Best Medical Coding Institute in Trivandrum

 PROTECTED HEALTH INFORMATION (PHI) PHI stands for Protected Health Information and is any information in a medical record that can be used to identify an individual, and that was created, used, or disclosed in the course of providing a health care service, such as a diagnosis or treatment. In other words, PHI is personally identifiable information in medical records, including conversations between doctors and nurses about treatment. PHI also includes billing information and any patient-identifiable information in a health insurance company's computer system. Protected Health Information is the definition used by HIPAA (Health Insurance Portability and Accountability Act) to define the type of patient information that falls under the jurisdiction of the law. eHealth applications that collect, store or share PHI need to follow HIPAA compliance guidelines in order to be compliant with the law. In order for health data to be considered PHI and regulated by HIPAA it needs to be two th...

  MODIFIERS 59, 25 AND 91: A GUIDE FOR CODERS “If it isn’t coded then it hasn’t been done,” is a proverb that isn’t heard in the healthcare setting frequently enough. Correctly applying modifiers, though, isn’t always as cut and dry as it seems. Many times providers inappropriately use modifiers, an abuse that inevitably leads to claim denials. MODIFIERS 59, 25 AND 91: A GUIDE FOR CODERS “If it isn’t coded then it hasn’t been done,” is a proverb that isn’t heard in the healthcare setting frequently enough. Correctly applying modifiers, though, isn’t always as cut and dry as it seems. Many times providers inappropriately use modifiers, an abuse that inevitably leads to claim denials. Learn about the pros and cons of in-house billing vs. outsourced medical billing. Click here. “Modifiers are essential tools in the coding process,” says Laura Reeds, director of coding compliance at IASIS Healthcare in Franklin, Tenn. “They clarify how things should be paid … and further explain or qua...

 An Introduction to ICD-10 Z Code In the last decade, there has been an increase in mental health conditions and substance use disorders observed across the globe. Whereas such conditions may vary from mild to severe and are treatable, physicians often find them difficult to code and bill.  Generally, behavioral health physicians rely on the International Classification of Disease (ICD) by the World Health Organization as a tool for medical diagnoses. From time to time, WHO issues updates to the ICD, with ICD-10 being the latest version. It is from the ICD that the US developed clinical modifications, meaning physicians adhere to ICD-10-CM.   One of the primary reasons that coding and billing are so complex and cumbersome is the need to provide detailed justification for the services that you provide. Unfortunately, the 70,000 different codes that describe conditions, signs, symptoms, complaints, findings, and external causes of injury do not aid this process.  ...

  Why ERAs Are More Efficient than EOBs It is no secret that the healthcare industry is burdened with costly administrative processes. A good example of this are paper explanation of benefits (EOB) forms that have been estimated to cost nearly $18,600 per physician per year in administrative fees. With the availability of tools like the electronic remittance advice (ERA), medical practices, hospitals, billing companies and other healthcare providers can jump on the paperless bandwagon and reduce these exorbitant administrative costs. An electronic remittance advice (ERA) — or what is frequently referred to as the HIPAA 835 file — is essentially an electronic EOB. ERAs contain information on whether a claim was paid or denied, final status claims and any adjustments the payer made to the billed amount. The Affordable Care Act (ACA) requires health plans to implement ERAs under Stage 2 of its Administrative Simplification provision. This represents a strong incentive for payers like...