Ama-HCPCS amakhodi ayizinombolo zeMedarezi ezabela wonke umsebenzi kanye nenkonzo udokotela angase anikeze isiguli. Kukhona amakhodi wezinsizakalo zezokwelapha, zokuhlinza, nokuxilonga. I-HCPCS imelela uhlelo lweCoding System Procedure Coding System.
Njengoba wonke umuntu esebenzisa amakhodi afanayo ukuze asho into efanayo, aqinisekisa ukufana. Isibonelo, kungakhathaliseki ukuthi udokotela ovakashele umuthi we-Medicine (i-HCPCS ikhodi 95115) kungakhathaliseki ukuthi ngumuphi udokotela ovakashela umuthi we-Medicare (ikhodi ye-HCPCS 95115) ozokhokhwa yi-Medicare inani elifanayo omunye udokotela endaweni efanayo esifanayo kuzoba yile nsizakalo efanayo.
Amakhodi wokukhokha we-HCPCS ahlolwe yi-CMS, amaCenter for Medicare neMedicaid Services. Zisekelwe kumakhodi we- CPT ( Amakhodi we- Current Procedural Technology) asethuthukiswe yi-American Medical Association. Amakhodi we-HCPCS alawulwa yi-HIPAA, okudinga zonke izinhlangano zokunakekelwa kwezempilo ukusebenzisa amakhodi ajwayelekile okuthengiswa okubandakanya ulwazi lwezempilo.
Amanothi we-HCPCS Amakhodi nama-Modifier
I-HCPCS ihlanganisa amazinga amabili amakhodi.
- Izinga linezimpawu ze-CPT. Amakhodi we-CPT noma ama-Current Procedural Terminology anamanani ayizinombolo ezingu-5 futhi alawulwa yi-American Medical Association (AMA). Amakhodi we-CPT asetshenziselwa ukukhomba izinsizakalo zezokwelapha nezinqubo eziyalwe odokotela noma ezinye izichwepheshe ezilayisensiwe.
- I-Level II ye-HCPCS yizikhombisi zezinhlamvu eziqukethe incwadi eyodwa ye-alfabhethi elandelwa izinombolo ezine futhi ilawulwa yi-The Centers for Medicare neMedicaid Services (CMS). Lezi zimpawu zikhomba amasevisi angewona odokotela njengamasevisi we-ambulensi, imishini yokwelapha ehlala njalo, kanye nekhemisi. Lezi ngokuvamile azikho izindleko ezidlulelwa ehhovisi likadokotela ngakho kumele ziphathwe yi-Medicare noma i-Medicaid ngokuhlukile ngendlela inkampani yomshuwalense wezempilo ezobhekana nayo.
Amanye amakhodi we-HCPCS adinga ukusetshenziswa kwe-modifiers. Zinezinombolo ezimbili zamadijithi, izinhlamvu ezimbili noma izinhlamvu ze-alphanumeric. Ama-modifiers amakhodi we-HCPCS anikezela ngolwazi olwengeziwe mayelana nenkonzo noma inqubo eyenziwe. Amashintshi asetshenziselwa ukukhomba indawo yomzimba lapho kwenziwa khona inqubo, izinqubo eziningi esimisweni esifanayo, noma ukhombise inqubo eqalisiwe kodwa ishiyiwe.
Ngezinye izikhathi izinsizakalo zihlale zihlanganiswe ndawonye, lapho kwenzeka khona amakhodi abo angahle ahlanganiswe. Lezi zibizwa ngokuthi "amakhodi" .
Ukubaluleka kwabasebenzi bezeMpilo nabahlinzeki
Abahlinzeki kufanele baqaphele imihlahlandlela yekhodi ye-HCPCS yomshuwalense ngamunye ikakhulukazi uma kubhalwa i-Medicare ne-Medicaid. I-Medicare ne-Medicaid ngokuvamile ineziqondiso eziqinile kunezinye izinkampani zomshuwalense.
Abanikezeli kanye nabaphathi behhovisi lezokwelapha kumele baqinisekise ukuthi amakhodi abo ezokwelapha ahlale ehambisana namakhodi we-HCPCS. Amakhodi we-HCPCS abuyekezwa ngezikhathi ezithile ngenxa yamakhodi amasha athuthukiswa ngezinqubo ezintsha namakhodi wamanje abuyekezwa noma alahlwa.
Lapho iziguli zingathola Amakhodi we-HCPCS / CPT
Iziguli zingathola Amakhodi we-HCPCS / CPT kunamba yezindawo. Njengoba usuka ehhovisi likadokotela, unikezwa ukubuyekezwa kokuqokwa kwakho okungahle kube nohlu olude lwezinsizakalo ezingakusiza udokotela wakho azinikezile, ezinye zazo zijikeleze. Izinombolo ezihambisanayo, ngokuvamile amadijithi amahlanu, yiwo amakhodi.
Uma ukuqokwa kwakho kudinga ukukhokha okulandelwayo ngudokotela wakho nge-copays noma co-inshurensi, khona-ke amakhodi angase abe kulawo mabhilikithi.
Umthengi ohlakaniphile nesiguli sokunakekelwa kwezempilo uzosebenzisa lezi zimakhodi ukuze abuyekeze izindleko zezokwelashwa ezivela kubasebenzi, izikhungo zokuhlola, izibhedlela noma ezinye izikhungo.
Yindlela enhle yokuqiniseka ukuthi umshuwalense wakho (kanye ne-co-akho ne-co-inshurensi yakho) ukhokha kuphela lezo zinsizakalo ozitholile.
Uma uthola izitatimende ezivela kudokotela noma umshuwalense wakho wezempilo futhi amakhodi we-HCPCS / CPT awaveli, uxhumane neqembu owabathumele futhi ucele isitatimende esisha esihlanganisa amakhodi.