Understanding Hospital Billing and Coding

Understanding Hospital Billing and Coding, 3rd Edition

Understanding Hospital Billing and Coding, 3rd Edition,Debra Ferenc,ISBN9781455723638





276 X 216

A comprehensive, approachable guide to hospital insurance billing and coding, Understanding Hospital Billing and Coding, 2nd Edition covers everything hospital billers need to know, from patient admission to accounts receivable management and HIPAA. It builds on your knowledge so that you can make a successful transition from the physician/outpatient environment to the hospital setting. Written by coding expert Debra P. Ferenc, this book covers the hospital regulatory setting, the structure and functions of hospital departments, patient accounts and data flow, the billing process, coding, claim forms, reimbursement, accounts receivable management, HIPAA requirements, and much more.

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Key Features

  • UB-04 Claim Simulation on the companion Evolve website lets you practice entering information from source documents into the claim form.
  • Over 300 illustrations and graphics bring important concepts to life.
  • Detailed chapter objectives highlight what you are expected to learn.
  • Key terms, acronyms, and abbreviations with definitions are included in each chapter.
  • Concept Review boxes reinforce key concepts.
  • Test Your Knowledge exercises reinforce lessons as you progress through the material.
  • Chapter summaries review key concepts.
  • Practice hospital cases let you apply concepts to real-life scenarios.

Debra Ferenc


Understanding Hospital Billing and Coding, 3rd Edition

Section 1: Hospital Overview

1. Hospital Introduction

2. Hospital Regulatory Environment


Section 2: Hospital Billing and Coding Process

4. Patient Accounts Data Flow

5. Hospital Billing Process

Section 3: Coding

6. ICD-9-CM Diagnosis and Procedure Coding

7. ICD-10-CM Diagnosis Coding

8. Procedure Coding (HCPCS and ICD-10-PCS)

9. Coding Guidelines and Applications (HCPCS and ICD-10-CM/PCS)

Section 4: Claim Forms

10. Claim Forms

Section 5: Health Care Payers and Reimbursement

11. Payers

12. Prospective Payment Systems

13. Accounts Receivable Management

Section 6: Appendixes

A: Cases

B: Claim Form Data

C: Web Resources

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