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A USER'S GUIDE TO MEDICAL CLAIMS PROCESSING        

    $245.00        Available CD ROM

This all-in-one reference manual is the key to efficient claims processing. The layout is easy to follow, explained in everyday language that is useful from the beginner to the most proficient claims examiner. This is a wonderful training tool and daily resource guide. Accurate claims processing results in fewer adjustments and fewer appeals!

Key Benefits

bulletAssistant Surgery - List of surgical codes that do not allow an assistant surgeon
bulletBilateral Procedures - List of procedure codes that are bilateral by definition and are not subject to the bilateral increase of 150% or 200% of the benefit
bulletClaim Forms - A complete layout of the CMS-1500 and UB-04 forms and full field descriptions
bulletAmbulatory Surgical Centers - Complete list of ASC groupers
bulletAnesthesia - Easy-to-follow instructions on how to process anesthesia claims. It lists the services that are included in this benefit and not paid separately, base units, and a cross-reference table identifying the surgical code and the corresponding general anesthesia code
bulletModifiers - All modifiers are listed with their meaning
bulletSurgery - How to pay multiple surgery, procedure codes not subject to multiple surgery reduction, procedure codes with follow-up days and much more

List of tables

Explanation of field numbers on CMS-1500 form

Explanation of field numbers on UB-04 form

Description of discharge status codes

Description of occurrence codes

Description of value codes

Description of revenue codes

Code number of patient's relationship to insured

Medicare ASC groupers

Description of modifiers

Codes not subject to the bilateral adjustment increase

Procedure codes that allow a surgical tray

Surgical procedure codes not subject to multiple surgery reduction

Procedure codes that do not allow an assistant at surgery

Procedure codes included in the global surgical package within a designated follow-up period

Procedure codes with 10 follow-up days

Procedure codes with 90 follow-up days

Anesthesia base units

Description of anesthesia modifiers

Description of physical status modifiers

Anesthesia special circumstance procedure codes

Crosswalk converting surgical procedure codes into general anesthesia codes

 

CMS-1500 Reference Guide (formerly HCFA-1500)

    $9.99

Colorized, laminated, 2-sided guide for commonly used field definitions on the CMS-1500 form (formerly known as the HCFA-1500 form).. 8 1/2 x 11

Key Benefits

bulletPlace of service codes
bulletCommonly used alpha modifiers
bulletNumeric modifiers
bulletTransportation modifiers
bulletUseful quick reference guide for answers at your fingertips!

UB-04 Reference Guide

 $9.99

Colorized, laminated, 2-sided guide for commonly used field definitions on the UB-04 form.  8 1/2 x 11

Key Benefits

bulletType of bill codes. Easily identifies inpatient, outpatient, late charges, and interim services
bulletSource of admission codes
bulletDischarge status codes
bulletAdmission/discharge hours converted from military time
bulletType of admission codes (easy identifier for emergency and urgent care services)
bulletAccident occurrence codes (important COB identifier!)
bulletAccess at your fingertips important field definitions that could cost money if unrecognized!

 

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