System and method for correlating medical procedures and medical billing codes

• US 5,325,293 A
• Filed: 02/18/1992
• Issued: 06/28/1994
• Est. Priority Date: 02/18/1992
• Status: Expired due to Term

• Current Assignee: Howard L. Dorne
• Original Assignee: Howard L. Dorne
• Inventors: Dorne, Howard L.
• Primary Examiner(s): Envall, Jr., Roy N.
• Assistant Examiner(s): Hazard, Jennifer L.
• Application Number:
  US07/838,493
• Time in Patent Office: 861 Days
• Field of Search: 364/401, 364/406, 364/408, 364/413.01, 364/468, 364/478, 364/403
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/04 Billing or invoicing
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A method and a system for performing the inventive method are provided to correlate billing codes with planned or performed medical procedures. The method comprises the steps of determining raw codes directly associated with all of the medical procedures performed or planned to be performed with a particular patient examination, and manipulating the raw codes by the steps of a final common pathway to generate intermediate codes without altering the raw codes. The method also comprises the step of determining the billing codes from the intermediate codes.

Claims

1. A method of generating official billing codes in response to selected medical procedures, said method for use with a host computer of the type having a processing unit, memory, a monitor, and a user interface, said method comprising the steps of:

providing a category of medical procedures;

providing a collection of raw codes, each raw code corresponding to a medical procedure of said category of medical procedures;

selecting a set of medical procedures from said category of medical procedures;

generating a set of raw codes associated with the set of selected medical procedures by recalling specific raw codes from said collection which correspond to said set of selected medical procedures;

analyzing said set of raw codes to compute a set of intermediate codes, said intermediate codes representing the interrelation of the set of selected medical procedures; and

generating a set of said official billing codes from said set of intermediate codes by providing a collection of official billing codes corresponding to a collection of intermediate codes, and recalling specific official billing codes associated with said set of intermediate codes.

2. The method of claim 1 additionally comprising the step of storing said raw codes in a memory location of the processing unit.

3. The method of claim 1 additionally comprising the step of storing said intermediate codes in a memory location of the processing unit.

4. The method of claim 1, wherein said step of analyzing said set of raw codes comprises the steps of:

comparing each raw code against the other raw codes in said set of raw codes associated with the set of selected medical procedures to determine whether said set of raw codes contains any raw code associated with any selected medical procedure of the set that is a subprocedure of another selected medical procedure of the set, and eliminating said raw code associated with the medical subprocedure to compute said set of intermediate codes; and

storing said intermediate codes in a memory location of the processing unit.

5. The method of claim 1, wherein said collection of raw codes comprises at least one raw code which specifies that the associated medical procedure involves catheterization of a vessel, said raw code further specifying a vascular family of and an order of said catheterized vessel, and wherein said step of analyzing said set of raw codes comprises the steps of:

evaluating whether any of raw codes associated with the selected set of medical procedures designates that any medical procedure of the selected set involves catheterization of a vessel; and

if any of the medical procedures associated with the set of raw codes involve catheterization of a vessel, performing the steps of;

examining each raw code associated with said medical procedures which involve catheterization of a vessel to determine the order of vessels catheterized in each vascular family involved in the selected medical procedures; and

if any of the selected set of medical procedures involves catheterization of a third order vessel, performing the steps of;

providing a collection of intermediate codes representative of catheterization procedures of third order vessels for each vascular family;

recalling an intermediate code representative of the catheterization procedure of a third order vessel for each vascular family involved in the selected set of medical procedures; and

storing the intermediate code for each vascular family in a memory location of the processing unit.

6. The method of claim 5, wherein, if the selected set of medical procedures involve catheterization of more than one third order vessel of a vascular family, said step of analyzing said set of raw codes additionally comprises the steps of:

providing an intermediate code associated with the catheterization of additional second or third order vessels for each vascular family;

recalling an intermediate code representative of each catheterization procedure of additional second or third order vessels for each vascular family involved in the selected medical procedures; and

storing the associated intermediate code in a memory location of the processing unit once for each additional second or third order vessel of each vascular family involved in the selected medical procedures.

7. The method of claim 1, wherein said collection of raw codes comprises at least one raw code which specifies that the associated medical procedure involves catheterization of a vessel, said raw code further specifying a vascular family of and an order of said catheterized vessel, and wherein said step of analyzing said set of raw codes comprises the steps of:

evaluating whether any of the raw codes associated with the selected set of medical procedures designates that any medical procedure of the selected set involves catheterization of a vessel; and

if any of the selected set of medical procedures involve catheterization of a vessel, performing the steps of;

examining each raw code associated with said medical procedures which involve catheterization of a vessel to determine the order of vessels catheterized in each vascular family involved in the selected medical procedures; and

if any of the selected set of medical procedures involve catheterization of a second order vessel, performing the steps of;

providing a collection of intermediate codes representative of catheterization procedures of second order vessels for each vascular family;

recalling an intermediate code representative of the catheterization procedure of a second order vessel for each vascular family involved in the selected set of medical procedures; and

storing the associated intermediate code for each vascular family in a memory location of the processing unit.

8. The method of claim 7, wherein, if the selected set of medical procedures involve catheterization of more than one second order vessel of a vascular family, said step of analyzing said set of raw codes additionally comprises the steps of:

providing an intermediate code associated with the catheterization of additional second order vessels for each vascular family;

recalling an intermediate code representative of each catheterization procedures of additional second order vessels for each vascular family involved in the selected set of medical procedures; and

storing the associated intermediate code in a memory location of the processing unit once for each additional second order vessel of each vascular family involved in the selected medical procedure.

9. The method of claim 1, wherein said collection of raw codes comprises at least one raw code with specifies that the associated medical procedure involves catheterization of a vessel, said raw code further specifying a vascular family of and an order of said catheterized vessel, and wherein said step of analyzing said raw codes comprises the steps of:

evaluating whether any of the raw codes associated with the selected set of medical procedures specifies that any medical procedure of said set involves catheterization of a first order vessel;

providing an intermediate code associated with the catheterization of a first order vessel for each vascular family; and

if any of the selected medical procedures involve catheterization of a first order vessel, performing the steps of;

recalling an intermediate code representative of the catheterization procedure of a first order vessel for each vascular family involved in the selected set of medical procedures; and

storing the associated intermediate code for each vascular family in a memory location of the processing unit.

10. The method of claim 1, wherein said collection of raw codes comprises at least one raw code which specifies that the associated medical procedure involves a preselected anatomic location, and said method of analyzing said set of raw codes comprises the steps of:

evaluating whether any of the raw codes associated with the selected set of medical procedures involve a preselected anatomic location;

providing a collection of intermediate codes associated with medical procedures involving each preselected anatomic locating;

recalling intermediate codes associated with the selected medical procedures of said set which involve any of the preselected anatomic locations; and

storing the associated intermediate code in a memory location of the processing unit.

11. The method of claim 1 additionally comprising the step of storing said official billing codes in a memory location of the processing unit.

12. The method of claim 11, wherein said official billing codes correspond to Current Procedural Terminology (CPT) codes.

21. The method of claim 11, wherein said step of generating a set of billing codes additionally comprises the step of writing said official billing codes in the memory.

22. The method of claim 11, wherein said step of generating a set of billing codes additionally comprises spooling said official billing codes in the memory to the printer.

23. The method of claim 12, wherein said step of generating billing codes additionally comprises the steps of:

providing a collection of relative value units associated with the CPT billing codes;

recalling specific relative value units associated with said set of CPT billing codes stored in the memory location of the processing unit; and

sorting said relative value units in descending order.

13. A method of generating official billing codes in response to selected medical procedures, said method for use with a host computer of the type having a processing unit with volatile memory, nonvolatile memory, a monitor, a user interface and a data selector, said method comprising the steps of:

selecting a subset of medical procedures from a specified set of medical procedures;

analyzing said subset of selected medical procedures to determine if any of the medical procedures of said subset is a subprocedure of another selected medical procedure of said subset, and eliminating said subprocedures from said subset of selected medical procedures; and

generating a set of official billing codes for said subset of selected medical procedures by;

providing a collection of official billing codes corresponding to said specified set of medical procedures; and

recalling specific official billing codes associated with said selected medical procedures of said subset.

14. The method of claim 13 additionally comprising the step of analyzing said subset of selected medical procedures to determine if said subset of selected medical procedures contains duplicative medical procedures and eliminating any duplicative medical procedures from said subset of selected medical procedures.

15. A method of organizing medical examinations, said method for use with a host computer of the type having a processing unit with volatile memory, nonvolatile memory, a monitor, a user interface and a data selector, said method comprising the steps of:

selecting a subset of medical procedures from a specified set of medical procedures stored in the nonvolatile memory;

storing said subset of selected medical procedures in a first system variable of said volatile memory;

assigning a status to said subset of selected medical procedures and storing said status in a second system variable, said status being assigned by selecting said status from a specified set of progressive stages associated with said specified set of medical procedures, said specified set of progressive stages being stored in the nonvolatile memory; and

creating a recording having a plurality of data fields in a data base stored on the nonvolatile memory and writing said first and second system variables to corresponding data fields of said record.

16. The method of claim 15, wherein said status is selected from a group of progressive stages comprising planned, performed, reviewed and billed.

17. The method of claim 15, additionally comprising the step of:

providing a set of official billing codes for said set of selected medical procedures;

recalling a subset of specific official billing codes associated with said subset of selected medical procedures;

storing said subset of official billing codes in a system variable of said volatile memory; and

writing said system variable to a corresponding data field of said record.

18. The method of claim 15, wherein said step of selecting a subset of selected medical procedures comprises the steps of:

displaying on the monitor a plurality of examination screens which display said set of specific medical procedures; and

using the user interface or data selector to select a subset of medical procedures from said set of medical procedures displayed on said examination screens which the user plans to perform or has performed.

19. The method of claim 18 additionally comprising the step of indicating the selected subset of medical procedures displayed on an examination screen by displaying a graphical representation on the monitor of an anatomic location involved in the selected medical procedure of said subset of medical procedures.

20. The method of claim 19 additionally comprising the steps of:

storing said displayed graphical representation in a system variable specific to said examination screen display; and

writing said system variable to a corresponding data field of a record on the nonvolatile memory such that when the user recalls said examination screen, said graphical representation is redisplayed on the monitor.