Most people who have medical treatment here in the U.S. will be aware of what medical billing codes are. Those who work as medical coders will have a good understanding of what these codes mean and how they are used. Nevertheless, for the average person the codes make no sense, and they cannot tell what the numbers and digits mean. Moreover, because there are hundreds of thousands of different codes in use, it is hard going for those not in the industry to decipher a code relating to their treatment.
How do Medical Billing Codes Work?
There are three distinct categories of medical billing codes here in the U.S. These codes are:
- CPT (Current Procedure Terminology)
- ICD (International Classification of Diseases)
- HCPCS (Healthcare Common Procedure Coding System).
CPT codes give healthcare workers a way to label medical treatments and procedures quickly and easily, making reporting more accurate and efficient. ICD 10 codes are used in relation to a patient’s diagnosis. They describe the injuries, symptoms, and diseases that a patient might be suffering with. A new system has been recently introduced that uses ICD 11 diagnostic codes in the hope of making coding and billing more accurate. The two systems are similar to each other but in ICD 11 codes, the letters ‘I’ and ‘O’ are no longer used to avoid any confusion with the numbers ‘1’ and ‘0’.
ICD codes are alphanumeric codes and can have from three to seven characters. A code with more characters will indicate a more specific diagnosis. The first character in an ICD code will always be a letter but the remaining codes can be either letters or numbers.
HCPCS billing codes are based on the CPT code system and are used by both Medicare and Medicaid. The difference is that the American Medical Association holds the rights to the CPT codes whereas HCPCS codes are accessible by everyone according to the Health Insurance Portability and Accountability Act (HIPAA).
Why are Medical Codes Necessary?
Medical coding is a vital part of the healthcare system here in the United States. It provides uniformity and allows for seamless reporting. Coding is the language that healthcare providers and insurance companies use to communicate with each other in terms of a patient’s health. Every single aspect of a patient’s care is documented and translated into specific codes, understood by medical professionals and insurance providers alike.
When a claim is raised for payment, it will include a series of unique codes that correspond to diagnoses, treatments, equipment used, tests carried out, medication provided, and any administrative tasks connected to any of these. The insurance company uses the codes to work out how much they are going to reimburse the medical provider.
Making Sense of Medical Codes
Unless you work in coding or billing, the ability to understand medical coding will only become important if you are receiving treatment in a medical facility or if you are trying to make sense of a statement sent by your medical provider. The good news is that you do not actually have to search through a pile of books containing codes anymore. Online databases such as those at Findacode.com make it easier for everyone to search specific codes to find out what they mean.
You can also search for medical terms to find out what the relevant code is. So, for example, if you have been treated for a broken arm and want to find out what your insurance covers, you can get the relevant code before calling your insurance provider. This may make it easier for you to communicate and get the information you need.