Tag Archives: medical billing service

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.



Four Reasons to Consider Outsourcing Your Medical Billing

17 Jul

Small medical practices face a number of challenges. Perhaps the greatest challenge is handling medical billing.  Without adequate staff, a medical practice is not able to send out bills and receive payment in a timely fashion. This, in turn, can negatively affect all areas of the practice.

One solution to medical billing issues is outsourcing those tasks to a professional medical billing company. Many physician offices, however, are reluctant to consider outsourcing for a variety of reasons. These include everything from losing control over their billing staff to concerns about patient satisfaction and security.

While all of these are legitimate concerns, they can be alleviated by performing due diligence so as to guarantee hiring the best medical billing company possible. Further, reviewing the length, terms and conditions of any contract signed with a medical billing company will go a long way toward preventing potential problems.

While hiring a medical billing company is an important decision, when you consider the many benefits, it is likely that you will find it to be the right decision. What follows is a list of four of the most important benefits.

1. Superior Patient Care. The principal purpose of any medical clinic is to provide exceptional care to its patients. In smaller offices, the financial side of the practice can be a drain on staff and resources that could go toward a better patient experience. When you outsource billing tasks, all hands can be on deck to improve patient care.

2. Fewer Billing Errors. Smaller medical offices have fewer staff members to handle billing issues. This leads to more errors and a greater number of denied claims. Further, staff members have less time to make sure that they receive the maximum reimbursement on every claim. It also is difficult for small or understaffed billing offices to remain in compliance with constant changes in billing regulations and requirements related to Medicaid, Medicare and third-party payers. Professional billing companies provide ongoing training to their employees so that they are up to date on any and all changes related to compliance. That means claims filed are far less likely to contain errors.

3. Improved Cash Flow. A small medical billing staff means that when one or more staff members are on vacation or sick, claims cannot submitted in a timely manner. This disruption ultimately leads to an irregular flow of money into the practice. With a medical billing company, this will not happen.

4. Dedicated Billing Assistance. Superior patient care is critical to a medical clinic’s success. However, even if a patient gets the best medical care available, if they encounter issues related to billing, they are likely to move to another provider. When you outsource your billing to a quality medical billing company you can be assured that your patients will receive courteous and professional assistance when they have questions or issues related to their bill.

Outsourcing your medical billing can be a difficult decision and it is important that you do your homework and select the company that is best for your particular medical office. Once you do, however,  you may be pleasantly surprised at how much better you are at providing your patients the best care possible.


Need billing services or consulting?   Call or text 612-432-2366.  Or email, Bonnie J. Flom at bonnie@billingbuddies.com.  We have 24 years of medical billing experience.