Question

1. Briefly explain how to use procedural coding systems, diagnostic coding systems, and HCPCS level II coding system (3-4 sentences for each term).

2. What are upcoding and downcoding? Why use them?

Answer 1

( imptome dention diagnostia d Diagnostic coding system In health care system diagnostic coding are used to identity disease, desordeus, Symp tours and poisonings Many crassificate on have diagnostie coding system - • ICD-9-CM voteme 1 and 2 only.. volume 3 contains procedure codes o • Iepe-2 Includes reason bole. en countele, peocedure code and process of care o • Diagnostics no States ricas Plec mauly Psychiatrie disorden Manual of mental disorden

- A M 14cpcs lever RP coding system. lever Rf of the ticpcsos a Standard Zed coding system, that is used do Prumalu ly to identity products, supplees, seuices & thell tein) have Hepcs (Health care common procedwie code coding syste level Level 1- consist commor current and is procedural teuminowgy (CPT) a nemeleco Lever IP- Non pysicians seuvices (Amb- nance puusthetic device) 1 evel PRP - Medicaid agencies, Medicare contractors, prevate insuliens.

more expensive than e a upeoding: upcoding is a brand went medecal billing procedure, in which a bill sent tout a health seur ice es expensive than it should have been based on that sevices was puboo use a . Downcoding: Do mayo Downwaing is a very senious me stane that has s. effect as upcoding. It refeus to coding lower reve than the level Ole seuice given by medical necessity ? a uses of upcoding and downcoding: Фореоара ы wmanipulation od CPT codes bou ineleased payment. sowncode ng Meduce the level of codes on an insurance clan .

04 How to use:- system o mede procedural coding a - The Pao-10 procedure ictem is an international codeng ical classification used system of bole procedural codingo ICD-1o-pes was in te ally released in 1998. pt has been updated a annually since that teme. U rach code contain of seven alphanumeric characters. characteristics are - (1) The tinst character is the section. (11) the second through seventh character mean different thing in each sections. (111) Each characten can be 34 possible values the tendigits (0-9) 24 letters (A-H, I-N, P-z) may be used in each characten (10) The letteus 'o' and (1) are avoid oth the membeus и о фиқ Том 1 1 l'and l. as There are no decimalsin Red-10-pes.