CMS
www.cms.gov
Medicare offers an online Claims Processing Manual, which provides day-to-day operating instructions, policies, and procedures based on statutes and regulations, guidelines, and directives.
The CMS website is filled with educational information such as the guidelines for teaching hospitals, definitions (co-surgeon, assistant surgeon, etc.), internet-only manuals (IOMs), future updates to the IOM, paper-based manuals, transmittals, and quarterly provider updates.
Of the 38 chapters that comprise the IOM, chapters that provide general coding guidelines to the medical coder and to other healthcare providers are:
Chapter 1 – General Billing Requirements
Chapter 10 – Reporting ICD Diagnosis and Procedure Codes
10.1 – General Rules for Diagnosis Codes
10.2 – Inpatient Claim Diagnosis Reporting
10.3 – Outpatient Claim Diagnosis Reporting
10.4 – ICD Procedure Code
10.5 – Coding for Outpatient Services and Physician Offices
10.6 – Relationship of Diagnosis Codes and Date of Service
Chapter 12 – Physicians/Non-physician Practitioners
Chapter 14 – Ambulatory Surgical Centers
Chapter 20 – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
Chapter 23 – Fee Schedule Administration and Coding Requirements
These chapters may be downloaded and saved on your computer or other electronic device as PDF files.
Free resources that will help you report provider services accurately. Due to productivity demands, medical coders may be tempted to rely on word of mouthTake time to look up the information will increase subject matter knowledge, build essential fact-finding skills, and improve coding accuracy.
www.aapc.com
Medicare:
www.cms.gov
Private Insurance:
Ensuring the Affordable Care Act Serves the American People The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with helping implement many reforms of the Affordable Care Act, the historic health reform bill that was signed into law March 23, 2010. CCIIO oversees the...
www.cms.gov
Regulations & Guidance:
Affordable Care ActNo Surprises ActGood Faith Estimates for Uninsured (or Self-pay) IndividualsPatient-Provider Dispute ResolutionFederal Independent Dispute ResolutionAdvanced Explanation of Benefits (AEOB)
www.cms.gov
Outreach & Education:
www.cms.gov
Navigating the CMS.gov website- Did You Know CCO
