Tag Archives: Mental Health

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.