Lambar lafiyar wani ɓangare ne na lissafin kuɗi da sadarwa tsakanin ma'aikatan kiwon lafiya da masu insurers. Koyi mahimman abin da ake nufi da kuma yadda ake amfani da waɗannan lambobin.
Mene ne Codic Jiki?
Lambar lafiyar kwayar halitta ce ta yawan lambobi da takardun wasiƙa waɗanda suke da mahimmanci ga kowace ganewar asali, alama ko alamar alama, da kuma dalilin mutuwar mutane.
Bugu da ƙari, ana amfani da lambobi don sadarwa na yau da kullum game da kayayyaki da hanyoyin da aka yi amfani da su wajen kula da yanayin ɗan adam. Daidaitaccen tsari na kiwon lafiya yana da mahimmanci ga lissafin kuɗi da kuma kididdigar lissafi don cutar da magani.
Lambar kiwon lafiya babbar mahimmanci ne wajen samun biyan kuɗi da kuma rike bayanan kulawa. Coding da'awar da dama ya sa mai biyan kuɗi ya san rashin lafiya ko rauni na mai haƙuri da kuma hanyar magani.
Cikakken kiwon lafiya zai iya ƙunsar ɗaya ko fiye na waɗannan lambobin: Lambobin ICD, Lambobin CPT, Lambobin HCPCS, Lambobin DRG, da masu gyara. Duk wadannan sharuɗɗa masu mahimmanci suna da muhimmanci ga sadarwa da kuma dalilai na lissafin kuɗi. Ba wai kawai yana da muhimmancin coding a cikin aikin likita ba, yana da muhimmanci saboda masu biya bashi kamar kamfanonin inshora, Medicare da Medicaid bazai biya da'awar idan aka ba shi da kyau ba tare da yarda da lambobin.
Lambobin ICD
Ƙididdigar Lafiyar Ƙididdigar Duniya na Ƙungiyar cututtukan cututtuka ko ICD ita ce tsarin ka'idoji ɗaya. Wadannan suna da ƙayyadaddun tantance cututtuka, bayyanar cututtuka, da kuma haddasa mutuwar mutane. Ƙungiyar Lafiya ta Duniya tana ƙirƙirar, haƙƙin haƙƙin mallaka, da kuma kulawa da waɗannan ƙayyadaddun kuma suna da daidaituwa kuma dukkanin magungunan likita da masu aikata aiki suna iya ganewa a duniya.
A Amirka, Cibiyar Cibiyar Nazarin Lafiya ta Duniya, wadda ke cikin sashen Cibiyoyin Kula da Lafiya da Magungunan Medicaid ke kula da duk wani gyare-gyare ga dokokin ICD tare da WHO.
HCPCS Codes
HCPCS (Harkokin Kula da Kula da Lafiya ta Hanyar Kulawa da Kwayoyin Tsarin Mulki) matakan I da na II shine wani tsarin tsarin. Matsakaici na ƙunshi lambobin CPT, kuma matakin na II ya haɗa da lambobin alphanumeric waɗanda ake amfani dasu don gane samfurori, kayayyaki, da kuma ayyuka ba a cikin lambobin CPT ba lokacin da ake amfani dasu a ofishin likitan.
HCPCS lambobin an bayyana a matakan uku:
- Matsayi na CPT (Cikin ka'idojin ka'idoji na yau da kullum) yana da lambobi 5 da aka gudanar da Cibiyar Aiki na Amirka (AMA). Ana amfani da lambobin CPT don gano hanyoyin kiwon lafiya da ka'idojin da likitoci ko wasu masu sana'a masu lasisi suka umurce su.
- Mataki na II HCPCS sune lambobin alphanumeric wanda ya ƙunshi rubutun haruffan da aka biyo bayan lambobi hudu kuma ana gudanar da su ta Cibiyoyin Medicare da Medicaid Services (CMS). Wadannan lambobin suna gano alamun marasa likita irin su sabis na motar asibiti, kayan aikin kiwon lafiya mai mahimmanci, da kantin magani.
- Matakan matakin III sune lambobin alphanumeric W, X, Y, ko Z sun biyo bayan lambar lambobi hudu. In ba haka ba ana sani da lambobin gida, waɗannan lambobin suna amfani da su azaman lambobi daban-daban idan babu matakan I ko matakin matakin II don gano shi.
Masu gyara: Wasu Lambobin HCPCS sun buƙaci amfani da masu gyara. Sun ƙunshi lambobi biyu, haruffa biyu ko haruffan alphanumeric. HCPCS masu gyare-gyare na code suna ba da ƙarin bayani game da sabis ko aiki. Ana amfani da masu amfani don gano yankin jiki inda aka yi hanya, hanyoyi masu yawa a cikin wannan lokacin, ko nuna an fara hanya amma an katse.
Lambobin CPT
Ka'idodin CPT sune ka'idodin tsarin ka'idoji kuma an bunkasa su kuma alamar kasuwanci ta Ƙungiyar Magunguna ta Amurka a shekarar 1966. Waɗannan su ne tsarin ma'aunin alphanumeric biyar wanda ke bayyana a cikin hanyar kiwon lafiya, m, da kuma bincike.
DRG Codes
Ka'idodin DRG, lambobin haɗin gwargwadon ganewa, ana amfani da su ne kawai don ƙayyade ikirarin inpatient. Mutane da yawa insurers biya bisa ga DRG, sabili da haka, daidai da dukan aka gyara yana da muhimmanci a dace da'awar reimbursement.
Yadda ake amfani da Codic Cikal
Wadannan sharuɗɗa suna da muhimmanci ga sadarwa da dalilan lissafin kuɗi. Ba wai kawai yana da muhimmin mahimmanci a aikin likita ba, yana da matukar mahimmanci ga masu samar da kiwon lafiya saboda masu biya bashi kamar kamfanonin inshora, Medicare da Medicaid bazai biya da'awar idan an ba shi da kyau ba tare da yarda da lambobin.
Bugu da ƙari, ana amfani da lambobin ganewar asali don nazarin yanayin cututtuka a cikin al'umma da kuma kididdigar kiwon lafiya da mutuwa. Ƙungiyoyin ƙasashen duniya na Lafiya ta Duniya zasu iya amfani da kayan da ake buƙata don magance matsalolin kiwon lafiya da yawa, don ilmantar da jama'a game da rigakafi da magani, da kuma tabbatar da lafiyarsu da zaman lafiya a nan gaba ga 'yan ƙasa.
Ilimi a Cododar Cutar
Ƙungiyoyin kolejoji da makarantu masu cinikayya suna ba da horo, da takaddun shaida, har ma da Mataimakin Masanin Kimiyyar Kimiyyar Kimiyya a lissafin kiwon lafiya da kuma ƙayyadewa. Wadannan suna cikin zurfin zurfin koyi da ƙididdiga na shirin koya wa ɗaliban ilimin likita, daidaitattun tsari da fasaha na lissafin kujerun, hanyoyin yin aiki daidai, da kuma yawan ayyukan aiki. Wasu daga cikin waɗannan sun cancanci kuma wasu ba haka ba ne, saboda haka kowane ɗalibin ɗalibai ya kamata su yi aikin gine-gine kafin su zaɓi shirin koyo.
Muhimmancin ilimin farko da ci gaba da ilimi a asibitin ko ofishin likita ba za a iya rinjaye su ba. Kasancewa da canje-canje a canje-canje da biyan kuɗi, da ka'idodin tsarin mulki yana da muhimmanci a cikin tsarin tsarin dijital da sauri wanda muke aiki duka da rayuwa.
Coding da Lissafin Kuɗi
Coding da lissafin kuɗi ana ambaton su tare domin waɗannan su ne ɓangarori biyu na ofishin likita wanda ke da nasaba da juna. Ma'aikatan da suka kammala aikin likita da lissafin kuɗin aiki ya kamata suyi aiki tare tare don tabbatar da cikakken biyan kuɗi na duk maganin likita da kuma cikakke bayanan likita.
Abubuwan da ke da alaƙa kamar jerin littattafai na yau da kullum da ke ƙayyade lambobin daban ko software na yanzu don coding ko lissafin kuɗi yana da muhimmanci ga masu biyan kuɗi da ma'aikatan coding don tabbatar da cikakken ajiyar kuɗi zuwa kamfanonin inshora ko Medicare da Medicaid , da kuma biyan kuɗi daga waɗannan mahalli, haka nan kamar yadda cikakke ganewar asali da kuma bayanan likita. Bugu da ƙari ga ƙaddamarwa na farko na ƙuntatawar mai haƙuri, mai yin coder da mai ɗaukar nauyi zai iya zama alhakin biyan bayanan da aka ƙaryata game da ƙididdigar ta hanyar kulawa da sakon mai haƙuri, sake sakewa da iƙirarin, maida martani, ko ɗaukar wasu matakai don tabbatar da daidaiton da'awar.
Ba wa ma'aikatan lafiya da masu biyan kuɗi suna da alhakin daidaito na bayanan likita daidai da ka'idojin jihohin tarayya da tarayya, kuma muhimmancin masu biyan kuɗi da masu coders ba za a iya damuwa ba. Dole ne ma'aikatan kiwon lafiyar da ke cike da lafiya su sami horo sosai, tsara, da kuma likitocin likita da likitoci.