Book Review: 2007 Edison Answer Book- The Annual Coding, Reimbursement and Compliance Guide for Naturopathic Physicians, Integrative and CAM Practitioners
Stacie Deyglio, ND
The 2007 Edison Answer Book is an essential tool for successful documentation, coding and billing of a naturopathic practice. The mission and purpose of the book are designed to help the practitioner get paid for the services they provide. By following the detailed tips and advice of the book, the practitioner is guaranteed to attain more than just a larger reimbursement check; they will have a strong understanding of how the process works, yielding advantages above and beyond reimbursement.
This book is actually six books in one, and includes comprehensive explanations of insurance coding, compliance and reimbursement. The digest begins with Section A’s overview of insurance, including getting started, submitting claims, self-insurance, standard insurance, managed care, personal injury, worker’s compensation, Medicare/Medicaid and appeals. This section has instructions for step-by-step completion of the CMS-1500 form, and includes a figure of the form as well. Here’s an example of a tip offered in the book: “When communicating with patients about ‘insurance coverage,’ do not use the word ‘insurance’ alone. Always use ‘insurance portion.’ This is a powerful word couplet that clarifies the real message for both the sender and the listener. It is also an effective checkmate to the false perception of many patients that ‘insurance’ means total coverage” (p. A-2).
Section B includes the ICD-9-CM diagnosis codes by tabular listing, V codes, E codes and alphabetically. Section B also includes a quick reference guide about what’s new for 2007and ICD-9 coding conventions, as well as a significant discussion on getting started with diagnosis coding. Section C encompasses information regarding procedure coding. This section is divided into discussions on evaluation and management documentation, surgery codes, imaging and laboratory codes, medicine and therapies codes, category II and III codes, HCPCS or “G” codes, procedure modifiers, ABC codes and ABC coding solutions, as well as an alphabetical coding list at the end. Section D contains information on supply coding, specifically HCPS Supply Codes, HCPCS modifiers and ABC supply codes. Section E includes information on fees. Within this section is a discussion about getting started with fees and relative value units, dollar conversion factors and fee schedules (Medicare and personalized). Section F is all about compliance, providing information on compliance guidelines of CPT, CMS Documentation, POMR documentation, HIPPA and OIG. All six books and the appendix are color coded for straightforward information location.
The appendix, Section G, reviews diagnosis, procedure and supply code changes. This section also includes state and national directories as well as two documentation guides from the 1997 and 1995 Centers for Medicare and Medicaid Services Guidelines. The Edison Answer Book is updated every year for changes in coding and insurance procedures.
I sent this book to a colleague in Connecticut when she opened her practice. She found the book to be a great resource and valuable tool. She realized that in applying the information from the book to her practice management, she has minimized her reimbursement turnaround time and increased reimbursement totals. The book is so reader-friendly that her staff uses it daily to complete insurance claims.
The 2007 Edison Answer Book is instrumental for successful practice, supporting all the principles of naturopathic medicine by facilitating the individual practice to strengthen and grow.
Stacie Deyglio, ND received her baccalaureate degree in biology with a minor in chemistry from the College of Mt. St. Vincent in New York. Her personal health issues paved the way to discovering naturopathic medicine in 1999. Resonating with the philosophy and principles of naturopathic medicine, Dr. Deyglio graduated from the University of Bridgeport, College of Naturopathic Medicine in 2003. As a medical student, she was involved in student government, fundraising and the generation of two successful student-run health fairs. Dr. Deyglio’s interests include relating integrative therapeutics to the health of pediatric and geriatric populations. Currently residing in Phoenix, Dr. Deyglio is an avid bookworm, and is actively creating her practice.