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Showing posts from May, 2019

DRG – Diagnosis related grouping

Medicare and many health insurance companies pay hospitals using DRGs, or diagnostic related groupings. This means the hospital gets paid based on the admitted patient’s diagnosis rather than based on what it actually spent caring for the hospitalized patient. If a hospital can treat a patient while spending less money than the DRG payment for that illness, the hospital makes a profit. If, while treating the hospitalized patient, the hospital spends more money than the DRG payment, the hospital will lose money on that patient’s hospitalization. This is meant to control health care costs by encouraging the efficient care of hospitalized patients. Why You Should Care How a DRG Is Determined If you’re a patient, understanding the basics of what factors impact your DRG assignment can help you better understand your hospital bill, what your health insurance company or Medicare is paying for, or why you’ve been assigned a particular DRG. If you’re a physician rather than a p

What is Medical Coding?

Medical coding is the transformation of healthcare diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes.” Put simply, this refers to the process of translating important medical information into simple codes for the purpose of documenting medical records and informing accurate medical billing. There are a few different  types of medical codes  used in healthcare settings today, but each of them allows for uniform documentation between medical facilities. Having this standard system allows for a more seamless transfer of medical records and more efficient research and analysis to track health trends. The three main types of codes are ICD-10-CM, CPT-4, and HCPCS What is a medical coder? Medical coders are the individuals responsible for translating physicians’ reports into useful medical codes. These professionals work behind the scenes in a variety of settings, ensuring all pertinent information is coded appropriately to e

Coronary Angiogram

A coronary angiogram is a procedure that uses X-ray imaging to see your heart's blood vessels. The test is generally done to see if there's a restriction in blood flow going to the heart. Coronary angiograms are part of a general group of procedures known as heart (cardiac) catheterizations. Cardiac catheterization procedures can both diagnose and treat heart and blood vessel conditions. A coronary angiogram, which can help diagnose heart conditions, is the most common type of cardiac catheterization procedure. During a coronary angiogram, a type of dye that's visible by an X-ray machine is injected into the blood vessels of your heart. The X-ray machine rapidly takes a series of images (angiograms), offering a look at your blood vessels. If necessary, your doctor can open clogged heart arteries (angioplasty) during your coronary angiogram. Why it's done Your doctor may recommend that you have a coronary angiogram if you have: ·          Symptoms of coronary

Coding STEMI VS NSTEMI

Ischemic heart disease continues to be the leading cause of death in the United States and worldwide (World Health Organization, 2017). It’s no surprise that myocardial infarctions (MI) are frequently seen as reportable conditions when coding inpatient encounters. Recent ICD-10-CM changes offer new codes to further specify the type and cause of MIs. How and where the myocardial death occurs determines the ICD-10-CM code assignment. MIs are categorized in several ways. Historically, MIs were categorized based on the thickness of the myocardial necrosis. A transmural MI occurs when the myocardial necrosis is full thickness (extending from the endocardium through the myocardium to the epicardium), and a non-transmural MI includes necrosis of the endocardium or the endocardium and myocardium only.  Electrocardiogram  findings are more commonly used to identify the type of MI. This includes  ST-elevation MIs (STEMI), non-ST-elevation MIs (NSTEMI),