Imigaqo Eyisiseko yeCoding Coding

Izikhokelo zeMfuno zeCoder Izidingo zokuzi

Ikhowudi yezokwelapha iququzelela inkqubo yokuhlawula ngokuzisa ukulingana kwenkqubo ngokusebenzisa iinkcukacha ezibonakalayo. Ukusebenzisa iikhowudi eziqhelekileyo zokuxilongwa kunye neenkqubo zenkqubo ezibonwa yiinkampani zomshuwalense , zonke iinkqubo zonyango, kunye nee-arhente ezichaphazelekayo ezichaphazelekayo, i-coder yezokwelapha iya kuqinisekisa ukuba iinkampani zomshuwalense, umrhumeli wezorhwebo, okanye amaziko e- Medicare kunye neMedicaid (i-CMS) baya kuqonda into ehlawulweyo kunye nendlela ukuxilongwa kuqinisekisa ukuba inkqubo, uvavanyo okanye unyango.

Nangona kukho iindlela ezininzi ezahlukeneyo zokubhala ngekhowudi ngokusekelwe kwizodwa zonyango, kukho imigaqo ethile ebalulekileyo yokwenza ikhowudi eya kuhlala ikhona.

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Ikhowudi kuphela Yimqulu

Umsebenzi wengcali ugqirha irekhodi yonyango kunye nenkcazo echanekileyo yazo zonke iinkonzo, iimvavanyo kunye neenkqubo ezichanekileyo njengoko zenziwe kwaye zichaneke ngokufanelekileyo ngempawu zesigulane, izikhalazo, izimo, izifo kunye nokulimala. Njenge-coder yezokwelapha, kubalulekile ukuba iikhowudi ezirekhodiweyo kwiibango zonyango zihambelana namaxwebhu angaphandle kwirekhodi yezokwelapha.

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Bika iikhowudi kwi-Order echanekileyo

Akukuphela nje ukubhalwa kwenkcazo yokuxilongwa kunye neenkqubo ngokuchanekileyo ngokusemandleni kubalulekile, ukubhalwa kwikhowudi ngokuchanekileyo kubalulekile. Ikhowudi yokuqala yisoloko isisizathu esithile sokuvakatyezelwa kwesigulane nangona xa kukho ezinye izifo okanye izibonakaliso okanye nokuba kukho iinkqubo ezininzi.

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Landela i-NCCI ne-MUE Guidelines

I-Medicare neMedicaid ineentlukwano ezincinci malunga nemigaqo yokubhalisa kunezinye iibhorensi. Iikhowudi kufuneka zixele iinqununu zenkonzo ngokusekelwe kwiNkqubo yeCoding Coding Initiative (NCCI) kunye noHlelo olungabonakaliyo lweMveli (IMUEs). Oku kwenziwa ukwenzela ukuthintela ukunika iinkonzo ezininzi okanye iinkqubo ezingafaneleki ukuba zihlawuliswe kunye kuba inkonzo enye okanye inkqubo inokubandakanya enye okanye ngenxa yokuba kungenakwenzeka ukuba unyango luyenze kwisigulane esifanayo ngosuku olufanayo.

I-National Coding Initiative Initiative (NCCI) yasungulwa ngamaziko e-Medicare kunye neeNkonzo zeMedicaid (CMS) ukukhusela i-Medicare engafanelekanga kunye neentlawulo zeMedicaid ngenxa yokuphulwa kweefayile. Kukho iintlobo ezintathu ze-NCCI ezihleliweyo:

1. Ukulungiswa kwenkqubo-nkqubo-nkqubo : Le mihla ichaza iikhowudi ze-HCPCS kunye ne-CPT ezingafanele zihlawuliswe ngokudibana kunye. Ukuba ezi khowudi zihlawuliswa kunye enye okanye zombini zingavunyelwa.
2. Ukuguqulwa kwemilingo engenakwenzeka : Le mihla ichaza iikhowudi ze-HCPCS kunye ne-CPT ngenani elithile leeyunithi ezingenakwenzeka ukuba zihlawulwe ukuba ibango lichanekile. Kwamanye amaxesha, iiyunithi zenkonzo ziya kunqatshwa ukuba zidlula oko kubonwa ukuba kuyimfuneko yempilo.
3. Ukongezwa kwekhodi yokongeza : Ezi mpi zithintela ukuhlawulwa kweekhowudi ezongezelelweyo ezibhekwa njengenxalenye yeekhowudi eziphambili ze-CPT kunye ne-HCPCS.

Kaninzi

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Hlalani ku-Up-to-Date kwiCoding Changes

Ibango elichanekileyo lixhomekeke kwizinto ezininzi. Ukuhlala ufikelele kwiinguqulelo zonyaka zokulandela ikhowudi, ukulandela izikhokelo zokugcina iinkcukacha kunye nokugcina iirekhodi ezigulane eziqhelekileyo ziindlela ezilula zokuqinisekisa ukuba iimfuno zonyango zichanekile.

Amabango okukhangela ngokuchanekileyo avumela ukuba umntu ohlawula i-inshorensi azi iimpawu, ukugula, okanye ukulimala kwesigulane kunye nendlela yokonyango eyenziwa ngugqirha.

Iiposiso zeCoding zenzeka xa ibango lingeniswa kwikhampani yomshuwalense enexilongo engafanelekanga okanye ikhowudi yenqubo kwibango. Ukungena ngokungekho kakuhle kungakhokelela kwiziphumo ezininzi ezingalunganga. Kubalulekile ukuba iofisi yezobugcisa ivelise inkqubo yokuthobela inokuthintela ukuphulwa kweemfuno zokunikwa kwezokwelapha.

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Sebenzisa iiNguqulelo ezifanelekileyo

Ezinye iikhowudi ze-CPT kunye ne-HCPCS zifuna ukusebenzisa i-modifiers. Ziqukethe inombolo yeenombini ezimbini, iileta ezimbini okanye iilwimi ze-alphanumeric. I-CPT kunye ne-HCPCS ikhowudi yokuguqula inikezela ngolwazi olongezelelweyo malunga nenkonzo okanye inkqubo eyenziwa.

Ngamanye amaxesha abaguquleli basebenzisa ukuchonga indawo yomzimba apho kwenziwa inkqubo, iinkqubo ezininzi kwiseseshoni efanayo, okanye zibonisa ukuba inkqubo yaqalwa kodwa yavalwa. Abaguqulwayo abatshintshi inkcazo yenkqubo yeenkqubo ezidibeneyo.

Iimpawu eziphambili zeMenu:

• Azikho zonke iinguqulelo ezingasetyenziswa nazo zonke iikhowudi ze-CPT kunye ne-HCPCS
• Jonga kwiNkqubo yeCoding Coding Initiative (NCCI) ye-National Health Coroding Initiative (NCCI)
• Qwayelana nezixhobo eziguqulwayo okanye zisetyenziswe ngokungalunganga
• Ukuchithwa okungafanelekanga kwenkqubo yokuguqula ikhowudi kunokubangela ukulibazisa okanye ukunciphisa intlawulo

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