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Essay / Research Paper Abstract
This 3 page paper examines medical coding procedures created by the Centers for Medicare and Medicaid Services (CMS). CCI policies and procedures is the focus of this paper. Bibliography lists 4 sources.
Page Count:
3 pages (~225 words per page)
File: RG13_SA102cod.rtf
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Unformatted sample text from the term paper:
to Medicare and private health insurance companies has always been complicated, but as time goes on, more and more rules emerge. Of course, there is a good reason for these
practices and procedures. Fraud and simple mistakes have hurt the system. Therefore, procedures created to avoid errors have become quite complicated. For some time, Medicare carriers would
include a number of computerized edits in their claims processing systems (Jones 25). This was done in order to find improper coding procedures (Jones 25). While edits were similar in
nature, each carrier would apply them differently so there was a lack of consistency (Jones 25). To address coding issues, Centers for Medicare and Medicaid Services (CMS) would create something
called the Correct Coding Initiative or CCI (Jones 25). CCI policies promote correct coding around the nation (Jones 25). A student writing on this subject adds that allegations of improper
coding caused CMS to develop new coding methods. Indeed, the edits are largely used to assure that payment for a procedure would not be duplicated in a case where a
procedure might be bundled with a different procedure (Kelly-Farwell and Favreau 71). This safeguard is an idea that makes sense. For example, one might imagine that in a hospital,
when someone undergoes surgery, there are a number of things added to the bill. A surgery charge for instance will often include a follow up visit with the doctor.
This is an example of a bundled service. The patient undergoes surgery and about a week later, the patient visits the doctor for a follow up. One may suppose that
the doctors office might submit a claim for that charge, but it was something truly included in the initial bill for the surgery. While doctors offices do not bill the
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