Explain why it is important to know the differences between the code sets when submitting electronic claims?

The use of code sets is used to conceal sensitive information such that only professionals are able to decipher the information being transmitted. Hence, failure to understand the different code representation could lead to erroneous interpretation.

According to the Health Insurance Portability and Accountability Act, which is a federal law geared towards the protection of patient's health information. Sensitive health information must be duly protected and preserved. Hence, the use of codes in submitting electronic claims.

Therefore, the need to understand the different code sets is vital towards correct interpretation and understanding of patient's claim.

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It is important that the medical coder puts in the correct code when submitting claims. It is important because the codes show what the patient is seen for and what the doctor does during the procedure or office visit. If the coder puts in the wrong code set, the patient could be misdiagnosed to their insurer or charged unfairly. Each visit, procedure, lab test, etc has their own code set to abide by. The coder should have software that enables them to check over their codes before the final submission.

During the process of submitting electronic claims, HIPPA law must followed and the patients privacy should always be kept as the number one priority.

    however, coronary heart disease , or chd, is actually a result of coronary artery disease, or cad, said edward a. fisher, m.d., ph.d., m.p.h., an american heart association volunteer who is the leon h. charney professor of cardiovascular medicine and also of the marc and ruti bell vascular biology and disease program at the nyu school of medicine.

  with coronary artery disease, plaque first grows within the walls of the coronary arteries until the blood flow to the heart’s muscle is limited. view an illustration of coronary arteries. this is also called ischemia. it may be chronic, narrowing of the coronary artery over time and limiting of the blood supply to part of the muscle. or it can be acute, resulting from a sudden rupture of a plaque and formation of a thrombus or blood clot.

    the traditional risk factors for coronary artery disease are high ldl cholesterol, low hdl cholesterol, high blood pressure, family history, diabetes, smoking, being post-menopausal for women and being older than 45 for men, according to fisher. obesity may also be a risk factor.

    “coronary artery disease begins in childhood, so that by the teenage years, there is evidence that plaques that will stay with us for life are formed in most people,” said fisher, who is former editor of the american heart association journal, atvb. “preventive measures instituted early are thought to have greater lifetime benefits. healthy lifestyles will delay the progression of cad, and there is hope that cad can be regressed before it causes chd.”

  living a healthy lifestyle that incorporates good nutrition, weight management and getting plenty of physical activity can play a big role in avoiding cad.

    “coronary artery disease is preventable,” agreed johnny lee, m.d., president of new york heart associates, and an american heart association volunteer. “typical warning signs are chest pain, shortness of breath, palpitations and even fatigue.” if you feel any of these symptoms, don’t delay — call 9-1-1.

that information cannot be released except with patient permission or to immediate family members. you could state the patient is ok but you cannot give any information on the illness or on treatment being given.