Medical Coding Overview
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- čas přidán 9. 09. 2024
- Dr. Eric Bricker Explains the Basics of Medical Codes:
ICD-10 Codes: International Classification of Diseases, 10th Revision
These are Diagnosis Codes for Conditions Such as Diabetes or Pneumonia. They Are Also the Codes for Symptoms Such as Headache or Chest Pain.
CPT Codes: Current Procedural Terminology
These are Procedures Codes that Describe What is Done by the Healthcare Provider, Hospital, etc., such as MRI, Gall Bladder Surgery or Complete Blood Count Lab Test. CPT Codes are Also Used for Doctor's Office Visits... These CPT Codes are Referred to as E/M Codes for Evaluation and Management Codes.
DRG Codes: Diagnosis Related Groups
DRG Codes are Used for Inpatient Medical Services. A Hospitalized Patient May Have Multiple ICD-10 Diagnosis Codes and Multiple CPT Codes and these will be 'Rolled Into' One DRG Diagnosis Related Group for that Hospital Stay.
HCPCS Codes: Healthcare Common Procedure Coding System
HCPCS Codes are Also Procedures Codes, but They Are for Procedures that Are Not a Part of the CPT Coding System. Many Special Medications that are Administered in the Hospital are Coded with a HCPCS Code Because a CPT Code for Them Does Not Exist.
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Thank you so much for explaining without jokes, am in college taking up medical office assistant learning about CPT codes . Majority of people on CZcams take a lot of time of joking when they about to tech you something . You're the first person I did not have to fast forward . keep up the good work.
Thanks so much for watching!!
You never cease to amaze me
That’s very kind of you. Thank you for watching.
Thank you so much for the clear explanation.
Thank you for watching!!
Thank you so much for the explanation
Thank you for watching!
Wow I love this.
Thank you for watching.
Also the ICD-10 to HCC coding is something important in Value-based systems like ChenMed!
Thank you for watching and for your comment.
Your videos are gold.
Thank you for watching and for your kind comment.
You explained it like ABC
Thank you for your comment.
The detailed bill/statement that I requested only includes numbers, and no letters. It is ironic they they called it detailed. 🤦♀️ I think this is part of the attempt at deception.
What is your opinion on being billed for a facility fee when you had a virtual appointment?
What is your opinion on if you were billed two separate bills for the same visit, but different codes. It was a simple telehealth visit. Bill 1: the procedure codes codes is 99213. Bill 2: says Rev Code 0510 & procedure code 5100000953.
Odd. Seems wrong. Bill 1 is the doctor/professional fee. Bill 2 is the facility fee.
This is a great quick overview! What is the purpose of a DRG code? Is this just for extra reimbursement? Also, in this new ICD10 model, are ADG groupings obsolete?
Hi Jennifer, Very good questions. The DRG is used for coding and reimbursement of many inpatient hospital stays. For example, a 5 day stay for pneumonia would be coded and reimbursed based on the DRG rather than a CPT code. Use of a DRG for inpatient services vs. CPT for outpatient services does not necessarily mean 'extra' reimbursement, just a different set of codes. Good question about the ADG groupings. I don't know. Everything I've found on ADGs relates to ICD-9, not 10.
@@ahealthcarez I'm kind of confused when you mention 'outpatient' for CPT codes. Are all CPT codes 'outpatient'? You mentioned in the video that procedures such as x-ray or surgery are CPT codes, but what if they are done when you have an inpatient? Are they then reported as a DRG code?
Hi Dakoit Cave, Thank you for your question. CPT Procedure codes can be used for both inpatient and outpatient healthcare services. Typically, the cost of care for an outpatient service is based on the CPT code... not the ICD-10 Diagnosis Code. For example, a chest x-ray with a certain CPT code will cost $75 regardless if it is for a chronic cough or for concern for broken ribs from a fall.
@@ahealthcarez Hello AZ Finance. I just got thru watching your video on HEDIS for a new project I’m working on.
I did filter thru some of your videos. I didn’t see anything in the new inset of: VBR, HCC, & Telehealth. Will you be doing any videos on these new/updated mandates to our industry?
@@ahealthcarez And Dr. Eric, do u know of anyone that is an expert in graph/illustration creation related to HEDIS related.
What is the difference between charge entry and coding?
Thank you for your question. The term I am more familiar with is ‘charge capture’ and is the more all encompassing term that includes medical coding, in my opinion.
Appreciate you watching.
@@ahealthcarez I just don’t understand the difference between charges and codes? Are charges groups of codes?
Sorry. I should have given you a better answer.
The charges are the price for each individual med, supply, etc for the hospital stay. Those charges are added together to come up with the Total Billed Charges for a hospital stay.
That hospital stay also has diagnosis codes, procedure codes and diagnosis related group codes on the bill in addition to the Total Billed Charges.
The hospital is always paid less than Total Billed charges and Those codes determine how much less the hospital is paid.
That is a brief and incomplete explanation, but I hope it helps a little.
@@ahealthcarez a very helpful explanation. Thank you so much!
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Sorry, but HCPCS is NOT pronounced as "hicks-picks". It's pronounced "hick-picks". The "S" is at the end. During my healthcare admin classes, we were taught to NEVER, EVER say "hicks-picks". It's "hick-picks". Look at it.......H - C - P - C - S.
Thank you for watching and for your feedback.