What medisoft database contains the unique chart numbers of patients

Presentation On Medical Insurance

Medical Insurance A Revenue Cycle Process Approach

Eighth Edition

Joanne D. Valerius, RHIA, MPH Oregon Health & Science University

Nenna L. Bayes, AAS, BBA, M.Ed., CPC Ashland Community and Technical College, Retired

Cynthia Newby, CPC, CPC-P

Amy L. Blochowiak, MBA, ACS, AIAA, AIRC, ARA, FLHC, FLMI, HCSA, HIA, HIPAA, MHP, PCS, SILA-F

Northeast Wisconsin Technical College

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MEDICAL INSURANCE: A REVENUE CYCLE PROCESS APPROACH, EIGHTH EDITION

Published by McGraw-Hill Education, 2 Penn Plaza, New York, NY 10121. Copyright ©2020 by McGraw-Hill Education. All rights reserved. Printed in the United States of America. Previous editions ©2017, 2014, and 2012. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of McGraw-Hill Education, including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning.

Some ancillaries, including electronic and print components, may not be available to customers outside the United States.

This book is printed on acid-free paper.

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ISBN 978-1-259-60855-1 (bound edition) MHID 1-259-60855-7 (bound edition) ISBN 978-1-260-48911-8 (loose-leaf edition) MHID 1-260-48911-6 (loose-leaf edition)

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Library of Congress Cataloging-in-Publication Data

Names: Valerius, Joanne, author. Title: Medical insurance : a revenue cycle process approach / Joanne D.  Valerius, RHIA, MPH [and three others]. Description: Eighth edition. | New York, NY : McGraw-Hill Education, [2020] Identifiers: LCCN 2018043777| ISBN 9781259608551 (alk. paper) | ISBN  1259608557 (alk. paper) Subjects: LCSH: Health insurance. | Health insurance claims—United States. |  Health insurance—United States. Classification: LCC HG9383 .B39 2020 | DDC 368.38/2014—dc23 LC record available at https://lccn.loc.gov/2018043777

The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a website does not indicate an endorsement by the authors or McGraw-Hill Education, and McGraw-Hill Education does not guarantee the accuracy of the information presented at these sites.

mheducation.com/highered

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https://lccn.loc.gov/2018043777
https://mheducation.com/highered
iii

Preface ix

Part 1 WORKING WITH MEDICAL INSURANCE AND BILLING 1

Chapter 1 Introduction to the Revenue Cycle 2

Chapter 3 Patient Encounters and Billing Information 71

Part 2 CLAIM CODING 105

Diagnostic Coding: ICD-10-CM 106

Procedural Coding: CPT and HCPCS 137

Visit Charges and Compliant Billing 189

Chapter 4

Chapter 5

Chapter 6

Part 3 CLAIMS 217

Chapter 7 Healthcare Claim Preparation and Transmission 218

Chapter 8 Private Payers/ACA Plans 259

Chapter 9 Medicare 302

Chapter 10 Medicaid 338

Chapter 11 TRICARE and CHAMPVA 360

Chapter 12 Workers’ Compensation and Disability/Automotive Insurance 377

Part 4 CLAIM FOLLOW-UP AND PAYMENT PROCESSING 401

Chapter 13 Payments (RAs), Appeals, and Secondary Claims 402

Chapter 14 Patient Billing and Collections 434

Chapter 15 Primary Case Studies 458

Chapter 16 RA/Secondary Case Studies 495

Brief Contents

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Chapter 2 Electronic Health Records, HIPAA, and HITECH: Sharing and Protecting Patients’ Health Information 33

Part 5 HOSPITAL SERVICES 509

Chapter 17 Hospital Billing and Reimbursement 510

Appendix A: Place of Service Codes A-1

Appendix B: Professional Websites B-1

Appendix C: Forms C-1

Abbreviations AB-1

Glossary GL-1

Index IN-1

iv Brief Contents

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v

Contents

Preface ix

Part 1 WO NSURANCE RKING WITH MEDICAL I BILLING

AND 1

Chapter 1 Introduction to the Revenue Cycle 2  1.1 Working in the Medical Insurance Field 3  1.2 Medical Insurance Basics 6  1.3 Healthcare Plans 8  1.4 Health Maintenance Organizations 11  1.5 Preferred Provider Organizations 15  1.6 Consumer-Driven Health Plans 15  1.7 Medical Insurance Payers 16  1.8 The Revenue Cycle 18  1.9 Achieving Success 23 1.10 Moving Ahead 26 Chapter Review 27

Cha Patie Infor 3.1 N 3.2 In 3.3 In 3.4 V

In 3.5 D

R 3.6 D 3.7 W

pter 3 nt Encounters and Billing mation 71 ew Versus Established Patients 72 formation for New Patients 72 formation for Established Patients 81

erifying Patient Eligibility for surance Benefits 83 etermining Preauthorization and Referral equirements 86 etermining the Primary Insurance 89 orking with Encounter Forms 91

Chapter 2 Electronic Health Records, HIPAA, and HITECH: Sharing and Protecting Patients’ Health Information 33  2.1 Medical Record Documentation: Electronic

Health Records 34  2.2 Healthcare Regulation: HIPAA, HITECH,

and ACA 40  2.3 Covered Entities and Business Associates 43  2.4 HIPAA Privacy Rule 45  2.5 HIPAA Security Rule 53  2.6 HITECH Breach Notification Rule 54  2.7 HIPAA Electronic Health Care Transactions

and Code Sets 56  2.8 Omnibus Rule and Enforcement 58  2.9 Fraud and Abuse Regulations 60 2.10 Compliance Plans 61 Chapter Review 63

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vi Contents

 3.8 Understanding Time-of-Service (TOS) Payments 93

 3.9 Calculating TOS Payments 95 Chapter Review 99

Part 2 CLAIM CODING

Chapter 4 Diagnostic Coding: ICD-10-CM 106  4.1 ICD-10-CM 107  4.2 Organization of ICD-10-CM 108  4.3 The Alphabetic Index 109  4.4 The Tabular List 112  4.5 ICD-10-CM Official Guidelines for Coding and

Reporting 116  4.6 Overview of ICD-10-CM Chapters 123  4.7 Coding Steps 127  4.8 ICD-10-CM and ICD-9-CM 129 Chapter Review 131

Chapter 5 Procedural Coding: CPT and HCPCS 137  5.1 Current Procedural Terminology (CPT),

Fourth Edition 138  5.2 Organization 140  5.3 Format and Symbols 144  5.4 CPT Modifiers 147  5.5 Coding Steps 150  5.6 Evaluation and Management Codes 152  5.7 Anesthesia Codes 165

105  5.8 Surgery Codes 167  5.9 Radiology Codes 171  5.10 Pathology and Laboratory Codes 173  5.11 Medicine Codes 174  5.12 Categories II and III Codes 175  5.13 HCPCS 176 Chapter Review 183

Chapter 6 Visit Charges and Compliant Billing 189  6.1 Compliant Billing 190  6.2 Knowledge of Billing Rules 190  6.3 Compliance Errors 194  6.4 Strategies for Compliance 195  6.5 Audits 198  6.6 Physician Fees 201  6.7 Payer Fee Schedules 202  6.8 Calculating RBRVS Payments 204  6.9 Fee-Based Payment Methods 205 6.10 Capitation 208 6.11 Collecting Time of Service (TOS) Payments and

Checking Out Patients 209 Chapter Review 211

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Part 2

Contents vii

Part 3 CLAIMS

Chapter 7

217

2Healthcare Claim Preparation and Transmission 218  7.1 Introduction to Healthcare Claims 219  7.2 Completing the CMS-1500 Claim: Patient

Information Section 220  7.3 Types of Providers 227  7.4 Completing the CMS-1500 Claim: Physician/

Supplier Information Section 227  7.5 The HIPAA 837P Claim 240  7.6 Completing the HIPAA 837P Claim 243  7.7 Checking Claims Before Transmission 249  7.8 Clearinghouses and Claim Transmission 250 Chapter Review 252

Chapter 8 Private Payers/ACA Plans 259  8.1 Group Health Plans 260  8.2 Types of Private Payers 263  8.3 Consumer-Driven Health Plans 267  8.4 Major Private Payers and the BlueCross

BlueShield Association 270  8.5 Affordable Care Act (ACA) Plans 273  8.6 Participation Contracts 275  8.7 Interpreting Compensation

and Billing Guidelines 279  8.8 Private Payer Billing Management: Plan

Summary Grids 285  8.9 Preparing Correct Claims 287 8.10 Capitation Management 293 Chapter Review 294

Chapter 9 Medicare 302  9.1 Eligibility for Medicare 303  9.2 The Medicare Program 303  9.3 Medicare Coverage and Benefits 305  9.4 Medicare Participating Providers 310  9.5 Nonparticipating Providers 316  9.6 Original Medicare Plan 319

 9.7 Medicare Advantage Plans 320  9.8 Additional Coverage Options 32  9.9 Medicare Billing and Compliance 323 9.10 Preparing Primary Medicare Claims 328 Chapter Review 331

Chapter 10 Medicaid 338 10.1 The Medicaid Program 339 10.2 Eligibility 339 10.3 State Programs 342 10.4 Medicaid Enrollment Verification 345 10.5 Covered and Excluded Services 349 10.6 Plans and Payments 350 10.7 Third-Party Liability 352 10.8 Claim Filing and Completion Guidelines 352 Chapter Review 355

Chapter 11 TRICARE and CHAMPVA 360 11.1 The TRICARE Program 361 11.2 Provider Participation and

Nonparticipation 361 11.3 TRICARE Prime 363 11.4 TRICARE Select 364 11.5 CHAMPVA 365 11.6 Filing Claims 367 Chapter Review 370

Chapter 12 Workers’ Compensation and Disability/ Automotive Insurance 377 12.1 Federal Workers’ Compensation Plans 378 12.2 State Workers’ Compensation Plans 379 12.3 Workers’ Compensation Terminology 381 12.4 Claim Process 383 12.5 Disability Compensation and Automotive

Insurance Programs 389 Chapter Review 393

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viii Contents

Part 4 CLAIM FOLLOW-UP AND PAYMENT PROCESSING 401

res 442Chapter 13 Payments (RAs), Appeals, and Secondary Claims 402 13.1 Claim Adjudication 403 13.2 Monitoring Claim Status 406 13.3 The RA 410 13.4 Reviewing RAs 416 13.5 Procedures for Posting 417 13.6 Appeals 419 13.7 Postpayment Audits, Refunds,

and Grievances 422 13.8 Billing Secondary Payers 423 13.9 The Medicare Secondary Payer (MSP) Program,

Claims, and Payments 424 Chapter Review 429

Chapter 14 Patient Billing and Collections 434 14.1 Patient Financial Responsibility 435 14.2 Working with Patients’ Statements 438 14.3 The Billing Cycle 439 14.4 Organizing for Effective Collections 440

14.5 Collection Regulations and Procedu 14.6 Credit Arrangements and Payment Plans 447 14.7 Collection Agencies and Credit

Reporting 449 14.8 Writing Off Uncollectible Accounts 452 14.9 Record Retention 454 Chapter Review 454

Chapter 15 Primary Case Studies 458 15.1 Method of Claim Completion 459 15.2 About the Practice 459 15.3 Claim Case Studies 465

Chapter 16 RA/Secondary Case Studies 495 16.1 Completing Secondary Claims 496 16.2 Handling Denied Claims 496 16.3 Processing Medicare RAs and Preparing

Secondary Claims 498 16.4 Processing Commercial Payer RAs and

Preparing Secondary Claims 500 16.5 Calculating Patients’ Balances 502

Part 5 HOSPITAL SERVICES 509

Chapter 17 Hospital Billing and Reimbursement 510 17.1 Healthcare Facilities: Inpatient Versus

Outpatient 511 17.2 Hospital Billing Cycle 512 17.3 Hospital Diagnosis Coding 521 17.4 Hospital Procedure Coding 523 17.5 Payers and Payment Methods 525 17.6 Claims and Follow-Up 530 Chapter Review 541

Appendix A: Place of Service Codes A-1

Appendix B: Professional Websites B-1

Appendix C: Forms C-1

Abbreviations AB-1

Glossary GL-1

Index IN-1

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Part 5

ix

Preface

S te

p 9

Ste

p 1 0

Step 1 Step 2

Step 3

Step 8

Step 7 Step 6

St ep

5

S te

p 4

Revenue Cycle

Preregister patients

Establish

responsibility

Check in patients

Check out patients

Review billing compliance

Prepare and transmit claims

Monitor payer

adjudication

Generate patient

statements

Follow up payments

and collections

Review coding compliance

Follow the Money! Medical insurance plays an important role in the financial well-being of every healthcare business. The regulatory environment of medical insurance is now evolving faster than ever. Changes due to healthcare reform require medical office professionals to acquire and maintain an in-depth understanding of compliance, electronic health records, medi-

cal coding, and more.

The eighth edition of Medical Insurance: A Revenue Cycle Process Approach emphasizes the revenue cycle—ten steps that clearly iden- tify all the components needed to successfully manage the medical insurance claims process. The cycle shows how administrative medical professionals “follow the money.”

Medical insurance specialists must be familiar with the rules and guidelines of each health plan in order to submit proper docu- mentation. This ensures that offices receive maximum, appropriate reimbursement for services provided. Without an effective administrative staff, a medical office would have no cash flow!

The following are some of the key skills covered for you and your students in Medical Insurance, 8e:

Skills Coverage

Procedural Learning administrative duties important in medical practices as well as how to bill both payers and patients

Communication Working with physicians, patients, payers, and others using both written and oral communication

Health information management

Using practice management programs and electronic health records technology to manage both patient records and the billing/ collections process, to electronically transmit claims, and to con- duct research

Medical coding Understanding the ICD-10, CPT, and HCPCS codes and their importance to correctly report patients’ conditions on health insur- ance claims and encounter forms as well as the role medical cod- ing plays in the claims submission process

HIPAA/HITECH Applying the rules of HIPAA (Health Insurance Portability and Accountability Act) and HITECH (Health Information Technology for Economic and Clinical Health act) to ensure compliance, maximum reimbursement, and the electronic exchange of health information

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x Preface

Medical Insurance is available with McGraw-Hill Education’s revolutionary adaptive learning technology, McGraw-Hill SmartBook®! You can study smarter, spending your valuable time on topics you don’t know and less time on the topics you have already mastered. Succeed with SmartBook. . . . Join the learning revolution and achieve the success you deserve today!

Organization of Medical Insurance, 8e An overview of the book’s parts, including how they relate to the steps of the revenue cycle, follows:

Part Coverage

1: Working with Medical Insurance and Billing

Covers Steps 1 through 3 of the revenue cycle by introducing the major types of medical insurance, payers, and regulators, as well as the steps of the cycle. Also covers HIPAA/HITECH Privacy, Security, and Electronic Health Care Transactions/Code Sets/Breach Notification rules.

2: Claim Coding Covers Steps 4 through 6 of the revenue cycle while building skills in correct coding procedures, using coding references, and comply- ing with proper linkage guidelines.

3: Claims Covers Step 7 of the revenue cycle by discussing the general procedures for calculating reimbursement, how to bill compliantly, and preparing and transmitting claims.

4: Claim Follow-Up and Payment Processing

Covers Steps 8 through 10 of the revenue cycle by describing the major third-party private and government-sponsored payers’ proce- dures and regulations along with specific filing guidelines. Also explains how to handle payments from payers, follow up and appeal claims, and correctly bill and collect from patients. This part includes two case stud- ies chapters that provide exercises to reinforce knowledge of complet- ing primary/secondary claims, processing payments from payers, and handling patients’ accounts. The case studies in Chapter 15 can be completed using Connect for simulated exercises. The case studies in Chapter 16 can be completed using the CMS-1500 form.

5: Hospital Services Provides necessary background in hospital billing, coding, and payment methods.

New to the Eighth Edition Medical Insurance is designed around the revenue cycle with each part of the book dedicated to a section of the cycle followed by case studies to apply the skills discussed in each section. The revenue cycle now follows the overall medical documentation and revenue cycle used in practice management/electronic health records environments and applications.

Medical Insurance offers several options for completing the case studies at the end of Chapters 8–12 and throughout Chapter 15:

• Paper Claim Form: If you are gaining experience by completing a paper CMS-1500 claim form, use the blank form supplied to you (from the back of Medical Insurance) and follow the instructions in the text chapter that is appropriate for the particular payer to fill in the form by hand.

• Connect Simulations: The ability to understand and to use Electronic Health Records (EHR) systems are critical job skills and competencies required for employment in a Medical Office or Hospital. In the past, teaching students the hows and whys of using an EHR has been challenging. Live software solutions require complex installation and support, and often don’t translate well into the classroom. Simulated educational solutions often fall short in giving students the realistic experience of working in real world scenarios.

McGraw-Hill Education is proud to introduce EHRclinic, the educational EHR solution that provides the best of both worlds, both the experience of working in a

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Preface xi

live, modern EHR application, along with the convenience and reliability of simu- lated educational solutions.

EHRclinic is integrated into Connect, McGraw-Hill’s digital teaching and learning environment that saves students and instructors time while improving performance over a variety of critical outcomes.

For Medical Insurance, Connect provides simulated, auto-graded exercises in mul- tiple modes to allow the student to use EHRclinic to complete the claims. If assigned this option, students should read the User Guide at www.mhhe.com/valerius as the first step, and then follow the instructions with each chapter’s case studies. Note: some data may be prepopulated to allow students to focus on the key tasks of each exercise.

• Connect CMS-1500 Form Exercises: Another way to complete the claims exercises is by using the CMS-1500 form exercises in Connect if directed by your instructor. These exercises allow you to complete the necessary fields of the form in an auto- graded environment.

•

Please note that starting with this edition, we will no longer be offering live Medisoft® or Medisoft simulations as part of the options.

Key content features include the following.

• Pedagogy •

Learning Outcomes reflect the range of difficulty levels to teach and assess crit- ical thinking about medical insurance and coding concepts and continue to reflect the revised version of Bloom’s Taxonomy.

• Objective end-of-chapter questions cover all Learning Outcomes.

• HIPAA-Related Updates •

2018 ICD-10-CM and CPT/HCPCS codes are included.

• The new Notice of Privacy Practices (NPP) that addresses disclosures in compli- ance with HITECH is illustrated.

• Key Chapter Changes •

Chapter 1: New: Thinking It Through 1.7. Revised: Thinking It Through 1.2. Updated: statistics and data in Figures 1.1 and 1.4; Compliance Guideline on ICD-10-CM implementation.

• Chapter 2: New: two HIPAA/HITECH Tips on Texting and Plans Mandated; PHI on the cloud. Updated: four WWW features on HHS, Medical Notice of Privacy Practices, HHS Breach Notifications, and CMS HIPAA Enforcement. Deleted: old Figures 2.1, 2.2, and 2.6; information on the National Health Information Network.

• Chapter 3: Deleted: old Figure 3.7. • Chapter 4: Updated: all ICD-10-CM codes and conventions for 2018; Figures 4.1

and 4.3; Case 4.1 in Applying Your Knowledge. Deleted: key term ICD-9-CM. • Chapter 5: New: Billing Tips on Category III Code Sunsets and Revised Guide-

lines Coming; symbol for telemedicine. Updated: all CPT codes, conventions, and modifiers for 2018; WWW features on CPT Updates, AMA Vaccine Code Updates, and Category II and III Updates; all cases in Applying Your Knowledge; Tables 5.2, 5.3, and 5.6; structure of E/M section. Deleted: symbol for moderate sedation.

• Chapter 6: New: image for Figure 6.3. Revised: Figures 6.1 and 6.2. Updated: Case 6.1 in Applying Your Knowledge.

• Chapter 7: New: key terms 5010A1 version and Healthcare Provider Taxonomy Code (HPTC); text for 5010A1 Version and the CMS-1500. Revised: Figure 7.1; art in Cases 7.2, 7.3, and 7.4. Updated: all conventions for completing the CMS-1500 and all Item Numbers; WWW features on POS Codes, Current Taxonomy Code Set, and All Administrative Code Sets for HIPAA Transactions. Deleted: old Fig- ures 7.2, 7.3, 7.4, 7.5, 7.6, and 7.8; old Table 7.1; Billing Tip on How Many Pointers?

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https://www.mhhe.com
xii

•

Chapter 8: New: item in Thinking It Through 8.9. Revised: Figures 8.5, 8.7, 8.9, and 8.10; Case 8.4 introduction and art. Updated: high-deductible health plan deductibles; out-of-pocket limits for metal plans in section 8.5.

• Chapter 9: New: key terms Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medicare Beneficiary Identifier (MBI), Quality Payment Pro- gram (QPP); Figure 9.1; WWW features on New Medicare Card Information and QPP; Medicare coverage text in section 9.3; Medicare incentives text in section 9.4. Revised: WWW feature on Beneficiary Preventive Services; Figures 9.7 and 9.9; Applying Your Knowledge introduction; Cases 9.1, 9.2, and 9.3. Updated: Billing Tips on Medicare Part A and Part B; WWW features on Medicare FFS Provider Web Pages Bookmark and Medicare Physician Fee Schedule; Thinking It Through 9.8. Deleted: key terms Medicare health insurance claim number (HICN), Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (VBPM); WWW feature on MPFS Online.

•

i

Chapter 10: New: Thinking It Through 10.7. Revised: Figure 10.5; Applying Your Knowledge introduction; Cases 10.1 and 10.2. Updated: Medicaid info in intro; Medicaid changes in section 10.1; WWW feature on CHIP; websites in Table 10.1; covered services in section 10.5.

• Chapter 11: New: key terms Prime Service Area, TRICARE For Life, TRICARE Select; section 11.3 on TRICARE Prime; section 11.4 on TRICARE Select; Figure 11.1. Revised: Figure 11.2; Review Questions section; Applying Your Knowl- edge Introduction; Cases 11.1, 11.2, and 11.3. Updated: TRICARE regions in sec- tion 11.6. Deleted: key terms catchment area, nonavailability statement (NAS), TRICARE Extra, TRICARE Prime Remote, TRICARE Reserve Select, TRICARE Standard, TRICARE Young Adult (TYA); old Figures 11.1, 11.2, 11.3; Compliance Guideline on Preauthorization.

• Chapter 12: Revised: Figure 12.2; Applying Your Knowledge introduction; Cases 12.1 and 12.2.

• Chapter 13: Revised: Figures 13.1 and 13.8; Thinking It Through 13.3 and 13.5. Updated: key term claim adjustment group code (CAGC); Medicare appeals costs n section 13.6. Deleted: question D in Case 13.2.

• Chapter 14: Revised: chart in section 14.2; Thinking It Through 14.2; Figures 14.3 and 14.4. Deleted: old Figures 14.3a, 14.3b, and 14.3c; relating statements to the PMP section.

• Chapter 15: Updated: all CPT codes, conventions, and modifiers for 2018; Updated: Patient Account Number section so students no longer assign patient chart num- bers; Updated: Dates for each case study.

• Chapter 16: Updated: Dates for each case study. • Chapter 17: New: Figure 17.3; WWW feature on Medicare Secondary Payer Ques-

tionnaire; NUBC information on electronic claim submission. Updated: Compli- ance Guideline What Determines the Correct Code Set for Hospital Coding?

For a detailed transition guide between the seventh and eighth editions, visit the Instructor Resources in Connect.

Preface

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xiii

Workbook for Use with Medical Insurance: A Revenue Cycle Process Approach, Eighth Edition (1-260-48914-0, 978-1-260-48914-9)

The Workbook for Use with Medical Insurance has excellent material for reinforcing the text content, applying concepts, and extending understanding. It combines the best features of a workbook and a study guide. Each workbook chapter enhances the text’s strong pedagogy through:

•

Assisted outlining—reinforces the chapter’s key points • Key terms—objective questions • Critical thinking—questions that stimulate process understanding • Guided web activities—exercises to build skill in locating and then evaluat-

ing information on the Internet • Application of concepts—reinforcements and extensions for abstracting

insurance information, calculating insurance math, and using insurance terms

The workbook matches the text chapter by chapter. It reinforces, applies, and extends the text to enhance the learning process.

Medical Coding Workbook for Physician Practices and 2018–2019 Edition (1-259-63002-1, 978-1-259-63002-6) The Medical Coding Workbook provides practice and instruction in coding and using compliance skills. Because medical insurance specialists verify diagnosis and procedure codes and use them to report physicians’ services, a fundamental understanding of cod- ing principles and guidelines is the basis for correct claims. The coding workbook rein- forces and enhances skill development by applying the coding principles introduced in Medical Insurance, 8e, and extending knowledge through additional coding guidelines, examples, and compliance tips. It offers more than seventy-five case studies that simulate real-world application. Also included are inpatient scenarios for coding that require com- pliance with ICD-10-CM Official Guidelines for Coding and Reporting sequencing rule as explained in Chapter 17 of the text.

Preface

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For Instructors You’re in the driver’s seat. Want to build your own course? No problem. Prefer to use our turnkey, prebuilt course? Easy. Want to make changes throughout the semester? Sure. And you’ll save time with Connect’s auto-grading too.

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