Medical Billing and the PPO Plan

Procedure codes are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals. The ICD-10-PCS is a system of medical coding used for procedure codes.

The coding professional world is getting trained and waiting for the implementation of the ICD-10-PCS. Developed by The National Center for Health Statistics (NCHS) this new procedure coding system will be a successor to Volume 3 of ICD-9-CM and a modified version of the original ICD-10. Who is responsible for the implementation of the new coding system? Well it is the World Health Organization (WHO) that gave permission to the NCHS to develop the ICD-10-PCS and only the WHO has to decide on the date when the new system will replace the ICD-9-CM. The ICD-10-CM is the proposed replacement for ICD-9-CM, Volumes 1 & 2. Has the rest of the world also been implementing similar processes? Here is a document on the assessment of the ICD-10 in the South East Asia region from the WHO website http://whqlibdoc.who.int/searo/2002/SEA_HS_220.pdf

Take a look at the NCHS Homepage at http://www.cdc.gov/nchs/Default.htm

Every medical code has seven characters that can be alphanumeric (either alphabets or numbers) These are the characters.

• Section
• Body System
• Root Operation
• Body Part
• Approach
• Device
• Qualifier

Labels: AAPC 2008 National Medical Coding Conference, ICD-10-PCS, medical billing, Procedure Coding System

• Networking with colleagues, physicians and educators
• 70 vendors showcasing latest products
• Over 30 educational sessions
• A gathering of top coding professionals from all over the country

Labels: AAPC, AAPC 2008 National Medical Coding Conference, Medical Coding, Orlando Coding conference

Medical coding/ billing is today one of the 10 fastest-growing allied health occupations. Medical coding and billing professionals are responsible for submitting the proper documents to the various insurance companies and federal agencies for reimbursement of the medical expenses. Medical coders use special codes to specifically identify outpatient and also inpatient procedures / services and this is very useful for billing of both private as well as public insurance companies.

HCPCS stands for Healthcare Common Procedure Coding System. It is a set of health care procedure codes based on the American Medical Association's Current Procedural Terminology (CPT). See the official website of HCPCS at http://www.cms.hhs.gov/MedHCPCSGenInfo

Established in the year 1978, HCPCS provides a standardized coding system for describing the specific items and services provided in the delivery of health care. This type of coding ensures that insurance claims are processed properly and is needed by Medicare, Medicaid, and other health insurance programs.

HCPCS codes exist in two levels.

• Level I is numerical and consists of the American Medical Association's Current Procedural Terminology (CPT)
• Level II codes are alphanumeric and meant for non-physician health services.

Labels: HCPCS, Healthcare Common Procedure Coding System, medical billing, Medical Coding, medical transcription

Whenever there are problems during a medical bill claim it becomes quite embarrassing leading to stress for the client and others. Hence it is best to avoid mistakes right from the beginning itself. Medical billing and collection errors do occur due to oversight or even incompetence. Some of the common mistakes that cause problems in the medical billing process are listed below.

• Bills are confusing and difficult to understand
• Not consistent billing cycle
• Double billing/ overcharges
• Charges for services not given
• Time constraints
• Credit card payment problems
• Not well filed insurance
• Disputed outstanding bills
• Problem with billing network
• Medical billing software problems
• Denial of care to prepaid insurance coverage
• Taking out very old bills
• Denial of care to children of parents with outstanding balances
• Improper collection practice
• Wrong place, person, address
• Balance owed overlooked
• Failure in credit payment

Labels: insurance bill claim Problems, medical billing, Medical Coding, medical outsourcing, medical transcription

The American Academy of Professional Coders (AACP) is now offering audio conferences with various topics throughout the year. Professional coders can get coding education from a qualified presenter while obtaining CEUs (continuing education units) online. During each session one can listen and also interact with the presenters. Each session is worth 1.5 CEUs.

Upcoming schedules:

• December 18th 2007 (Radiology Coding)
• December 19th 2007 (Opthalmology Coding)Update

• Can get the skinny on new codes and the latest on the federal government's OIG work plan, fee schedule issues, and instructions on new modifiers for 2008 all targeted to the important 2008 coding and compliance issues of radiology.
• Highlights on the 2008 CPT® and 2008 ICD-9-CM changes.
• For CPT® 2008, there are 242 new codes, 298 revised codes, and 364 deleted codes. These code changes must be implemented by January 1

CPT

Understand the latest CPT code and modifier updates that are specific to radiology with instructions for successfully implementing them into your practice. Learn how these changes will affect your organization, and how you can prepare effectively.

HCPCS Level II

Successfully implement the Medicare rules for new and revised HCPCS Level II codes. BONUS: We also cover ICD-9-CM

Find out how the ICD-9-CM changes (effective Oct. 1, 2007) will alter the way you code and how it affects your reimbursement.

Details on the Ophthalmology conference scheduled for December 19th can be seen at http://www.aapc.com/onlinestore/item-details.aspx?pid=5140&id=141

Conference registration forms can be accessed at http://www.aapc.com/documents/Workshop_Audio%20Reg.pdf

AACP Membership details are at http://www.aapc.com/membership/index.aspx

Outsource Strategies International (OSI) is a US based medical transcription company offering professional solutions for medical billing, medical coding and medical transcription outsourcing.

Labels: 2008 coding updates, AACP, CPT codes, Medical coding audio conference, Medical Coding Updates, medical transcription