The essential guide for medical billing professionals, updated for ICD-11 standards
Medical Billing & Coding For Dummies will set you up for success in getting started as a medical biller and coder. To ensure data accuracy and efficient data processing, medical offices need professionally trained coders to handle records. This book provides prospective allied health professionals with everything they need to know to get started in medical billing and coding as a career. In addition to an introduction to the basics of medical coding, you'll get information on how to find a training course, meet certification requirements, and deal with government agencies and insurance companies. Learn about the standard practices in the medical billing industry and get up to speed on the ethical and legal issues you're likely to face on the job. This accessible guide is a great entry point—and a great refresher—for anyone interested in the medical billing and coding profession.
- Get a primer on your career options in the field of medical billing
- Learn coding practices for telehealth, viral outbreaks, and other emerging issues
- Update your knowledge of the changes between ICD-10 and ICD-11 coding systems
- Find training programs and explore your options for certification
This Dummies guide is an accessible entry point for prospective professionals looking get a jump on their new career, and current professionals intent on staying up-to-date in this flexible and growing field.
Table of Contents:
Introduction 1
Part 1 Getting to Know Medical Billing and Coding 5
Chapter 1 Dipping Your Toes into Medical Billing and Coding 7
Chapter 2 Exploring the Billing and Coding Professions 17
Chapter 3 Weighing Your Employment Options 31
Part 2 Boning Up on the Need-to-Knows of Your Profession 43
Chapter 4 Compliance Understanding the Rules 45
Chapter 5 Not-So-Strange Bedfellows Medical Terminology and Medical Necessity 61
Chapter 6 Getting to Know the Payers 87
Part 3 Becoming a Professional Getting Certified 105
Chapter 7 Your Basic Certification Options, Courtesy of the AAPC and AHIMA 107
Chapter 8 The Path to Certification Finding a Study Program 121
Chapter 9 Signing Up and Preparing for the Certification Exam 141
Chapter 10 Adding Street Cred Specialty Certifications and Continuing Ed 161
Part 4 Dealing and Succeeding with Nitty-Gritty On-the-Job Details 173
Chapter 11 Processing a Run-of-the-Mill Claim An Overview 175
Chapter 12 Homing In on How to Prepare an Error-Free Claim 193
Chapter 13 From Clearinghouse to Accounts Receivable to Money in the Pocket 211
Chapter 14 Handling Disputes and Appeals 223
Chapter 15 Keeping Up with the Rest of the World 245
Part 5 Working with Stakeholders 253
Chapter 16 Dealing with Commercial Insurance Claims 255
Chapter 17 Caring about Medicare and Medicaid 267
Chapter 18 Coding Ethics Being an Advocate for Your Employer 281
Part 6 The Part of Tens 297
Chapter 19 Ten Billing and Coding Mistakes and How to Avoid Them 299
Chapter 20 Ten Acronyms to Burn into Your Brain 305
Chapter 21 Ten (Plus One) Tips from Billing and Coding Pros 311
Glossary 317
Index 325
About the Author :
Karen Smiley, CPC, is a certified coding expert in physician and out-patient reimbursement with an extensive background as a coder, auditor, and accounts receivable manager.
