In the health-care environment, coding has an impact

Freshman (College 1st year) ・Healthcare&Medicine ・MLA ・2 Sources

The International Standard Diagnosis Classification (ISDC) is a system that healthcare agencies use to systematically identify and classify diseases and aid resource allocation for care delivery. Codes are alphanumeric designations given to every diagnosis, symptom description, abnormal findings, and cause of death attributed to humans in classification systems. These classifications are developed, monitored, and copyrighted by the World Health Organization (WHO). All modifications and changes to the International Classification of Diseases are overseen in the United States by the National Center for Health Statistics (NCHS), which is part of the Centers for Medicare and Medicaid Services (CMS). Healthcare organizations use the International Standard Diagnosis classification to classify illnesses and allocate resources to provide care. Billing for the services and goods provided is gauged on the procedures used to treat the patients. Fee for service and capital reimbursement are different ways of paying for healthcare organizations. In capital reimbursement, the doctors are paid a specific amount for each patient they see while in fee for service the doctors are paid according to which procedures they used to treat a given patient. Coding is a necessary step required to submit medical claims and bills for third-party payers and patients. It is also critical for demographic assessment and studies of diseases prevalence, treatment outcomes, and accountability-based reimbursement systems.
For a while, International Classification of Diseases (ICD-9) has been the standard medical diagnostic code system of classification, but ICD-10 has been developed and adopted. ICD codes are used to identify and track health care trends and disease threats. They also provide new ways of evaluating the use of new procedures and technologies. Diagnosis coding accurately shows the medical condition experienced by a patient. They are intended to project an exact aspect of medical information and reflect the organizations finding (O'malley et al). A healthcare system progress notes are comprised of four components. First is the patient's main complaint, the reason that initiates the healthcare encounter. Secondly, the healthcare provider documents the observations including a review of the patient's history, a review of pertinent medical systems and physical examination. Following these, an assessment is rendered in the form of diagnosis and a care plan. Reimbursement methods used in the healthcare organization break down into the following types, Fee for service, pay for coordination, pay for performance, bundled payment, upside shared savings programs, partial or full capitation and global budget downside shared savings programs (CMS or Commercial).
Diagnosis code can be used to measure mobility and mortality. They are assigned by a health professional trained in medical classification such as a clinical coder or a Health Information Manager. These codes focus towards a particular patient encounter type such as mental health, inpatient, outpatient, emergency and surgical care. Diagnosis codes are mostly used as a representation of admitted episodes in healthcare settings.
They are subjected to ethical evaluations as they contribute the total coded medical record in health services organizations such as hospitals. They are also subjected to scrutiny as they tend to affect the outcome of the organization’s funding; in particular, the Principal Diagnoses and the Additional Diagnoses significantly affect the total funding. Assignment of the diagnoses code may be influenced by a decision to optimize reimbursement of funding (Rains, Skurka, and White).
Six reimbursement codes were added to Current Procedural Terminology (CPT) coding system used to bill social, behaviour and physiological services for the prevention, treatment or management of physical health problems in 2002. The (CSPA) California Primary Care Association describes them as follows.
96150-Health and Behaviour assessment to determine the biological, psychological and social factors affecting the patient and any treatment problems
96151-Health and Behaviour re-assessment
96152-Health and Behaviour intervention service provided to a patient to modify the social, psychological, and behavioral factors affecting the patients’ health and well-being.
96153-Health and Behaviour intervention service provided to a group.
96154-Health and Behaviour intervention service provided to a family with the patient present.
96155-Health and Behaviour intervention service provided without the patient present.
These HBA codes are used to bill for services provided to patients who are not diagnosed with a psychiatric problem but whose social, psychological, and behavioral functioning affect treatment, prevention, and management of a physical health problem.

Works Cited

Rains, Sandra K., Margaret A. Skurka, and Margie White. "Coding, Compliance, and Classification Systems." Health Information Management: Principles and Organization for Health Information Services (2017).
O'malley, Kimberly J., et al. "Measuring diagnoses: ICD code accuracy." Health services research 40.5p2 (2005): 1620-1639.

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