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TRICARE REIMBURSEMENT MANUAL 6010.55M, AUGUST 1, 2002 OUTPATIENT PROSPECTIVE PAYMENT SYSTEM (OPPS)AMBULATORY PAYMENT CLASSIFICATIONS (APCS)CHAPTER 13 SECTION 1 GENERAL ISSUE DATE: AUTHORITY:July 27,
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01
Gather all relevant patient information including insurance details, medical history, and treatment received.
02
Assign appropriate medical codes to all procedures and services provided using the correct coding system (ICD-10, CPT, etc.).
03
Double-check all codes for accuracy and consistency.
04
Fill out a CMS-1500 form or electronic equivalent with the coded information.
05
Submit the completed form to the appropriate insurance provider for reimbursement.

Who needs billing and coding of?

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Healthcare providers such as doctors, nurses, and medical facilities.
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Insurance companies for processing claims and reimbursements.
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Medical billing and coding specialists who specialize in this field.
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Billing and coding are processes used in the healthcare industry to ensure accurate and efficient payment for services rendered.
Healthcare providers and medical facilities are required to file billing and coding for services provided to patients.
Billing and coding forms are typically filled out using specific codes and documentation related to the services provided, which are then submitted to insurance companies or government programs for reimbursement.
The purpose of billing and coding is to accurately track and bill for the services provided by healthcare providers in order to receive payment from insurance companies or government programs.
Billing and coding forms typically require information such as patient demographics, diagnosis codes, procedure codes, and insurance information.
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