Week 2 table sample MedicalRecords

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University of Notre Dame *

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MATH211WEE

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History

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Feb 20, 2024

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docx

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2

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ICD-10 CPT HCPCS Description An ICD code is billable/specific ICD- 10 CM code that can be used to indicate a diagnosis for reimbursement purposes. In 1948 The International classification of Diseases. With the main intention of tracking and helping to eliminate diseases within various populations. ICD codes consist of up to seven characters that classify medical diagnosis in a specific way. The first three characters are letters, and two numbers classify the disease or health condition. Each code starts with a capital letter from A-Z. The letters broadly categorize the nature of the diagnosis. CPT codes are used for administrative management purposes such as claims processing and developing guidelines for medical care review. The AMA first developed and published CPT in 1966. The first edition helped encourage the use of standard terms and descriptions to document procedures in the medical record, helped communicate accurate information on procedures and services to agencies concerned with insurance claims. HCPCS is a standardized code system necessary for medical providers to submit healthcare claims to Medicare and other health insurances in a consistent and orderly manner. HCPCS began in 1978 when the federal government created this coding system to standardize the reporting of medical services to the federal government for reimbursement. Difference ICD-10 codes are related to diagnosis and CPT codes are related to procedures. Differences between ICD-10 and CPT codes lie in their purposes within the healthcare industry. CPT codes, ICD-10 and HCPCS codes all work together to help ensure accurate billing for medical services rendered by providers. The main difference between HCPCS codes and CPT codes lies in their respective focuses. HCPCS codes are primarily used to classify medical supplies, equipment, and services that are not typically covered by CPT codes. But they’re both essential coding systems in healthcare, although they all three serve different purposes. Example 1. ICD-10 1.CPT Codes: “99201 1. HCPCS Codes
CodeZ20.882: billable/specific 2. E10 Type 1 diabetes mellitus a physical exam” 2.CPT Codes: 99214 used for an Office Visit. J9355: “Injection”. 2. G9631: Patient sustained ureter injury. References: 1. Torrey, T. (2023, December 11). ICD 10 codes and how to look them up. Verywell Health. https://www.verywellhealth.com/finding-icd-codes-2615311 2. Admin. (2024, January 12). CPT vs ICD-10 and HCPCS CODES : Coding guide. iRCM Inc. https://ircm.com/blog/cpt-vs-icd10-and-hcpcs-codes/ 3. HCPCS codes - HCPCS level II coding. AAPC. (n.d.). https://www.aapc.com/resources/what- is-hcpcs
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