Foreword; Introduction; Contents; Contributors; Part I: Coding and Valuation; Chapter 1: Medical Coding in€the€United States: Introduction and€Historical Overview; References; Suggested Reading; Chapter 2: ICD-10; ICD-10-CM; History; ICD-10-CM Code System; ICD-10-CM Chapters; Using ICD-10; Conventions Used Throughout the€Coding System; Coding Diseases and€Their Manifestations; Level of€Detail and€Coding; The Seventh Character; External Causes of€Morbidity; Factors Influencing Health Status; Office or Ambulatory Coding; Future Directions; Procedure Codes ICD-10-PCS.

Chapter 4: A Resource-Based Relative Value Scale (RBRVS) System Legislation Mandating an€RBRVS System; Developing an€RBRVS System; Implementing the€Medicare RBRVS; Revising and€Maintaining the€Medicare RBRVS: Formation of€the€AMA RUC; Advising the€RUC: Role of€the€Advisory Committee; Assigning New RVUs or Updating RVUs in€an€RBRVS System; References; Part II: Reimbursement; Chapter 5: CMS, the€SGR, and€MACRA; Introduction; OBRA; MVPS; SGR; MACRA; References; Chapter 6: Global Period; Overview; History; Classification; Services in€the€Global Period; Current Practice.

Future of€the€Global PeriodReferences; Chapter 7: Medicare Part A€and€DRG's; Hospital and€Outpatient Facility Reimbursement for€Medicare Patients; Medicare; The Development of€Diagnosis-Related Groups (DRGs) and€the€Politics of€Healthcare; Diagnosis-Related Groups: Connecticut and€New Jersey Studies; DRGs Become an€Issue of€Political and€Financial Urgency; DRGs Today; Outpatient Prospective Payment System (OPPS) and€the€Ambulatory Payment Classification (APC) [17,18]; Facility and€Non-facility CPT Reimbursement; CPT Code Detail-38500: Biopsy of€Lymph Node; Facility Fees.

Organization of ICD-10-PCS First Character Section of€the€Coding System; Second Character: Body System; Third Character: Root Operation; Root Operations That Take Out Some or All of€a€Body Part; Root Operations That Take Out Solids/Fluids/Gases from€a€Body Part; Root Operations That Involve Cutting or Separation Only; Root Operations That Put In/Put Back or Move Some/All of€a€Body Part; Root Operations That Alter the€Diameter/Route of€a€Tubular Body Part; Root Operations That Always Involve a€Device; Root Operations Involving Examination Only.

Root Operations That Define Other Repairs Root Operations That Define Other Objectives; PCS Charts; So Why Does This Matter to€Me?; Suggested Reading; Chapter 3: The CPT Code; History of€the€CPT Code; Current Status of€CPT Code; Category 1 Codes; Category 2 Codes; Category 3 Codes; CPT Modifiers; CPT Panel; CPT Process/Application; Category 1 and€3 Application; Category 1 Literature Requirements; Category 2 Code Application and€Process; Reconsideration of€Rejected Proposal; Clinical Examples of€CPT Coding; Example 1; Example 2; References.

This text provides the in-depth understanding of the mechanisms that guide coding and reimbursement. The text is meant to be useful to surgeons in practice, both in general surgery and in surgical subspecialties; practice management teams of surgical practices and to resident physicians in surgery. Part 1 of the text addresses the CPT coding process, the relative valuation system (RVU), the ICD-9 and ICD-10 systems of classification, Medicare Part B payment rules for physicians, the DRG system and Medicare Part A payment for hospitals, alternative payment models, and the myriad of quality measures of importance to surgeons. Part 2 of the text addresses specific coding in areas where surgeons historically have had the most difficulty. This is not meant to substitute for the available texts, software or courses on coding, but to provide the historical background and rationale for the specific coding rules. Principles of Coding and Reimbursement for Surgeons will be of great value to general surgeons and surgical subspecialists in private practice, academic institutions, and employed positions. It will provide direction to management teams from practice and institutional levels. It is also of use to surgical trainees and to researchers in health policy issues.