Indlela Amakhodi E-ICD-10 Athinta Ukunakekelwa Kwenu Ne-Wallet Yakho
Kuthatha iminyaka emfundo nokuqeqesha ukufundisa odokotela amakhono adingekayo ukuze ahlolisise isiguli, ahlolisise futhi aphathe lowo muntu ngokwezinga lokunakekelwa. Ngo-2015, isendlalelo esisha sobunzima esiyinkimbinkimbi esithinta noma ngabe uhlelo lwakho lomshuwalense luzokhokhela ukunakekelwa kwakho - ushintsho lwamakhodi okuxilongwa.
Indlela Ukukhokhwa Kwezimali KwezeMpilo kusebenza kanjani
Ungathatha inkambo ukuqonda izinkinga zokukhokha kwezokwelapha , kodwa lokho okudingayo ngempela ukuthi yiziphi izici zokukhokha ezithinta wena ezingeni lomuntu siqu.
Ngendlela elula, udokotela wakho uhlola, ukhetha ikhodi yokuxilonga ukuze afane nesimo sakho, futhi ukhetha ikhodi yokukhokha ngokusekelwe kwinkimbinkimbi yokuvakasha kwakho. Noma yikuphi ukuhlolwa okufakiwe kufanele kuhlanganiswe nekhodi yokuxilongwa. Lolu lwazi luqondiswa inkampani yakho yomshuwalense, uMedare ufakiwe, ngakho udokotela wakho uyakhokhwa ngenkonzo yakhe.
Uma udokotela wakho engayitholi ikhodi efanele yokuxilongwa, kungenzeka ukuthi uhlelo lwakho lomshuwalense ngeke lukhokhele ukunakekelwa owutholile. Lokhu kukushiya ukuthi ukhokhe kuphela i- copay noma i-coinsurance yokuhlolwa noma uvakashele kodwa inani eligcwele lama dollar.
Ukushintsha kusuka kuma-ICD-9 kuya kuma-ICD-10 Amakhodi
I-International Classification of Diseases ibhokisi lamathuluzi lokuxilongwa. Kuhlelo lwayo lwama-10 (i-ICD-10) kusukela ngo-1990, lolu hlu lwezinto zokuxilonga lusetshenziswa emhlabeni wonke ukulandelela izinga lokugula nokufa. Ukumisa amakhodi wokuxilonga nakho kuthuthukisa ikhono lokulandelela izinhlelo zezempilo, ukuqapha izitayela zezempilo, nokuphendula izinsongo zempilo.
Kodwa-ke, i-United States yayiphuthuma ukuthola amakhodi amasha kakhulu futhi ayizange ishintshe kusukela ku-ICD-9 kuya ku-ICD-10 kuze kube ngu-Okthoba 2015.
Kukhona amakhodi amaningi okuxilongwa ongakucabanga. Inombolo yamakhodi angakhona umhlinzeki wakho wezempilo kufanele akhethe kusukela ekukhuleni ngokucacile ngo-Okthoba 2015. Kunamakhodi angu-155,000 atholakalayo ngo-2015 inguqulo ye-ICD-10 uma kuqhathaniswa namakhodi angu-17,000 ku-ICD-9.
Ngo-2018, kuzoba namakhodi amasha angu-363, amakhodi angu-142 angasebenzi, namakhodi abuyekeziwe angu-226.
Lokhu kwanda okwenziwe kwenza kube nzima odokotela ukuthola amakhodi abawadingayo ukuze bathole umshuwalense ukukhokha. Ukutadisha umshayeli we-Healthcare Information Management Systems Society kuphakamisa ukuthi amaphesenti angu-63 kuphela ekhodi ye-ICD-10 angalungile. Amaphutha amaningi okukhokha angakuholela kuwe ukukhokha ngaphezu kwesabelo sakho esihle.
Ukukhetha ikhodi efanele
Ukuze uthole umqondo wenkimbinkimbi ye-ICD-10, bheka izikhalazo ezivamile zokuphefumulela ezivamile. I-allergenic rhinitis (impumu egijima emithonjeni yegazi) inezimboni eziyisithupha ezihlukene okumele ukhethe kuzo, amakhodi angu-20, amaphilisi angu-15, amakhodi ama-5, ama- sinusitis angu-21, namakhodi angu-7 omlomo. Lokho yizinto ezilula.
Izimo eziyinkimbinkimbi ezinjenge- hypertension zinezici eziningi zokuxilongwa ezibonisa ukuthi isimo sifana kanjani nesifo senhliziyo, isifo sezinso, ukukhulelwa, nokuningi. Isifo sikashukela sinamakhodi amaningi. Kukhona ngisho namakhodi amathathu okushaywa yizinto eziwa phansi esikebheni! Ungakwazi ukuzijabulisa futhi ufune amakhodi kumaCenter for Medicare and Medicaid (CMS) iwebhusayithi.
Isibonelo: Imithi ikhokhela kuphela ukuhlolwa kwethambo ukuhlolwa kwe-osteoporosis uma amanye amakhodi e-ICD-10 asetshenziswa. I-Medicare izophika ukukhishwa kwekhodi ye-ICD-10 M85.80, "ezinye izinkinga ezicacisiwe zethambo kanye nesakhiwo, isayithi elingacacisiwe", kodwa izovuma ukubuyisela i-M85.81x-M85.89x, amakhodi achaza indawo (izinyawo, unyawo, ingaphambili, isandla, umlenze ophansi, ihlombe, ithanga, ingalo ephezulu, noma amasayithi amaningi) kanye ne-laterality (kwesobunxele noma kwesokudla) we-bone disorder, okungukuthi, i-M85.822, "nezinye izifo ezicacisiwe zethambo kanye nesakhiwo, .
Lokhu kungaphezu kokucindezela njengoba kunamanye amakhodi amaningi azohlanganisa ukuhlolwa kwesitembu. Noma kunjalo, kulula ukubona ukuthi idijithi eyodwa inganquma ukuthi ubani okhokhela ukunakekela kwakho, wena noma umshwalense wakho.
Ukudlulisa icala lakho
Ngemva kokushintshela ku-ICD-10 ngo-2015, amaCenter for Medicare kanye neMedicaid Services (CMS) avunyelwe isikhathi sonyaka somusa ngezinhloso zokukhokha. Kulula nje, i-CMS yanikeza odokotela izinyanga ezingu-12. Uma nje odokotela babhala ngesigaba esifanele sesifo, noma ngabe kwakungesona ikhodi ethandwayo, bebengeke bahlawuliswe yi-CMS futhi kufanele ukunakekelwa kwakho. Lokho akusasekho.
Uma kunoma yisiphi isikhathi uthola ibhilikhithi ongacabangi ukuthi kufanele ukhokhelwe, xhumana nehhovisi likadokotela wakho. Kungenzeka ukuthi basebenzise ikhodi ye-ICD-10 engalungile. Udokotela wakho angase akwazi ukushintsha ikhodi yokuxilongwa kulowo okunika ukukhokhela umshuwalense oyidingayo.
Izwi kusuka
Odokotela bayazi kangcono ekunakekelweni kwezokwelapha kunokukhokha kwezokwelapha. Ngamakhodi angaphezu kuka-155 000 ICD-10 atholakalayo, kungenzeka ukuthi udokotela wakho angakhetha okungeyona. Uma i-Medicare iphika inkokhelo yezinsizakalo ngenxa yephutha lokubhala, ushiywe ukukhokha ephaketheni. Yazi amalungelo akho. Finyelela ehhovisi lakho lokukhokhisa lomhlinzeki wezempilo uma uthola noma yikuphi ukungahambisani nokukhokha kwakho.
> Imithombo:
> 2018 ICD-10 CM kanye nama-GEM. Amasevisi we-website ye-Medicare ne-Medicaid Services. https://www.cms.gov/Medicare/Coding/ICD10/2018-ICD-10-CM-and-GEMs.html. Ibuyekezwe ngomhla ka-8/11/2014.
> I-Bone Mass Measurement I-ICD-10 Isevisi Ehlanganisiwe. I-American College of Radiology iwebhusayithi. https://www.acr.org/Advocacy/Economics-Impilo-Imigomo/Ukukhokha-Coding/Coding-Source-List/2016/March-April-2016/Bone-Mass-Mesurement-ICD-10-Ukuqapha-Izinkonzo- Kubuyekezwe.
> Herman, B. Ngu-63% kuphela wezincwadi ze-ICD-10 ezibhalwe ngokucophelela. I-Becker's Hospital CFO Report website. http://www.beckershospitalreview.com/finance/report-only-63-of- > icd > -10-imibhalo-ngokunembile-coded.html. Ishicilelwe ngo-Okthoba 24, 2013.
> Ikhodi ye-ICD-10 Buka Phezulu. Amasevisi we-website ye-Medicare ne-Medicaid Services. https://www.cms.gov/medicare-coverage-database/staticpages/icd-10-code-lookup.aspx.
> Ukuhlukaniswa Kwezifo Zomhlaba Wonke (ICD). Iwebhusayithi ye-World Health Organization. http://www.who.int/classifications/icd/en/.