Guide to Medical Billing, 3rd edition

Published by Pearson (December 27, 2011) © 2013

  • Sharon Brown
  • Lori Tyler

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For all courses in medical billing, medical coding, and/or medical insurance, in any institution or environment.

This unique textbook/workbook brings together all the theory and practical skills students need to succeed as medical billers. After introducing students to the medical practice, it presents in-depth coverage of every common medical billing procedure and practice used in both medical offices and hospitals. This edition includes extensive new coverage of transitioning to ICD-10-CM from ICD-9-CM in medical offices, and using the newer UB-04 form in hospitals. Coverage also includes: Current Procedural Terminology (CPT®) coding, stress and time management, CMS-1500 forms and medical procedures, hospital procedures, basic office functions and communications, and much more. To enhance understanding and retention, the text uses proven pedagogical features, including learning objectives, key terms and definitions, critical thinking questions, in-text chapter activities simulating professional practice, and additional end-of-chapter exercises.

Hallmark Features

Combines theory with practice, giving students all they need in a single, up-to-date book. Unique textbook/workbook format brings together all the knowledge and hands-on skills students need to succeed as medical billers and/or coders.

Promotes mastery through a logical learning format. Begins by providing essential context; then walks step-by-step through every job duty medical billers must perform; and provides bulleted concept review summaries at the end of each chapter.

Helps students focus on what’s most important. Begins each chapter with clear, bulleted learning objectives that help students focus on the most pertinent topics, skills, and concepts.

Gives students extensive hands-on practice. Provides in-chapter and end-of-chapter professional practice exercises that enable students to immediately perform real-world billing and coding tasks.

Reinforces understanding of key concepts. Provides up-to-date concept review questions at the end of every chapter, helping students prepare for exams and identify areas where they need further study.

Promotes critical thinking. Provides critical thinking questions within chapters, challenging readers to think more deeply about what they’re learning.

Gives students instant access to definitions of unfamiliar terms. Lists key terms at the beginning of each chapter, and presents them in bold with definitions where they are initially introduced.

Helps students discover productivity shortcuts and avoid common mistakes. Includes insider “Practice Pitfalls” features identifying good ideas, shortcuts, good habits, bad work habits to avoid, outcomes of sloppy work, common mistakes – and how those mistakes can be avoided.

Updated to provide more hands-on workbook features, reflect the transitions to ICD-10-CM and UB-04, and present more online resources.

Improved! Greater emphasis on workbook featureswith more hands-on exercises that help students demonstrate essential skills and knowledge
  • Gives students all the theory and knowledge they need in a single book 
New! Detailed coverage of ICD-10-CM coding and the transition from ICD-9-CMincluding practical solutions to real-world problems encountered by medical offices
  • Helps students successfully transition from ICD-9-CM – a major issue for thousands of medical offices, and for many experienced coders who originally learned the older version 
New! Reflects hospitals’ use of the newer UB-04 formwith updates to procedural and diagnosis codes wherever needed
  • Prepares students to work with the latest billing form used by hospitals
Expanded! Contains more online research suggestions and toolshelping students discover more information about the subjects being discussed
  • Promotes online exploration through web sources students can rely upon

Section I. Medical Practice Administration

1. Introduction to Medical Billing

2. Legal and Ethical Issues of Medical Billing

3. Clinical Records and Medical Documentation

 

Section II. Health Insurance Programs

4. Health Insurance Programs

5. Medicare and Medicaid

6. Workers’ Compensation

7. Managed Care

 

Section III. Finances and Accounting

8. Medical Practice Accounting

 

Section IV. Medical Coding

9. Reference books

10. International Classification of Disease (ICD-9-CM) Coding

11. Transitioning from ICD-9-CM to ICD-10-CM/PCS

12. Coding with ICD-10-CM/PCS

13. Current Procedural Terminology (CPT®) Coding

 

Section V. Medical Billing

14. The CMS-1500 Form and Medical Billing Procedures

15. The UB-04 Form and Hospital Billing Procedures

 

Appendix A. Glossary

Appendix B. Tables and Forms

Index

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