ABSTRACT
This Viewpoint discusses the legal risks physicians and health care facilities may incur by miscoding a surgical or chemical abortion as a miscarriage to conceal an abortion procedure.
Subject(s)
Abortion, Induced , Abortion, Legal , Clinical Coding , Female , Humans , Pregnancy , Abortion, Induced/legislation & jurisprudence , Abortion, Legal/legislation & jurisprudence , Hospitals , Clinical Coding/legislation & jurisprudence , Clinical Coding/standards , Legislation, Hospital , Legislation, Medical , Liability, LegalABSTRACT
This article addresses coding and liability related to obstetric and gynecologic ultrasound examinations. The coding section includes an overview of general concepts, highlighting the differences between coding in hospital-owned facilities and provider-owned clinics. It also addresses the importance of correct International Classification of Diseases, 10th edition, coding, emphasizing the use of the most specific applicable codes. This section discusses proper coding and applicable parameters for early pregnancy and gynecologic ultrasound examination. The liability section addresses common errors leading to litigation in obstetric and gynecologic ultrasound practice. Examples are given demonstrating how such errors lead to liability actions.
Subject(s)
Clinical Coding/legislation & jurisprudence , Fetus/diagnostic imaging , Genitalia, Female/diagnostic imaging , Gynecology/legislation & jurisprudence , Obstetrics/legislation & jurisprudence , Ultrasonography/standards , Clinical Coding/methods , Clinical Coding/standards , Diagnostic Imaging , Female , Gynecology/economics , Gynecology/standards , Humans , Liability, Legal , Obstetrics/economics , Obstetrics/standards , Pregnancy , Radiology/economics , Radiology/legislation & jurisprudence , Radiology/standards , Ultrasonography/economics , Ultrasonography/methodsABSTRACT
The American Academy of Pediatrics provides this technical report as supplemental background to the accompanying coding and valuation system policy statement. The rapid evolution in health care payment modeling requires that clinicians have a current appreciation of the mechanics of service representation and valuation. The accompanying policy statement provides recommendations relevant to this area, and this technical report provides a format to outline important concepts that allow for effective translation of bedside clinical events into physician payment.
Subject(s)
Clinical Coding , International Classification of Diseases , Pediatrics , Relative Value Scales , Centers for Medicare and Medicaid Services, U.S. , Clinical Coding/legislation & jurisprudence , Current Procedural Terminology , Health Insurance Portability and Accountability Act , Humans , Medicare Access and CHIP Reauthorization Act of 2015 , United StatesSubject(s)
Clinical Coding , Medicare , Reimbursement Mechanisms , Centers for Medicare and Medicaid Services, U.S. , Clinical Coding/legislation & jurisprudence , Government Regulation , Humans , Medicare/economics , Medicare/legislation & jurisprudence , Physician-Patient Relations , Reimbursement Mechanisms/legislation & jurisprudence , Reimbursement, Incentive/legislation & jurisprudence , United States , Value-Based Health InsuranceABSTRACT
No disponible
Subject(s)
Humans , Clinical Coding/organization & administration , Clinical Coding/standards , Quality Assurance, Health Care/legislation & jurisprudence , International Classification of Diseases/legislation & jurisprudence , Clinical Coding/legislation & jurisprudence , Reference Standards , International Classification of Diseases/standards , International Classification of DiseasesSubject(s)
Chronic Disease/economics , Clinical Coding/legislation & jurisprudence , Fees, Medical/legislation & jurisprudence , General Practice/legislation & jurisprudence , National Health Programs/legislation & jurisprudence , Reimbursement Mechanisms/legislation & jurisprudence , Chronic Disease/therapy , Clinical Coding/economicsSubject(s)
Clinical Coding/economics , Clinical Coding/legislation & jurisprudence , Fees, Medical/legislation & jurisprudence , General Practice/economics , General Practice/legislation & jurisprudence , Medical History Taking , National Health Programs/economics , National Health Programs/legislation & jurisprudence , Reimbursement Mechanisms/economics , Reimbursement Mechanisms/legislation & jurisprudence , Germany , HumansSubject(s)
Blood Transfusion, Autologous/economics , Blood Transfusion, Autologous/legislation & jurisprudence , Fees, Medical/legislation & jurisprudence , Immunization, Passive/economics , National Health Programs/economics , National Health Programs/legislation & jurisprudence , Reimbursement Mechanisms/economics , Reimbursement Mechanisms/legislation & jurisprudence , Tendinopathy/economics , Tendinopathy/therapy , Clinical Coding/economics , Clinical Coding/legislation & jurisprudence , General Practice/economics , General Practice/legislation & jurisprudence , Germany , Humans , Insurance Coverage/economics , Insurance Coverage/legislation & jurisprudenceSubject(s)
After-Hours Care/economics , After-Hours Care/legislation & jurisprudence , Clinical Coding/economics , Clinical Coding/legislation & jurisprudence , Electronic Mail/economics , Electronic Mail/legislation & jurisprudence , Referral and Consultation/economics , Referral and Consultation/legislation & jurisprudence , Fee Schedules/economics , Fee Schedules/legislation & jurisprudence , General Practice/economics , General Practice/legislation & jurisprudence , Germany , Humans , Reimbursement Mechanisms/economics , Reimbursement Mechanisms/legislation & jurisprudenceSubject(s)
Clinical Coding/economics , Clinical Coding/legislation & jurisprudence , Fee Schedules/legislation & jurisprudence , National Health Programs/economics , National Health Programs/legislation & jurisprudence , Referral and Consultation/economics , Referral and Consultation/legislation & jurisprudence , Reimbursement Mechanisms/economics , Reimbursement Mechanisms/legislation & jurisprudence , Germany , HumansSubject(s)
After-Hours Care/economics , After-Hours Care/legislation & jurisprudence , General Practice/economics , General Practice/legislation & jurisprudence , Reimbursement Mechanisms/economics , Reimbursement Mechanisms/legislation & jurisprudence , Clinical Coding/economics , Clinical Coding/legislation & jurisprudence , Germany , HumansSubject(s)
Chronic Disease/economics , Chronic Disease/therapy , Clinical Coding/economics , Clinical Coding/legislation & jurisprudence , Cooperative Behavior , Fee Schedules/legislation & jurisprudence , Interdisciplinary Communication , National Health Programs/economics , National Health Programs/legislation & jurisprudence , Reimbursement Mechanisms/economics , Reimbursement Mechanisms/legislation & jurisprudence , Germany , HumansSubject(s)
Chronic Disease/economics , Chronic Disease/therapy , Clinical Coding/economics , Clinical Coding/legislation & jurisprudence , Fee Schedules/legislation & jurisprudence , National Health Programs/economics , National Health Programs/legislation & jurisprudence , Reimbursement Mechanisms/legislation & jurisprudence , Germany , HumansSubject(s)
Clinical Coding/economics , Clinical Coding/legislation & jurisprudence , General Practice/economics , General Practice/legislation & jurisprudence , Health Services for the Aged/economics , Health Services for the Aged/legislation & jurisprudence , Aged , Cooperative Behavior , Germany , Humans , Interdisciplinary Communication , National Health Programs/economics , National Health Programs/legislation & jurisprudence , Reimbursement Mechanisms/economics , Reimbursement Mechanisms/legislation & jurisprudenceABSTRACT
This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or "2015 Edition'') and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying the ONC Health IT Certification Program to make it open and accessible to more types of health IT and health IT that supports various care and practice settings. The 2015 Edition establishes the capabilities and specifies the related standards and implementation specifications that Certified Electronic Health Record Technology (CEHRT) would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs (EHR Incentive Programs) when such edition is required for use under these programs.
Subject(s)
Certification/legislation & jurisprudence , Electronic Health Records/legislation & jurisprudence , Health Information Exchange/legislation & jurisprudence , Health Information Exchange/standards , Medical Informatics/legislation & jurisprudence , American Recovery and Reinvestment Act , Clinical Coding/legislation & jurisprudence , Clinical Coding/standards , Computer Security/legislation & jurisprudence , Computer Security/standards , Cost-Benefit Analysis , Electronic Health Records/standards , Humans , Meaningful Use/legislation & jurisprudence , Meaningful Use/standards , Medicaid/legislation & jurisprudence , Medicaid/standards , Medical Informatics/standards , Medicare/legislation & jurisprudence , Medicare/standards , Privacy/legislation & jurisprudence , United StatesABSTRACT
The International Classification of Diseases (ICD) standardizes diagnostic codes into meaningful criteria to enable the storage and retrieval of information regarding patient care. Whereas other countries have been using ICD, 10th Revision (ICD-10), for years, the United States will transition from ICD, Ninth Revision, Clinical Modification (ICD-9-CM), to ICD-10, on 1 October 2015. This transition is one of the largest and most technically challenging changes that the medical community has experienced in the past several decades. This article outlines the implications of moving to ICD-10 and recommends resources to facilitate the transition.