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Medicare Insider, October 7, 2014

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Hospital Billing From A to Z
 
Charlotte L. Kohler, RN, CPA, CVA, CRCE-I, CPC, ACS, CHBC
 
Hospital billing departments are known by various names, but their staff all experience the same problems understanding and complying with Medicare’s many billing requirements.
 
Hospital Billing From A to Z is a comprehensive, user-friendly guide to hospital billing requirements, with particular emphasis on Medicare. This valuable resource will help hospital billers understand how compliance, external audits, and cost-cutting initiatives affect the billing process.
Beginning with Advance Beneficiary Notice and ending with Zone Program Integrity Contractors, this book addresses 88 topics, including the following:
  • 2-Midnight Rule and Inpatient Admission Criteria
  • Correct Coding Initiative
  • CPT®, HCPCS, Condition Codes, Occurrence Codes, Occurrence Span Codes, Revenue Codes, and Value Codes
  • Denials, Appeals, and Reconsideration Requirements
  • Hospital-Issued Notice of Noncoverage
  • Deductibles, Copayments, and Coinsurance
  • Local and National Coverage Determinations
  • Medically Unlikely Edits and Outpatient Code Editor
  • Medicare Part A and Part B
  • Observation Services
  • Outlier Payments
  • Present on Admission
  • UB-04 Form Definitions



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