Adams' Coding And Reimbursement: A Simplified Approach

Here’s the concise, reader-friendly text that makes coding, insurance, and claims easy to understand. It gives readers the big picture so they understand how each step in the coding and claims process affects reimbursement. It starts first with coding rules and applications as its foundation and then moves into insurance carrier specifics -- helping readers understand the impact of carrier rules in relation to claims submission. Then it helps readers through the maze of the reimbursement system. Plus, it provides plenty of real-world practice along the way with new in-book exercises and Code It and Claim It! software – free with each text. Instructor resources are also available.

• By combining coding rules and applications along with carrier specifics and reimbursement, students gain a well-rounded view into the total workings of the coding system and insurance claim submission.
• The concise text makes it simple to fit into any course schedule - not just one based on quarters or semesters.
• Examples that illustrate concepts in realistic settings are highlighted to help students understand difficult concepts.
• Key terms (with definitions) at the beginning of each chapter, along with a glossary at the back of the book help students recognize and identify important coding and insurance terminology.
• Coding Exercises where students are given conditions and cases and asked to code them teach learners how to code and how to correctly use the ICD-9-CM and CPT-4 manuals.
• Full-color page design and illustrations enliven presentation of content and improve visual appeal - making learning easier.

• HIPAA coverage has been added to the insurance chapters and the legal issues chapter and where appropriate throughout the book. In the coding chapters, medical necessity is addressed -- where the importance of consistency between the diagnosis code and the procedural code is emphasized.
• Updates on industry and governmental changes since 1998 have been added (for example, HCFA’s name change to CMS).
  New practice applications have been added within each chapter, as Test Your Knowledge questions, and at the end of each chapter, as Review Questions.
• Code It and Claim It! software -- bound-in to each text -- contains case material for 10 cases for practice and/or homework assignments. Students code cases then enter the information to complete the claim form. All the information is then displayed in a CMS-1500 form, and the student either prints the form to give to the instructor or has the software grade the form.

Wanda Adams, CPC