Unit VIII Case Study EHR Coding and Reimbursement

EHR Coding and Reimbursement

A 16-year-old female who has asthma has an Emergency Department visit for angina, shortness of breath, and wheezing. The doctor performs a chest x ray, breathing treatments, and a Nuclear Medicine Stress Test utilizing a treadmill while monitoring the patient’s heart palpitations. While the patient is in the ED, the doctor evaluates her asthma and changes her prescription medication. Review the chapter and consider the following

questions:

 

1. How would you select the ICD-9 and CPT codes for the procedural claim (encounter) for the ED visit?

 

2. What diagnosis and procedure codes will result in dull reimbursement for the procedures rendered?
3. How will the claim demonstrate the medical necessity for the exams?

HTH 2305

 

After reading the required chapter on EHR Coding and  Reimbursement  complete and submit the following in an APA

format:

 

• Begin your case study with an introduction explaining the purpose of the case study.
• In no more than three paragraphs explain and answer the questions listed above. Be descriptive on the steps necessary to perform the above scenario. Defend your response and use terminology related to the scenario.
• Describe billing upcoding and downcoding. Describe the penalties related to

performing these tasks. Is there a chance for the scenario listed above to be upcoded or downcoded? Explain your response.

• Important reminder, do not forget to include a reference page, including all sources cited in your essay. Upload before the assignment deadline. Be sure to support your work with specific citations from this week’s required reading

and any additional resources. Format your Case Study using APA style. Use your own words, and include citations and references as needed to

avoid plagiarism

 

Gartee, R. (2011). Electronic health records: Understanding and using computerized          medical records (2 nd ed.). Upper Saddle River, NJ: Pearson Education.