Medical Billing Professionals Know

Navigating the world of medical billing can be treacherous. Using the correct procedure and diagnosis codes determines whether or not insurance will provide compensation for the treatment provided to patients. Mental health, counseling, and psychiatry related billing and coding (and the related codes) adds a layer of complexity and is not to be taken lightly. The complex codes and procedures required to properly reflect a provided mental health service take time to learn. This is one of the many reasons that billing is an entire profession for which one can receive certification after training and education. Certified Professional Coders (CPC) are backed by the American Academy of Professional Coders (AAPC) after passing an exhaustive exam, while Certified Medical Reimbursement Specialists (CMRS) are accredited through certification from the American Medical Billing Association (AMBA).

These professionals use CPT codes and ICD codes together in the medical billing process. But what, exactly, are these codes?

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CPT Codes

CPT stands for Current Procedural Terminology. CPT codes are a set of numerical codes used to report provided services of a medical or diagnostic nature to other physicians, accreditation entities, and especially to health insurance companies. Procedures described by these codes usually must be related to a corresponding and appropriate ICD diagnosis code. Without an appropriate diagnosis, a procedure code (which is the purview of CPT coding) can be easily denied. There are three categories of CPT codes, including an entire category of non-billable supplementary tracking codes for the purpose of providing greater detail about the healthcare services provided.

ICD Codes

These alphanumeric codes are used in medical, mental health, surgical and other healthcare settings to represent diagnoses as accurately and precisely as possible. These codes function in multiple capacities, as they are used to inform medical reimbursement decisions in addition to tracking epidemiological trends in populations. The current standard is the ICD-10, which stands for International Statistical Classification of Diseases and Related Health Problems, 10th Revision. ICD codes are developed, owned and published by the World Health Organization (WHO). Regulating organizations and national governments adopt the system, by which the standards of the medical diagnostic community are established.

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Medical Coding Updates and Shakeups

Due to the still relatively recent update from ICD-9 to ICD-10, which occurred in October of 2015, standards for coding have improved. With this increase in level of detail, the changeover has not been as smooth as was originally anticipated, and medical coding and billing errors have seen a corresponding increase. Being a provider- be it in the mental health, psychiatric, chiropractic or other arenas- carries its own set of burdens. Dealing with returned reimbursement claims due to a lack of specificity or incorrect pairing of CPT and ICD codes is far too common a problem. A simple solution is to not try and do it all in-house!

Coding and Billing Help

Establishing a clientele, providing quality medical care, and tracking patients with follow-up and aftercare requires enough diligence on its own. Psych Biller is a medical billing and coding company with experience in psychiatric and mental health billing and coding. Our expertise in ICD-9, ICD-10 and CPT coding is a result of our quality, experienced billing professionals. Let us provide you with a modern and streamlined solution for your billing and coding needs- call us for more information at (800) 955-3461.