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The American Health Lawyers Association, the American Academy of Professional Coders and LexisNexis are pleased to bring you Deciphering Codes: Fraud & Abuse for Coders and Coding Insights for Healthcare Lawyers. This unique publication is designed to help coders and attorneys understand and navigate the complex intersection of healthcare coding and the law. This valuable manual discusses the nuances of coding, why proper coding is essential for healthcare facilities and professionals, and the legal implications of improper coding.
The manual begins with introductory chapters on the various sources for codes, including Current Procedural Terminology (CPT), International Classification of Diseases Ninth Revision (ICD-9), and Healthcare Common Procedural Coding System (HCPCS). This is followed by an overview of the applicable fraud & abuse statutes and regulations, including Civil Monetary Penalties Law (CMPL), the False Claims Act (FCA), the Anti-Kickback Statute (AKS), and the Stark Law. These discussions are followed by ten chapters that are dedicated to specific specialty settings in healthcare where coding is a critical element: physicians, emergency rooms, ambulatory surgery centers, critical care, radiology, pathology, evaluation and management, anesthesiology, surgery, and medicine.
The importance of a detailed compliance plan for coding is discussed throughout the book, as are cases brought by federal and state governments against healthcare providers for improper coding. Also included is a searchable CD-ROM containing the full text of the manual with links to selected cases, statutes, and regulations. Don't miss out on this indispensable resource for health law attorneys, professional coders and other professionals who need to understand the nuianced world of medical coding.
PROJECT LEADERS: Rhonda Buckholtz & Robert A. Pelaia
EDITORS: Brad Ericson & Renee Dustman
AUTHORS: Katherine Abel, Nicole Benjamin, Richard J. Brooderson, Rhonda Buckholtz, Gregory A. Chaires, Julie E. Chicoine, Shelly Cronin, Kerin Draak, Stephanie Ellis, Brad Ericson, Amy Fouts, Michael A. Gardner, Nate Gilmer, Deborah Grider, JoAnn M. Guerrero, Jillian Harrington, Raemarie Jimenez, Jodi Laurence, Terry Leone, Kelly Loya, Theresamarie Mantese, Jonnie Massey, Robert E. Mazer, Leslie Murphy, Gregory M. Nowakowski, Christopher A. Parrella, Abby Pendleton, Liston E. Radney III, David L. Rogers, Donna SanGiovanni, Harry R. Silver, Kevin Solinsky, Jennifer L. Weaver