Momwe Mapulogalamu Otsata Zamankhwala Amakhudzira Thanzi Lanu Labwino
Nthawi zonse mukakhala ndi chithandizo chamankhwala operekedwa kapena chithandizo cha zaumoyo choperekedwa, amalembedwa mu rekodi yanu yachipatala yakutsata ndi kulipira. Zizindikiro za CPT ndi ma HCPCS ndizofanana ndi zolembera zachipatala zofunikira kwa opereka ndi inshuwalansi kutumiza uthenga pakompyuta. Onani momwe amagwiritsidwira ntchito komanso zomwe akutanthauza pa chisamaliro chanu.
Kodi Mapu a CPT ndi ati?
Mapulogalamu a CPT (Common Procedural Technology) ndi nambala zomwe zimagwiritsidwa ntchito pa ntchito iliyonse ndi ntchito yomwe dokotala angapereke kwa wodwalayo kuphatikizapo chithandizo chamankhwala, opaleshoni, ndi chithandizo.
Amagwiritsidwa ntchito ndi a inshuwalansi kuti adziwe kuchuluka kwa kubwezera komwe dokotala adzalandira ndi inshuwalansi pa utumikiwo. Popeza aliyense amagwiritsa ntchito zizindikiro zomwe zimatanthauza chinthu chomwecho, amaonetsetsa kuti ali ofanana.
Chikhombo cha CPT chikuwoneka ngati chikhodi cha majiti asanu opanda malemba, ngakhale ena ali ndi nambala zinayi ndi kalata imodzi. Ena amagwiritsidwa ntchito mobwerezabwereza monga 99213 kapena 99214 (kawirikawiri kufufuza).
Makalata a CPT apangidwa, osungidwa ndi ovomerezedwa ndi AMA (American Medical Association). Monga momwe chithandizo cha zaumoyo chimasinthira, zizindikiro zatsopano zimapangidwira ntchito zatsopano, zizindikiro zamakono zikhoza kubwerezedwa, ndipo zikho zakale, zosagwiritsidwa ntchito sizichotsedwa. Zikwizikwi za ma code zimagwiritsidwa ntchito ndipo zimasinthidwa pachaka.
Kufanana kumvetsetsa chomwe ntchitoyo ndi madokotala osiyanasiyana akubwezeredwa sizingakhale zofanana. Izi zimatsimikiziridwa ndi mgwirizano pakati pa ogwira ntchito ndi omwe ali ndi inshuwalansi.
Mwachitsanzo, Dokotala A akhoza kufufuza (99396) ndikubwezeredwa $ 100 ndi kampani yanu ya inshuwaransi. Ngati munapita ku Dokotala B, kubweza kwake ndi kampani yanu ya inshuwalansi pofuna kufufuza, Code 99396, ikhoza kukhala $ 90 okha.
Kodi ma HCPCS Ma Code ali okhudzana ndi ma CPS Codes?
HCPCS imayimira Healthcare Common Procedure Coding System.
Amagwiritsidwe ntchito ndi kusungidwa ndi Centers for Medicare & Medicaid Services ndipo amagwiritsidwa ntchito kuti adziwe Medicare, Medicaid, ndi ena ambiri omwe amapereka ndalama. Ngati mumagwiritsa ntchito Medicare, mudzawona zizindikiro za HCPCS m'makalata anu.
Pali magawo awiri a zizindikiro. Ma Code Level amachokera ku ma CPT (omwe ali ofanana) ndipo amagwiritsidwa ntchito pazinthu ndi machitidwe omwe amaperekedwa ndi madokotala. Malamulo a Mndandanda wachiwiri amalembera chithandizo chaumoyo ndi njira zomwe siziperekedwa ndi madokotala. Zitsanzo za zinthu zomwe zili ndi zida zapamwamba II ndizo zipangizo zamankhwala, zopereka, ndi ma ambulansi. Zizindikiro Zachiwiri za HCPCS zimayamba ndi kalata ndipo muli ndi manambala anayi. Iwo akhoza kukhala ndi modifiers omwe ali makalata awiri kapena kalata ndi nambala.
Zitsanzo za Mapu a CPT
- 99214 angagwiritsidwe ntchito pa ulendo wa ofesi
- 99397 ikhoza kugwiritsidwa ntchito ngati chithandizo chodziletsa ngati muli ndi zaka zoposa 65
- 90658 imasonyeza kuti chimfine chinagwidwa
- 90716 angagwiritsidwe ntchito pa nkhuku pox vaccine (varicella)
- 12002 ikhoza kugwiritsidwa ntchito kusinthitsa kudula kwa inchi imodzi pa mkono wa wodwalayo
Zizindikiro zina za CPT zimatengedwa . Izi zikutanthauza kuti zimagwiritsidwa ntchito podziphatikiza wina ndi mzake kotero zimalongosola mbali zingapo za chisamaliro.
Maofesi Ogwirizana a CPT ku Mapulogalamu Amene Amaimira
Chidwi chanu m'ma code amenewa nthawi zambiri chimagwirizana ndi madokotala anu ndi inshuwalansi .
Zipangizo Zachiwiri za HCPCS zingapezeke pa intaneti, koma msinkhu umene ndimagwiritsa ntchito ndi zizindikiro za CPT ndizovomerezedwa ndi AMA. AMA imapereka ndalama zothandizira kugwiritsa ntchito zida za CPT ndi kupeza zolemba zonse, zomwe zikutanthauza kuti simungapeze mndandanda waufulu pa intaneti. Pofuna kuti apite kwa odwala mosavuta, AMA imapereka njira zowonera zizindikiro za CPT zomwe mungapeze pa ngongole za dokotala kapena EOB (kulingalira za phindu).
Ngati muli ndi mapepala omwe ali ndi code ya CPT kapena HCPCS pa izo, ndipo mukufuna kudziwa chomwe chiwerengerochi chimayimira, mukhoza kuchita motere:
- Chitani chikhombo cha CPT pa webusaiti ya American Medical Association. Muyenera kulembetsa (kwaulere) ndipo simungathe kufufuza zisanu pa tsiku. Izi zimalola odwala kufufuza chikhombo cha CPT kapena kugwiritsa ntchito mawu ofunikira kuti awone zomwe chiwerengero cha CPT chikhoza kukhala.
- Lumikizani ofesi ya dokotala ndikuwapempha kuti akuthandizeni kuti mufanane ndi ma CPT ndi mautumiki.
- Lankhulani ndi ogwira ntchito akulipira ngongole ndikuwapempha kuti akuthandizeni.
- Kumbukirani kuti zizindikiro zina zingathe kusungidwa koma zingayang'ane mofanana.
- Mndandanda wa makalata a HCPCS wamtundu wachiwiri angapezeke pa webusaiti ya CMS komanso pofufuza mawebusaiti a malo ena ochezera osuta.
Kumene Mungapeze Ma code a CPT mu Zolemba Zanu Zamankhwala ndi Mapepala
Zizindikiro za CPT ndi HCPCS zimapezeka ndikugwiritsidwa ntchito pamapepala osiyanasiyana ndi zolemba ngati mukusintha kudzera mwachithandizo chilichonse chaumoyo. Mauthenga angagwiritsidwe ntchito kuti adziwe chirichonse kuchokera pa matenda anu mpaka mtengo wa chisamaliro chanu chaumoyo.
- Pamene mukuchoka ku dokotala kapena mutatulutsidwa kuchipatala kapena kuchipatala china, mumapatsidwa mapepala omwe akuphatikizapo chidule chazinthu zomwe akupatsani. Makhalidwe asanu amtunduwu ndi ma code CPT kapena ma HCPCS (ngati mumagwiritsa ntchito Medicare). Pali zizindikiro zina pa mapepala, nawonso. Ena angakhale ma ICD , omwe angakhale nawo manambala kapena makalata ndipo kawirikawiri amakhala ndi mfundo zapamwamba.
- Mukalandira kalata kuchokera kwa dokotala, musanayitumize kulipira kwanu (inshuwalansi kapena Medicare), idzakhala ndi mndandanda wa mautumiki. Pambuyo pa utumiki uliwonse udzakhala nambala ya madijiti asanu. Ndiyo code CPT kapena HCPCS code.
- Mukalandira EOB, Kufotokozera Ubwino , kuchokera kwa Wopereka (inshuwalansi, Medicare kapena ena), izo ziwonetsa kuchuluka kwa ntchito iliyonse yomwe inalipidwa m'malo mwathu. Monga kalata ya dokotala, utumiki uliwonse udzakhala wogwirizana ndi code yake ya CPT kapena HCPCS.
Momwe Amapereka ndi Ogwirizira Amagwiritsa Ntchito Ma CPT ndi HCPCS Ma Code
- Makalata a CPT ndi HCPCS amakhudza kwambiri ndalama za wothandizira. Momwemonso, iwo amadziwika kwambiri momwe kuwerengera kumachitika ndipo nthawi zambiri amagwiritsa ntchito zipangizo zamakono kapena zamakalata kuti azionetsetsa kuti ndondomekoyi imalembedwa molondola.
- Ofesi yanu ya udokotala nthawi zambiri imayamba njira yolembera. Ngati agwiritsira ntchito mawonekedwe a mapepala, adzazindikira pa zomwe CPT zimagwirira ntchito pa ulendo wanu. Ngati amagwiritsa ntchito mbiri yachipatala paulendo wanu, zidzatsimikiziridwa mu dongosolo.
- Mutachoka ku ofesi ya dokotala, zolemba zanu zimayang'aniridwa ndi makalata a zachipatala ndi mabanki kuti apereke zizindikiro zolondola. Zolembera zanu ndiye pitani kulipira kuti mupereke mndandanda wa mautumiki omwe munapatsidwa kwa inshuwalansi kapena wobwereketsa. Madokotala ndi zipangizo zambiri amagwiritsira ntchito njira zamagetsi kuti asunge ndi kutumiza uthenga uwu, ngakhale kuti ena angakhale akuchitidwa ndi makalata kapena fax.
- Ndondomeko yanu yaumoyo kapena wothandizira monga Medicare ndiye mugwiritse ntchito zizindikirozo kuti mugwirizane ndi chiwerengero chanu ndikudziwe kuchuluka kwa momwe mungabwezerere dokotala wanu.
- Ofufuza a boma ndi boma amagwiritsa ntchito deta kuchoka ku coding kuti awone zochitika zachipatala ndikudziwe bajeti ya Medicare ndi Medicaid.
- Makampani a inshuwalansi ya zaumoyo ndi olemba masewera a boma amagwiritsira ntchito deta yolongosola kuti adziwonetse ndalama zamtsogolo zothandizira odwala m'mayendedwe awo.
Mawu Ochokera
Kukhala wodwala wodziwa zambiri ndi mbali yotsimikizirani kuti mumalandira chithandizo chamankhwala chabwino kwambiri. Mukawona chinachake chimene simukuchidziwa mu rekodi yanu yachipatala kapena ngongole, kambiranani ndi wothandizira zaumoyo kapena inshuwalansi. Muli ndi ufulu wogwira ntchito mwakhama poonetsetsa kuti chithandizo chanu chaumoyo chikuyendetsedwa bwino.
> Zotsatira:
> Njira ya CPT®: Momwe Code Yakhalira Code. AMA. https://www.ama-assn.org/practice-management/cpt%C2%AE-process-how-code-becomes-code.
> HCPCS_Coding_Maganizo. Malo a CMS.gov a Medicare & Medicaid Services. https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/HCPCS_Coding_Questions.html. Idasindikizidwa pa July 22, 2013.