CPT (Current Procedural Terminology) system was developed by the American Medical Association (AMA) to assist in standardizing medical billing practices. The medical codes are incorporated to designate multiple health care services provided by a doctor. Thriving practices and clinicians must have superior knowledge about using the correct codes. CPT codes fall under several classifications. The health care coding services system is regulated by CMS (Centers for Medicare and Medicaid Services) following the mandate provided by HIPAA. Working as a medical billing and coding specialist can be both challenging and rewarding in many ways.
ICD-10CM is the brand-new US professional requirement for (International Classification of Diseases) consists of more than 68,000 medical diagnostic codes while ICD-9 includes more than 13000 diagnoses. HCPCS (Healthcare Common Procedure Coding System Codes) are further subdivided into two categories. HCPCS Level I codes relate to medical procedures and medical services whereas HCPCS Level II codes are used in reporting medical supplies, items, procedures and particularly professional services not covered by any CPT codes.
Modifiers and diagnosis codes are ascribed within these sheets. This is a flexible way to keep records of CPT codes that help in billing for various coverages, payment options and also track records of medical procedures. There are printable coding practice worksheets readily available online to cross reference and help professional coders to identify diagnostic coding practices. This helps train and test the working knowledge of medical billing and coding professionals.
Practical Use of Medical Coding Worksheets
The relevance of cpt coding practice worksheets cannot be denied in preparing for the identification and application of the right CPT codes for maximum reimbursements. Memorizing a huge number of diverse CPT codes is no piece of cake. Numerous quizzes in the form of online tools, reference guides, and specialty content are devised for budding coding specialists. These are also available in the form of flashcards that are more conducive for E-learning of CPT coding. Coding specialists spend most of their time cramming up diagnostic codes to review medical records for accurate and timely reimbursements for providers. Resource-Based relative scale RBRVS is a schema used by providers that serve to outline the reimbursements that are due. It is used by CMS and most payers out there today. There is a high need for competent medical coders that are fully aware of government regulations and private insurance policies. Being well versed in acronyms, medical jargons that define medical apparatus also helps coders.
Medical Terminologies for Adept Coding Practices
Supporting phrases that aid in translating medical documentation into code is extremely crucial for a coding practice to thrive. Accredited training can be accessible in the form of acquiring a degree in the health care management discipline. Several self-study courses that cover the topics related to deciphering specialized terminologies to point out the necessity of any medical procedure. This chalks out the relevant path for adequate insight and knowledge to understand what the patient went through. This also necessitates the differentiation of the anatomical structure of the body. This only goes to show that a medical coder’s work is not limited to reading codes but having an adept ability to connect the dots. This can further be understood by the prescription advised by the practitioner which has short abbreviations that need to be understood in depth. A discernment of medical documentation is a critical skill for any medical billing and coding service provider.
Value-based Pointers while Studying for CPC Exams
Aspiring medical billing and coding experts have to pass the AAPC American Association of Professional Coder (AAPC)’s Certified Professional Coder (CPC) exam to gain their certification. Study areas that require in-depth preparation could be medical terminologies, HCPCS codes, Modifiers, ICD-10 CM codes, and all bodily functions. CPC certification guides, coding audio tutorials, prep courses, medical coding ebooks and online classes are the best online resources available for the exams. For greater medical coding exam preparation and success, the AAPC study manual provides immense support in all practice management related terminologies and coding best practices. Tutorial videos by seasoned veterans of medical billing and coding provide real-time coding practice as well. MCQs also help in gaining proficiency in all coding related materials. There are further categories of medical coding exams such as CPMA (Certified Professional Auditor), COC (Certified Outpatient Coder)and CIC (Certified Inpatient Coder) to refine the skill set of medical billing and coding professionals. All these certifications are extremely crucial for the modern-day medical coding expert.
Practical Coding tips for pediatrician evaluation and management
Pediatric care revolves around counseling the sensitive needs of infants, children and adolescents. It requires more patience for pediatricians to attend to obesity related health hazards and patients that require focused care. The type of care or treatment required also depends on whether the case is simple, problematic, complex or extreme. EM (Evaluation and Management) codes directly correlate to office and outpatient codes for new or established patients. E&M codes help in establishing and knowing what visit codes are used in each outpatient or inpatient treatment. E&M coding is the process by which physician-patient encounters are translated into five-digit CPT codes to facilitate billing. There are different E&M codes for different types of encounters such as office visits or hospital visits. Every billable procedure has its own CPT code. Evaluation and management CPT Coding worksheets can help in the reduction of billing errors for Pediatricians immensely.
ALSO READ: Is mental health billing different from medical billing?
How Transitional Management Coding Works
All about Transitional Care Management (TCM) Coding: Transitional Care is the period between the complete treatments of a patient at a facility to the point of their discharge. Several Medicare policy holders in the US are susceptible to medical readmission at a health care facility within a month of discharge. The underlying issue is the late follow up regarding new diagnostic medications adjustments or treatments for a chronically ill patient. It is the period that includes the physical stay of a patient within a facility to their release back home. The primary goal for a health care facility is to lower the ratio of patient readmission through proper steps at the time of transition. Two CPT codes have been in place since 2013 for the payment of Transitional Care Management (TCM) services.
Specific CPT Codes for TCM reporting are:
99495 –A mild medical complication that requires a face-to-face visit within the first two weeks of discharge from a facility. It covers communication with the primary care provider within two business days. This can be done in-person, through a call or via email.
99496 – A medical complexity that is intense and requires face to face visit to a facility within a week of dismissal from a medical facility. This code also entails communication with the doctor within two business days through the same mediums of calling, emailing or in-person.
The prevalence of medical billing and coding practice worksheets helps in identifying areas of improvement and critical assessment of medical coding knowledge. The complex usage of CPT, ICD-9 and ICD-10 coding guidelines in the healthcare industry cannot be overlooked. Tens of thousands of dollars are charged in medical billing due to errors in coding.
GreenSense Billing has been serving the needs of health care providers for over 20 years with our team of experts. As physicians are pressured to deliver an increasing number of preventive services, all while following strict guidelines, and engaging in quality patient care. We handle of all their medical billing and coding needs with precision.
