DEBRA P. FERENC BS, CPC, CPC-I, CPC-H, CMSCS, PCS, FCS Senior Consultant and Educator Medical Recovery & Consulting Experts, Inc. (MRCE) Lead Instructor, Medical Insurance Billing and Coding Everest University Founder, Past President and Education Officer Gulf to Bay Local Chapter of the AAPC

SECTION ONE Hospital Overview, 1 Chapter 1 HOSPITAL INTRODUCTION, 2 Chapter 2 HOSPITAL REGULATORY ENVIRONMENT, 37 Chapter 3 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA), 66 SECTION TWO Hospital Billing Process, 101 Chapter 4 PATIENT ACCOUNTS AND DATA FLOW, 102 Chapter 5 HOSPITAL BILLING PROCESS, 138 SECTION THREE Coding, 175 Chapter 6 ICD-9-CM DIAGNOSIS AND PROCEDURE CODING, 176 Chapter 7 ICD-10-CM DIAGNOSIS CODING, 217 Chapter 8 PROCEDURE CODING (HCPCS AND ICD-10-PCS), 259 Chapter 9 CODING GUIDELINES AND APPLICATIONS (HCPCS, ICD-10-PCS, AND ICD-10-CM), 306 SECTION FOUR Claim Forms, 351 Chapter 10 CLAIM FORMS, 352 SECTION FIVE Health Care Payers and Reimbursement, 385 Chapter 11 HEALTH CARE PAYERS, 386 Chapter 12 PROSPECTIVE PAYMENT SYSTEMS (PPS), 431 Chapter 13 ACCOUNTS RECEIVABLE (A/R) MANAGEMENT, 469

SECTION SIX Appendixes, 505 A CASES, 506 B CLAIM FORM DATA, 565 C LIST OF WEB RESOURCES, 582

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