neeNkonzo zeMedicaid) ukuchonga iikhowudi ezisetyenziswa rhoqo kwizibonelelo zesibhedlele, ukubonelela kunye neziyobisi. Ziyiikhowudi zeefayili kunye neleta enye elandelwa ngamanani amane.
Ininzi Inkqubo Yonyango Yokusetyenziswa Kwezonyango
Iikhowudi eziqhelekileyo ezisetyenziswayo ziinkqubo zoVavanyo kunye noLawulo (E / M), eziyinxalenye yenkqubo yekhowudi ye-CPT. Zibandakanyiwe kumanqanaba amanani ukusuka ku-90000 ukuya ku-99999. Zizodwa ngokubhekiselele kwisicwangciso seenkonzo (isisiphene, isigulane, isifo esiphuthumayo, indawo yokunesiza) kunye neentlobo ezahlukeneyo zeemviwo (ingxaki ejoliswe kuyo, ingxaki eyongeziweyo ingqwalasela, ingcaciso, kwaye olubanzi).
Ezi ziintandathu zeendlela zonyango ezisetyenziswa ngokuqhelekileyo.
- Ukuvakasha kweeNtsholongwane ezitsha (99201-05): Ezi khowudi zonyango zisetyenziselwa ukubhalwa izigulane ezingazange zibonwe naluphi na ugqirha ekhethekileyo kwiqela elifanayo kule minyaka emithathu edlulileyo. 99201: Ugxininiso lweengxaki. 99202: Inkxalabo eyongeziweyo. 99203: Inkcukacha. 99204: Iphelele, i-moderation. 99205: Epheleleyo, ephakamileyo.
- Ukunyulwa kweeNdwendwe zoLuntu oluPhezulu (99211-15): Ezi khowudi zonyango zisetyenziselwa ukunyulwa kwezigulane eziye zabonwa naluphi na ugqirha ekhethekileyo kwiqela elinye kule minyaka emithathu edlulileyo. 99212: Ugxininiso lweengxaki. 99213: Ingxaki ewandisiweyo. 99214: Inkcukacha. 99215: Inkcazelo.
- Ukunyamekwa kweZibhedlele zokuqala kwiMpilo entsha okanye eyagxilwe (99221-23): Ezi khowudi zonyango zisetyenziselwa ukubhalwa kwezigulane ezivunyelwe esibhedlele.
- 99231-23: Ukunakekelwa kweSibhedlele esilandelayo
- 99281-85: Ukutyelela iSebe eliPhezulu
- 99241-45: Iingxoxo zeeHhovisi. Ezi zigulane zifuna umbono wegqirha ngesicelo somnye ugqirha. 99241: Ugxininiso lweengxaki. 99242: Inkxalabo eyongeziweyo. 99243: Inkcukacha. 99244: Ukuqonda, ukulinganisela. 99245: Iphelele, ephakamileyo.
Inqanaba lenkonzo lixhomekeke kumaxwebhu embali, ukuhlolwa ngokomzimba kunye nokwenza izigqibo zonyango. Ugqirha kufuneka anikezele iinkcukacha ezaneleyo zokuxhasa inqanaba lenkonzo. Ukutyelela okujoliswe ngxaki kuhlalutya enye kwizinto ezinhlanu ngaphakathi kwenkqubo. Ukutyelela okujoliswe ngongxaki kwandisiweyo kuhlola ubuncinane ubuncinci. Uhambo oluthe ngqo luvavanya ubuncinane ubuncinane ezimbini kwiinkqubo ezithandathu okanye izinto ezili-12 kwiinkqubo ezimbini okanye ngaphezulu.
Uvavanyo olunzulu luvavanya lonke uphononongo lweenkqubo, ukuchonga enye okanye ezimbini kwiinkqubo nganye.
Ukongeza kwi-coding echanekileyo yonyango, amabango ezokwelapha kufuneka ahlawulwe ngokudibanisa neefowuni zeenkonzo ezongezelelweyo ezenziwe eofisini, i-modifiers ehambelanayo, ukuba kuyimfuneko, kunye ne-ICD-9 okanye iikhowudi zokuxilongwa.
Umthombo:
Choat DE. Ukukhokhwa kwenkqubo kunye nemisebenzi. Iikliniki kwiColon kunye noBuqhwala obuPhezulu . 2005; 18 (04): 279-284. i-doi: 10.1055 / s-2005-922852.