Changing of the Codes; ICD-10 and CPT Codes

4 Feb

https://www.podbean.com/media/share/pb-einvm-a6b4a6

Changing of the Codes; ICD-10 and CPT Codes

 

Welcome to Billing Buddies YouTube and Podcast series. 

In this episode, we will be discussing the annual changing of the codes; particularly, the ICD-10 and CPT codes.

Healthcare professionals, medical billers and payers rely on several types of codes sets in order to communicate pertinent information about patients.  These code sets include TOS (Type of Service); POS (Place of Service), and NPI (National Provider Identifier) to name a few.  In this writing, I will address the codes that are updated annually, the ICD-10 and CPT Codes.

The ICD-10 codes are specifically called either ICD-10 CM or ICD-10 PCS.  The ICD-10 CM codes are used for all healthcare settings except hospital inpatient settings where ICD-10 PCS codes are used.  For the purposes of this writing, I will be referring to ICD-10 CM codes and abbreviate them to ICD-10.  Each year on October 1st, the ICD-10 codes have revisions, additions and deletions.  These codes are copyrighted and maintained by the World Health Organization.  The ICD-10 codes define the diagnosis of the patient.   There are many free resources online for healthcare professionals and billers to find the updated codes.  One of my favorite sites is the www.icd10data.com.   On this site, you can see the added, deleted and revised codes.   Codes with red arrows next to them signify codes that are non-billable/non-specific codes.  These codes cannot be used for billing purposes.  Codes with green arrows next to them signify codes that are billable codes.  It is important to note that diagnosis codes should be coded to the highest specificity.  Besides free online resources, ICD-10 coding books may also be purchased from several publishers.

CPT codes are copyrighted and maintained by the AMA.  CPT is the acronym for Current Procedural Terminology.  The CPT codes define the services and procedures received by patients.  Each year on January 1st, the CPT codes have revisions, additions and deletions.   The CPT coding updates need to be purchased either in books or an online subscription.   Many of the CPT codes are addressed in payer policies and can be read for free online, but for a complete resource, it is best to purchase an updated manual or online subscription.

It’s important to note that HIPAA defined which codes sets are used to communicate.  Prior to HIPAA, many payers defined their own codes sets.  For example, in some specialties, like chiropractic, codes varied by payer.  Medicare, worker’s compensation and commercial insurance each had their own code sets.  HIPAA streamlined the coding processes by defining one code set for each data element.

In summary, whether you use online resources or purchase manuals, it is important to note that ICD-10 codes update each year on October 1st and CPT codes update each year on January 1st.  You want to stay updated to the most current codes to be compliant with your coding and billing and to reduce denials from payers.

This was brought to you by Billing Buddies.  Billing Buddies is a medical billing and consulting service established in 1994.  We offer services to a variety of specialties across the United States.  For more information, please call or text 612.432.2366.  Thank you for listening to Billing Buddies YouTube and Podcast Series and remember to “Buddy Up with the Best”, Billing Buddies.   Have a great day!

Changing of the Codes; ICD-10 and CPT Codes

4 Feb

Changing of the Codes; ICD-10 and CPT Codes

 

Welcome to Billing Buddies YouTube and Podcast series.

In this episode, we will be discussing the annual changing of the codes; particularly, the ICD-10 and CPT codes.

Healthcare professionals, medical billers and payers rely on several types of codes sets in order to communicate pertinent information about patients.  These code sets include TOS (Type of Service); POS (Place of Service), and NPI (National Provider Identifier) to name a few.  In this writing, I will address the codes that are updated annually, the ICD-10 and CPT Codes.

The ICD-10 codes are specifically called either ICD-10 CM or ICD-10 PCS.  The ICD-10 CM codes are used for all healthcare settings except hospital inpatient settings where ICD-10 PCS codes are used.  For the purposes of this writing, I will be referring to ICD-10 CM codes and abbreviate them to ICD-10.  Each year on October 1st, the ICD-10 codes have revisions, additions and deletions.  These codes are copyrighted and maintained by the World Health Organization.  The ICD-10 codes define the diagnosis of the patient.   There are many free resources online for healthcare professionals and billers to find the updated codes.  One of my favorite sites is the www.icd10data.com.   On this site, you can see the added, deleted and revised codes.   Codes with red arrows next to them signify codes that are non-billable/non-specific codes.  These codes cannot be used for billing purposes.  Codes with green arrows next to them signify codes that are billable codes.  It is important to note that diagnosis codes should be coded to the highest specificity.  Besides free online resources, ICD-10 coding books may also be purchased from several publishers.

CPT codes are copyrighted and maintained by the AMA.  CPT is the acronym for Current Procedural Terminology.  The CPT codes define the services and procedures received by patients.  Each year on January 1st, the CPT codes have revisions, additions and deletions.   The CPT coding updates need to be purchased either in books or an online subscription.   Many of the CPT codes are addressed in payer policies and can be read for free online, but for a complete resource, it is best to purchase an updated manual or online subscription.

It’s important to note that HIPAA defined which codes sets are used to communicate.  Prior to HIPAA, many payers defined their own codes sets.  For example, in some specialties, like chiropractic, codes varied by payer.  Medicare, worker’s compensation and commercial insurance each had their own code sets.  HIPAA streamlined the coding processes by defining one code set for each data element.

In summary, whether you use online resources or purchase manuals, it is important to note that ICD-10 codes update each year on October 1st and CPT codes update each year on January 1st.  You want to stay updated to the most current codes to be compliant with your coding and billing and to reduce denials from payers.

This was brought to you by Billing Buddies.  Billing Buddies is a medical billing and consulting service established in 1994.  We offer services to a variety of specialties across the United States.  For more information, please call or text 612.432.2366.  Thank you for listening to Billing Buddies YouTube and Podcast Series and remember to “Buddy Up with the Best”, Billing Buddies.   Have a great day!

 

Insurance and Credit Cards – Streamlining Your Cash Flow in the New Year

5 Jan

Insurance and Credit Cards – Streamlining Your Cash Flow in the New Year

 

Welcome to Billing Buddies YouTube and Podcast series.

In this episode, we will be discussing streamlining your cash flow in the New Year by obtaining current insurance cards and credit card authorizations.

With the New Year upon us, it is especially important to get copies of your patients’ active insurance cards and to get credit card authorizations to secure their accounts with your clinic.  These two steps will significantly increase your cash flow.  In fact, these two simple tasks will, if followed, increase your cash flow all year long.

Let’s start with the understanding that in the fourth quarter of each year, Medicare and private insurance companies have Open Enrollment.  Open Enrollment is when patients can switch coverage for the first of the coming year.  Because so many of your patients may have changed insurance coverage the first of the year, it’s imperative to get new copies of insurance cards and to update your billers and billing software with the new policy numbers.  Also, if you get denials from insurance companies that coverage is terminated, it is wise to immediately call or send a statement to the patient for the balance, so they will either pay or respond with their current insurance information.

In addition, at the first of the year, deductibles go back into effect.  Many clinics are starting to secure the patient accounts with a credit cards on file.  Securing a patient account with a credit card on file is a straight forward process.  You need to have a form for the patient to complete and sign that gives their credit card information and permission for you to automatically charge their credit card for any balances due.  If you need a sample form to secure credit cards on file, please email bonnie@billingbuddies.com and put in the subject line “Credit Card Authorization”.  My email again is bonnie@billingbuddies.com spelled out b-o-n-n-i-e-@-b-i-l-l-i-n-g-b-u-d-d-i-e-s.com.

Finally, remember that all year long it is important to verify a patient’s active coverage by getting copies of their current insurance cards and it’s important to secure their account with your clinic by having a credit card authorization on file.

Billing Buddies is a medical billing and consulting service established in 1994.  We offer services to a variety of specialties across the United States.  For more information, please call or text 612.432.2366.  Thank you for listening to Billing Buddies YouTube and Podcast Series and remember to “Buddy Up with the Best.”  Have a great day.

 

Billing Buddies ® Medical Billing and Consulting Services

25 Dec

https://www.podbean.com/media/share/pb-z7iis-a2bf42

Need medical billing services?  “Buddy Up with The Best” Est. 1994 ® – Billing Buddies ® 

Call or Text (612) 432-2366 or email bonnie@billingbuddies.com.

Chiropractic ABN’s

25 Dec

https://www.podbean.com/media/share/pb-uvrc7-a2bf2d

Chiropractic ABN’s

 

Welcome to Billing Buddies YouTube and Podcast series. 

In this episode, we will be discussing Chiropractic ABNs. 

First, let’s define an ABN.  An ABN is an abbreviation of a Medicare form known as the Advanced Beneficiary Notice.  Medicare requires providers give an ABN to beneficiaries if the Medicare services they are proposing to deliver is suspected to not be covered by Medicare.  If the service is statutorily excluded from the Medicare program, such as exams and therapies for chiropractic care, Medicare does not require an ABN be presented to the patient.  Medicare only requires an ABN be presented on services that can be covered under the program such as CMT’s for chiropractic care.    

It’s very important when receiving information that you can look up and research the data yourself.  For this reason, whenever possible, Billing Buddies will share the source for you to review.  The information from this presentation came from www.CMS.gov.  You can type ABN in the upper right-hand corner of the screen and search for information on Advance Beneficiary Notices or ABN’s.

Now, let’s take a look at the form.  There are several boxes to complete.  You can see items A through J are to be completed by the provider and the patient.  Let’s review the form.

     Field A = Enter the Notifiers Information – This is the clinic and staff member presenting the ABN.

     Field B = Enter the Patient’s Name

     Field C = Enter the Patient’s Medicare Number

     Field D = Enter the Service to be provided.  In Chiropractic care, this would be the CMT.  You could enter codes 98940 – 98942 in this field.

     Field E = Enter the Reason Medicare may not pay.  In Chiropractic care, the most common reason would be that the CMT was considered maintenance care.  But, review your Local Coverage Determination from your carrier for a complete list.

     Field F = Enter the estimated cost.  If more than one service is listed in Box D, enter the estimated cost for all services.

     Field G = All the fields on the ABN are important, but this one is especially important.  Patient’s are required to pick one of the three options.  The provider may not complete this portion of the form or it will invalidate the form.

    Field H = This is a field where additional information may be provided.

    Field I = This requires the patient or representative to sign the form.  If a representative signs the form, have the representative write “representative” in parenthesis after his/her signature.

    Field J = The patient or representative must date the form when signed.

 

That completes our ABN video.  Thank you for watching.  Please subscribe to our channel and like our videos. Also, please comment if you would like other videos presented and suggestions on topics.  

Billing Buddies has been assisting providers since 1994 and offers billing services, training and consulting.  For more information, call or text 612.432.2366 or email bonnie@billingbuddies.com.

 

 

Chiropractic ABN’s

25 Dec

Welcome to Billing Buddies YouTube and Podcast series.

In this episode, we will be discussing Chiropractic ABNs.

First, let’s define an ABN.  An ABN is an abbreviation of a Medicare form known as the Advanced Beneficiary Notice.  Medicare requires providers give an ABN to beneficiaries if the Medicare services they are proposing to deliver is suspected to not be covered by Medicare.  If the service is statutorily excluded from the Medicare program, such as exams and therapies for chiropractic care, Medicare does not require an ABN be presented to the patient.  Medicare only requires an ABN be presented on services that can be covered under the program such as CMT’s for chiropractic care.

It’s very important when receiving information that you can look up and research the data yourself.  For this reason, whenever possible, Billing Buddies will share the source for you to review.  The information from this presentation came from www.CMS.gov.  You can type ABN in the upper right-hand corner of the screen and search for information on Advance Beneficiary Notices or ABN’s.

Now, let’s take a look at the form.  There are several boxes to complete.  You can see items A through J are to be completed by the provider and the patient.  Let’s review the form.

Field A = Enter the Notifiers Information – This is the clinic and staff member presenting the ABN.

Field B = Enter the Patient’s Name

Field C = Enter the Patient’s Medicare Number

Field D = Enter the Service to be provided.  In Chiropractic care, this would be the CMT.  You could enter codes 98940 – 98942 in this field.

Field E = Enter the Reason Medicare may not pay.  In Chiropractic care, the most common reason would be that the CMT was considered maintenance care.  But, review your Local Coverage Determination from your carrier for a complete list.

Field F = Enter the estimated cost.  If more than one service is listed in Box D, enter the estimated cost for all services.

Field G = All the fields on the ABN are important, but this one is especially important.  Patient’s are required to pick one of the three options.  The provider may not complete this portion of the form or it will invalidate the form.

Field H = This is a field where additional information may be provided.

Field I = This requires the patient or representative to sign the form.  If a representative signs the form, have the representative write “representative” in parenthesis after his/her signature.

Field J = The patient or representative must date the form when signed.

That completes our ABN video.  Thank you for watching.  Please subscribe to our channel and like our videos. Also, please comment if you would like other videos presented and suggestions on topics.

Billing Buddies has been assisting providers since 1994 and offers billing services, training and consulting.  For more information, call or text 612.432.2366 or email bonnie@billingbuddies.com.

 

Quickly Learn ICD-10 Updates and Revisions

11 Oct

Each year on October 1st, the ICD-10 codes are updated and revised.  Watch our YouTube Video that explains how to quickly learn the updates and revisions.