Coding for HIPAA: How to Report Professional Claims

This one-of-a-kind resource takes you from the paper-based world of health care claims and gives you the data content knowledge necessary for reporting claims in the HIPAA environment.

In clear language, this reference guide examines the CMS-1500 claim form in detail, gives a brief overview of the electronic transactions standards mandated by the secretary of the Department of Health and Human Services, and primarily addresses the non-medical code sets required under HIPAA, including:

• Place of service codes
• Claim adjustment reason codes
• Provider taxonomy code set
• Remittance remark codes
• Claim status codes

The book also provides a comprehensive education on particular elements not found in other HIPAA publications, particularly reporting the specialty of the practitioner providing the service using the appropriate provider taxonomy code on an electronic form.

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