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Medical Industry Articles
recent articles
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by Find-A-Code™
The transition from ICD-9 to ICD-10 wasn't expected to be easy. Healthcare providers and medical coders expected bumps in the road. But nearly a decade after ICD-10's release in the U.S., it still faces significant challenges. For example, the majority of rheumatology codes included in ICD-10 still aren't being used.
by Find-A-Code™
Newly certified medical coders just getting their feet wet may not think a lot about HIPAA. It is easy to assume that the relationship between the Health Insurance Portability and Accountability Act and medical codes is a casual one. But a quick perusal of the CMS Code Sets Overview tells another story. The relationship is not casual at all.
May 14th, 2024
ICD-10 Influenza Diagnosis Accuracy Questioned by New Study
by Find-A-Code™
Medical coders are tasked with the job of translating clinical text into alpha-numeric codes that describe medical events. Medical billers then use those codes to prepare claims before submitting them to insurance companies. It would seem that something like influenza, as common as it is, would be easy enough to correctly code. But how accurate are actual diagnoses?
by Find-A-Code™
Young people taking a long look at compensation before deciding on a career is normal. Even people who have been in the workforce for many years consider compensation before looking for a new job or jumping careers. It is expected. Given our industry, this leads us to wonder how medical coders and billers fare compared to other careers.
by Find-A-Code™
When a health insurance company receives claims from a medical provider, those claims are checked both electronically and with human eyes to make sure they are accurate and legitimate. But sometimes inaccurate or fraudulent claims slip through. An example are claims filed under what is known as phantom billing.
by Find-A-Code™
There has been a lot of talk about generative AI and its potential to replace human medical coders over the last 12 months or so. We have done our best to alleviate any fears among our readers. Now we can point to scientific research demonstrating that generative AI just isn't up to the task.
Apr 23rd, 2024
What Are My Sources for Medical Billing Codes for Medicare?
by Find-A-Code™
Billing Medicare for healthcare services can be challenging. Between complex policies and a plethora of medical billing codes, getting it right every time is never guaranteed. Healthcare providers and their billing departments need to be incredibly careful. They also need to use the right information, including those billing codes compatible with Medicare systems.
Apr 19th, 2024
Medical Billing Codes: Widely Adopted but Not Universal
by Find-A-Code™
If you are just getting started in your career as a medical coding or billing specialist, you may be confused as to why there are so many code sets to work with. There are several reasons, but the overarching reason that trumps all others is this: while medical billing codes are widely adopted, they are not universal.
Apr 15th, 2024
How Automation Could Address the Medical Coder Shortage
by Find-A-Code™
As artificial intelligence (AI) continues to make inroads in virtually every industry, there is legitimate concern over what it will mean to jobs that have historically been labor intensive. Concerns over AI implementation have certainly been raised in medical coding. Right now, the biggest AI influence is automation.
by Find-A-Code™
Bias is a fascinating thing. It is present in all decisions human beings make. Unfortunately, bias is impossible to avoid one hundred percent of the time because the human brain is always influenced by external forces. Even in medical billing, bias is an issue that could probably stand to get a bit more attention.
Apr 4th, 2024
Beware of 4-Week Medical Billing and Coding Courses
by Find-A-Code™
Medical coding and billing are two healthcare careers that do not require much, if any, patient-facing work. In addition, there are no legal requirements for certification. Yet most employers want their medical coders and billers to be minimally certified by an accrediting entity. That leads us to the main topic of this post: 4-week medical billing and coding courses.
Apr 2nd, 2024
Are You Familiar with Current Dental Terminology Codes?
by Find-A-Code™
Medical coding and billing specialists tend to be intimately familiar with CPT codes. They need to be. But what about CDT codes? If you don't do a lot of dental work as a medical coder or biller, you probably aren't familiar with this particular code set. Yet it is just as important as the CPT and ICD-10 sets.
by Find-A-Code™
The American Medical Association (AMA) published an announcement in mid-January discussing some minor changes to the Common Procedural Terminology (CPT) Category III Long Descriptor document. For us, the bulletin served as a reminder that often obscure, category III codes are still important.
Mar 20th, 2024
Major Healthcare IT Attack Proves Nothing Is Perfect
by Find-A-Code™
If you haven't heard the news by now, you should probably know that a substantial ransomware attack against one of the nation's leading healthcare IT providers has created a whole lot of headaches for hospitals, clinics, doctor's offices, and even patients. The attack is further evidence that nothing is perfect. Not even the most secure networks are 100% impervious to hacking.
by Find-A-Code™
Healthcare providers rely on a variety of medical billing code sets to document patient interactions for payment. Accordingly, clinicians need to account for the time they spend on individual cases for Evaluation and Management Services (E/M) under the Common Procedural Terminology (CPT) code set. A few years ago, a new total time metric was introduced for this very purpose.
Mar 12th, 2024
How Consumer-Friendly Terms Could Help Billers and Coders
by Find-A-Code™
The 2024 edition of the American Medical Association's (AMA) CPT code set includes some significant changes, among them being some 349 editorial changes. The new code set went into effect on January 1 of this year. Interestingly, the code set also includes consumer-friendly terms that could ultimately help billers and coders.
by Find-A-Code™
Every year the American Medical Association (AMA) releases an updated version of their Common Procedural Terminology (CPT) code set. If you are a medical coder or biller, you know just how prominent the CPT code set is. But how is it maintained and updated? Who determines what gets added, what gets dropped, and so forth?
by Find-A-Code™
Those interested in seeing a number of changes to the current remote patient monitoring billing codes within the CPT set will have to wait a little bit longer. The American Medical Association's (AMA) CPT Editorial Panel failed to move on the changes, citing differences among panel members. The panel says that the proposed changes are dead, at least for now.
by Find-A-Code™
Although medical billing is subject to quite a bit of generalization across the entire healthcare spectrum, different billing environments call for different requirements. Take the ambulatory surgery center (ASC). It is a very different environment compared to a GP's office.
by Find-A-Code™
Here at Find-A-Code, we will be the first once to recommend online medical code lookup for coders and billers of all skill levels. But that begs the question of whether our users still need printed materials. The answer to that question is really a matter of personal preference. There are both pros and cons to online and traditional printed code lookup.
Feb 16th, 2024
How AI Could Help Address the Shortage of Medical Coders
by Find-A-Code™
There is no denying that artificial intelligence (AI) is gradually making its way into medical coding and billing. AI's entrance into just about every aspect of technology is inevitable. As far as medical coding is concerned, it will never fully replace human coders. But there is one particular benefit the industry is beginning to come to grips with: AI could help address the shortage of medical coders.
by Find-A-Code™
As the largest and most recognized education and credentialing entity for medical coders and billers, the AAPC sets the standard for training and certification. Did you know they offer separate certifications for medical coders looking to work in hospitals? Indeed, they have certifications for both inpatient and outpatient coding.
by Find-A-Code™
Medical coders and billers work together to ensure that healthcare providers are paid for their services. Coders translate clinician notes into medical codes using typical code sets like CPT and ICD-10. Meanwhile, medical billers take the work coders do and transform it into bills that are subsequently sent to payers. But there is one more spoke in the wheel, so to speak: claim denials management.
by Find-A-Code™
Medical coding is often looked at as an administrative mechanism for ensuring prompt and timely payment in a fee-for-service medical environment. But with an emerging emphasis on transitioning from fee-for-service to outcome-based medicine, does medical coding take on a new role? Can it be leveraged to improve patient experience?
by Find-A-Code™
We are firm believers in complete training and certification for medical coders and billers. There is a lot to know in order to be a competent biller or coder. You need to know more than just how to look up medical billing codes online. For example, you need to know and understand the Levels of Medical Decision Making (MDM) table.
Jan 24th, 2024
Medical Coding and Billing: What Is the Superbill?
by Find-A-Code™
Translating a doctor's notes into an actual payment from an insurance company requires a long and detailed process involving many complex steps. Both medical coders and billers do their parts to ensure doctors get paid for the services they provide. Along the way, they create and utilize something known as the 'superbill'.
by Find-A-Code™
Although there is no federal requirement that medical coders be certified, basic certification is often a job requirement in the modern era. Employers like to see certification as proof that potential coders have undergone a comprehensive training program and demonstrated their knowledge through a certification exam. But what about additional certifications?
Jan 15th, 2024
How to Make Sure Your Coding Team Is at the Top of Its Game
by Find-A-Code™
Efficient medical billing requires competent and accurate medical coding. Everything medical coders do impacts their counterparts in the billing department. Therefore, it is to everyone's advantage to make sure that the coding team remains at the top of its game day in and day out.
Jan 11th, 2024
How Medical Reception and Coding Affect Medical Billing
by Find-A-Code™
Medical billing represents the final step of submitting medical claims to payers. A medical biller takes all the data generated from a single medical encounter and translates it into a claim that is then sent off to a private insurance company, Medicare or Medicaid, or a self-paying patient.
Jan 8th, 2024
How ICD-10 Combination Codes Streamline Medical Coding
by Find-A-Code™
If there is one thing that keeps the pressure on medical coders, it is the need for efficiency. Fortunately, there are a few tricks of the trade that coders can employ to be more efficient. One of them is using ICD-10 combination codes when applicable. These codes are often described as tools for doing more with less.
by Find-A-Code™
Medical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.
by Find-A-Code™
Sending employees home to work was the norm during the COVID pandemic. But now that the pandemic is largely behind us, companies are calling their people back to the office. This includes medical coders and billers who have been enjoying the benefits of remote work all along. But has the time come for a new employment model? Is it time to let medical coders and billers work from home permanently?
by Find-A-Code™
Medical coding and billing are all about getting paid when you boil the two practices down to their simplest forms. And yet, there are other things to think about. Compliance is one of them. That is why hospitals, clinics, and private practices conduct medical coding audits. A big question for smaller offices is how frequently audits should be conducted.
by Find-A-Code™
Medical billing and coding blogs talk an awful lot about code sets. They tend to discuss individual codes and how to apply them in real world scenarios. Codes and code sets are obviously important – they are what medical coding and billing are built on. But there is something else equally important to consider: coding guidelines. To be the best possible coder you can be, you need to have a handle on those guidelines.
by Find-A-Code™
There is no lack of blog posts and news articles detailing how America's healthcare sector is grappling with shortages of doctors, nurses, etc. But did you know that the shortages are not limited to clinicians? They exist industry wide. And it includes medical coders.
Dec 4th, 2023
5 Medical Coding and Billing Trends to Watch in 2024
by Find-A-Code™
One thing we can say about medical coding and billing is that it never stops changing. Change is part of the game. Keeping up with changes is often a matter of watching trends so that one isn't caught off guard when new changes are implemented. With that in mind, we believe there are some medical coding and billing trends to watch closely in 2024.
by Find-A-Code™
Healthcare administrators and financial officers are very familiar with the management revenue cycle (RMC). They may not be as familiar with medical coding, at least from the standpoints of terminology and best practices. Yet there is an undeniable link between medical coding and managing revenue. What is that link? It is data.
Nov 15th, 2023
Productivity is the Key to Holding On to Remote Work
by Find-A-Code™
The COVID pandemic sent a lot of people home to work remotely. In recent years, however, employers have been working to get their people back into the office. Even medical coders and billers are being asked to return. If you find yourself in such a position, you might not be able to do anything about it. But if there is any possibility of continuing to work remotely, productivity is the key.
by Find-A-Code™
You have undoubtedly heard the phrase, 'practice makes perfect'. What if we applied the principle to preparing to take a medical coding exam? Would practice increase your chances of passing? While there are no guarantees, your chances of success will likely be higher if you take some practice exams prior to sitting for the real thing.
Nov 9th, 2023
How Medical Billers Can Stay at the Top of Their Game
by Find-A-Code™
Anyone who follows pro sports is familiar with the concept of an athlete wanting to stay at the top of his game. Athletes of all types want to be the best at what they do. But what about other careers? What about medical billing? It is probably a safe bet that most medical billers want to stay at the top of their game as well. That is the way a medical biller earns promotions, pay raises, and other perks.
Nov 6th, 2023
Helpful Tips for Better Medical Coding in 2024
by Find-A-Code™
The end of the year is fast approaching. It will not be long before we are turning the calendar to 2024. As a medical coder, do you have any professional goals for the coming year? Hopefully, being a better coder is one of them. Medical coding constantly offers opportunities for improvement. We suspect you will be given plenty of them in 2024.
by Find-A-Code™
Medical billing codes are challenging enough even when things are straightforward. But throw in a modifier and you have the potential for all sorts of trouble. Take Modifier 59. It is among the most dreaded modifiers that medical coders and billers need to handle. Get it wrong and you could wind up with a denied claim or, worse yet, accusations of unbundling.
Oct 18th, 2023
UB-04 Revenue Codes - Obscure But Still Part of the Game
by Find-A-Code™
Medical coders and billers need to be intimately familiar with common code sets like CPT, ICD-10, and HCPCS. But there are other more obscure code sets as well. They may not be utilized as frequently, but they are still out there. They are still part of the medical coding and billing game. UB-04 revenue codes are a prime example.
Oct 16th, 2023
The 3 Most Frequently Asked Questions About CPT Codes
by Find-A-Code™
Medical coding and billing are challenging careers requiring a ton of knowledge and plenty of experience. Coders and billers need to be familiar with HIPAA regulations, medical terminology, NPI lookup and more. When it comes to the medical codes themselves, particularly CPT codes, there is more to know than any one person can possibly remember.
by Find-A-Code™
At first glance, it might seem like there is nothing to becoming a certified medical coder or biller. If you know how to look up codes online, you're all set, right? No, not really. There is a lot more to medical coding and billing than looking up numbers. You need to know a lot more than just the codes themselves.
by Find-A-Code™
Medical coding and billing are detail-oriented jobs that offer plenty of room for mistakes. For example, it is not uncommon for a coder to employ an older ICD-10 code when a newer ICD-11 code is more appropriate. Here is another one: improperly bundling or unbundling medical procedures and services.
Oct 4th, 2023
HCPCS and CPT Codes: Do You Know the Differences?
by Find-A-Code™
Two of the most commonly used coding systems in medical billing are the HCPCS and CPT codes medical billers and coders are intimately familiar with. They share some similarities, but they are by no means identical. Do you know the differences between the two coding sets?
by Find-A-Code™
No medical coder is perfect. Medical billing codes are complicated, and mistakes happen. It is part of the job. We were curious about the most common mistakes coders make, so we did some research. We ran across an interesting piece published by the American Medical Association (AMA), the owners and managers of the well-known CPT code set.
Sep 27th, 2023
Why the ICD-10 Manual Now Includes COVID Vaccination Codes
by Find-A-Code™
Last year, the set was updated with three new codes relating to COVID vaccination status. More than one coding specialist has openly wondered why the additions were made.
by Find-A-Code™
Medical billing and coding are two careers offering good pay and long-term stability. For people who appreciate the medical field but are not interested in patient-facing careers, medical billing and coding are good options. To land a job as a billing or coding specialist though, you need to possess a few key skills.
by Find-A-Code™
Medical billing has not been an easy task since the introduction of health insurance decades ago. As time has gone by though, both medical billing and payments have become more complicated. So it's no wonder that older Americans are now struggling with erroneous medical debt brought on by inaccurate medical billing.
Sep 19th, 2023
Parkinson's Disease, Parkinsonism, and ICD-10 Codes
by Find-A-Code™
Regular readers of our blog know that we advocate for online lookup of ICD-10 codes due to the complex nature of medical coding itself. In short, medical coding is complicated. There are lots of different paths a coder can take when coding a particular visit or procedure. Take Parkinson's disease and parkinsonism. They are completely different from the coder's standpoint.
Sep 14th, 2023
Timely Filing and Its Impact on Medical Coders and Billers
by Find-A-Code™
When people talk about medical coding and billing, they have a tendency to discuss things like CPT and ICD-10 codes. They talk about finding the right codes and making sure the right modifiers are used with them. Another topic worthy of discussion is something known as 'timely filing'. Timely filing has an enormous impact on coders, billers, and service providers.
by Find-A-Code™
As happens at the start of nearly every summer, the Centers for Disease Control and Prevention (CDC) released the annual changes and revisions to its ICD-10 codes in mid-June. Changes are set to take effect with the 2024 fiscal year. Needless to say there are a lot of changes to pay attention to this time around. There is no better time than right now to start preparing.
Sep 11th, 2023
How the Simplest Case Can Get Complicated for Medical Coders
by Find-A-Code™
The truth about medical coding is that even simple cases can quickly get complicated. There is a lot more to medical coding than looking up a CPT or ICD-10 code and entering it with a keystroke. Coders need to know, understand, and properly apply codes based on nuances that can take years to master.
by Find-A-Code™
Pursuant to the Clinical Laboratory Improvement Amendments (CLIA) of 1998, clinical laboratories must be certified to perform the tests they offer. Each test has an appropriate CPT code that goes along with it. However, these codes change from year to year. You should also note that certain tests are waived in terms of certification requirements. A separate modifier is attached when coding such tests.
Sep 7th, 2023
How Telehealth's Emergence Has Changed Medical Billing
by Find-A-Code™
The COVID pandemic ushered in a lot of changes in how healthcare services are provided and paid for. Among those changes was greater flexibility in billing Medicare and Medicaid for telehealth services. Some three years in, it is clear that telehealth is here to stay. Furthermore, its emergence has changed medical billing permanently.
by Find-A-Code™
Claim adjustment group codes (CAGW), and a companion set of codes known as claim adjustment reason codes (CARC), are just as important to medical coding and billing. But they are not utilized to code specific procedures, treatments, etc. They are utilized to help both payers and billers stay on the same page when claims are denied or adjusted.
Sep 5th, 2023
How AI Could Make Medical Coding Better in the Future
by Find-A-Code™
In recent months we have taken advantage of our blog to delve into some of the possibilities of integrating artificial intelligence (AI) into medical coding. We have discussed why AI deserves a place at the table, how it will change medical coding, and why coders don't need to be afraid of it. This post will continue that line of thinking by discussing how AI could make medical coding better.
by Find-A-Code™
Being certified as a medical coder or biller opens the door to plenty of job opportunities across the country. Yet taking that first job doesn't necessarily mean working for a hospital or private practice. It does not even have to mean working for an employer at all. You could set up your own medical coding and billing company that acts as an outsourcing partner for hospitals and private practices.
Aug 15th, 2023
5 Reasons Medical Coding and Billing Make Excellent Careers
by Find-A-Code™
There are lots of medical jobs that have nothing to do with direct patient care. Medical coding and billing are two examples.
by Find-A-Code™
Common Procedural Terminology (CPT) codes were developed by the American Medical Association (AMA) in the 1960s as a way to streamline medical billing by standardizing the codes healthcare providers used for billing purposes. In the more than 50 years since, the CPT code set has undergone a litany of changes including the introduction of CPT codes for chronic care management (CCM).
Aug 9th, 2023
The Basics of Medical Billing's Place of Service Codes
by Find-A-Code™
Discussions about medical billing records often focus on CPT and ICD-10 codes. Being the two most common code sets, they get talked about the most. But there is another code set that doesn't get a lot of attention despite being just as important. It is known as Place of Service (POS) codes.
by Find-A-Code™
ChatGPT, the artificially intelligent chatbot developed by OpenAI took the world by storm through the first six months of 2023. It seems like everyone who is anyone is talking about it and its potential to disrupt just about everything. Will ChatGPT and similar technologies have any impact on medical coding? Should coders be afraid of losing their jobs to machines?
Aug 3rd, 2023
Keeping Revenues Flowing With Efficient Medical Billing
by Find-A-Code™
Driving revenues are part of the business side of medicine. But they are only half the equation. Driving revenues offer limited value if poor billing practices do not keep them flowing in. So in addition to developing strategies for increasing revenues, providers need to give significant attention to efficient medical billing.
by Find-A-Code™
A medical biller's number one priority is guaranteeing that every claim is accepted and paid the first time. However, things do not always work out that way. Claims can be rejected due to errors, lack of information, or even not being submitted in a timely manner. One way to avoid rejected claims is to employ claim scrubbing.
Jul 21st, 2023
Top 4 Work Environments For Professional Medical Coders
by Find-A-Code™
Both new and experienced medical coders depend on Find-a-Code for accurate and up-to-date medical code lookup. Perhaps you have stumbled across our website looking for more information about medical coding in hopes of getting into the industry yourself. If so, welcome aboard.
Jul 17th, 2023
The PHE Is Over - Medical Billing Now Has A New Normal
by Find-A-Code™
The Public Health Emergency (PHE) initiated at the start of the COVID pandemic is over. It was allowed to expire in mid-May. With its expiration comes a 'new normal' for medical billing – particularly in the area of telemedicine. It is now up to facilities, clinicians, and medical billing and coding staff to acquaint themselves with CPT codes that will no longer be usable for billing purposes.
Jul 14th, 2023
Medical Coding: There's Enough To Keep You Busy All Day
by Find-A-Code™
There are some jobs that don't offer enough work to keep you busy all day. You end up doing other work to fill in the downtime. If you are looking at medical coding as a potential career, know this: it doesn't qualify as one of those jobs. There is enough medical coding to keep you busy all day, every day.
Jul 11th, 2023
Medical Billing For Cardioversion: External vs. Internal
by Find-A-Code™
Tachycardia and other abnormal heart rhythms can be converted to normal using a variety of therapies that include medications and electric shocks. Experienced medical billers and coders know that there are two primary CPT codes covering these therapies. They are 92960 and 92961. The codes apply to external and internal cardioversion. Do you know the difference?
Jul 6th, 2023
How Do Patient Rights Affect Medical Coding And Billing?
by Find-A-Code™
In most cases, patient rights and medical coding/billing intersect at HIPAA compliance. If you know how HIPAA relates to your profession and your daily tasks, you should have very little trouble guaranteeing patient rights are respected. If you don't know much about HIPAA, it's time to change that.
Jul 3rd, 2023
How Are You Doing With The 2023 MPFS Updates?
by Find-A-Code™
Though none of the updates for 2023 are necessarily drastic, they will affect medical coding, medical billing, and healthcare provider reimbursement for the entire year. By this time, most coders and billers should be comfortable with the 2023 MPFS final rule.
Jun 21st, 2023
Why Net Collection Rate Is Such An Important Billing Metric
by Find-A-Code™
Much of what gets talked about in the medical coding and billing field has to do with code sets, reducing billing errors, and so forth. Things like CPT codes and ICD-10 vs. ICD-11 are discussed in the deepest possible detail. Yet we don't hear a lot about topics like net collection rate.
Jun 16th, 2023
Should You Consider Outsourcing Your Medical Billing?
by Find-A-Code™
Every healthcare provider that accepts payments from insurance plans or Medicare/Medicaid needs to engage with the modern medical billing system. It is unavoidable. Sometimes, keeping up can seem like more trouble than it's worth. But since it is the only way to get paid, clinicians and billing departments have no other choice. Yet there is one thing that could make billing easier: outsourcing.
Jun 12th, 2023
How Much Do You Know About These 3 Common Coding Errors?
by Find-A-Code™
Medical coding errors are to be expected given the complexity of our modern coding system. What is not expected is the same errors occurring time and again among a single set of coders. But it happens. It might happen even more frequently than most people realize.
Jun 8th, 2023
How Are You Doing With The Updated CPT Codes For 2023?
by Find-A-Code™
Medical coders and billers across the country approached the end of 2022 with a combination of anticipation and anxiety over updated CPT codes set for release on January 1, 2023. More than four months after the fact, the updated codes are now fully entrenched. So how are you doing? Are you completely comfortable with them yet?
by Find-A-Code™
It only takes a minor mistake to slow down claims. Something as simple as not understanding the Medicare secondary payer (MSP) principle can cause big problems.
by Find-A-Code™
The medical coding and billing industry has its own chicken/egg question that goes something like this: do medical billing codes adapt to medicine or does medicine adapt to code sets? It is an interesting question that will probably never have a definitive answer. But from the AMA's perspective, their CPT codes evolve with the state of the healthcare system.
May 18th, 2023
What Is Medical Coding Boot Camp?
by Find-A-Code™
You are looking to become a certified medical coder or biller. In order to get certification though, you must pass an exam offered by an accrediting organization. Passing the exam will not be easy without undergoing some training first. Enter the medical coding boot camp.
by Find-A-Code™
Unless you work as a medical coder or biller, you are probably unfamiliar with how the whole medical billing system works. There is a lot to it – from diagnostic codes to HIPAA compliance to turning a physician's notes into billable codes. Did you know that the billing process actually starts before you show up for your appointment?
May 11th, 2023
Social Determinants Now Play A Bigger Role In Medical Coding
by Find-A-Code™
As the 2023 ICD-10 updates begin to roll out, medical coders and billers are seeing mostly what they have been led to expect. There have been a few surprises here and there. Right now, the hot topic of the day is how much social determinants now contribute to medical coding. As of April 1, among the 42 new diagnostic codes and 34 procedure codes, many of them are related to social determinants.
by Find-A-Code™
A recently released Kaiser Family Foundation and Peterson Center on Healthcare study shows that upcoding has been a common practice in healthcare for more than 15 years. It stands to reason that the practice contributes to higher medical bills. Is it responsible for higher bills in 2023? The research seems to indicate as much.
by Find-A-Code™
It is pretty easy for any medical coding specialist to use our website to find the proper codes for schizophrenia diagnosis and treatment. The codes are not hard to find if you know what you're looking for. But as a coding specialist yourself, how much do you know about the coding system beyond the knowledge that the work you do allows healthcare providers to bill insurance carriers and Medicare/Medicaid?
by Find-A-Code™
It is understandable that someone new to medical billing codes would understand them as little more than alphanumeric representations of medical services designed to keep track of payments. That they are. But they are so much more. In fact, billing codes have become so integral to how healthcare services are provided that they can actually affect patient access.
Apr 19th, 2023
Why Learning To Read Medical Billing Codes Is A Must
by Find-A-Code™
If you are a trained and certified medical coder or biller, we are guessing you know how to read medical billing codes. Reading them is probably second nature if you've been on the job for a couple of years. To someone who is new to the profession though, there may be some confusion as to why learning to read the codes is so important.
Apr 17th, 2023
Why AI Won't Make Medical Coding Careers Obsolete
by Find-A-Code™
No doubt artificial intelligence (AI) has come a long way since it was first introduced. The technology is capable of doing a lot of amazing things. It is advanced enough that some people are speculating it will eventually make medical coding careers obsolete. We do not agree. As helpful as AI can be, it is not likely to ever be capable of doing the same job as human medical coders.
Apr 12th, 2023
Who Knew That Medical Coding Required So Much Translating
by Find-A-Code™
Medical coders and billers wear many hats. They are data entry specialists; they are medical professionals; they are even translators to some degree. Translators, you ask? Absolutely. Medical codes are not as static and straightforward as they appear to be. A lot of translating is required to get from a clinician's original notes to a payer actually making payment.
Apr 10th, 2023
Top 5 Reasons For Medical Billing Denials
by Find-A-Code™
The last thing healthcare providers want is a stack of denials coming in from insurance companies. Providers and their coding and billing departments work extremely hard to avoid denials. But denials still happen. Even the most accurate coding and billing departments make mistakes from time to time. When they do, payers have no problem jumping on those mistakes to deny claims.
by Find-A-Code™
Few questions relating to medical coding and billing are searched online more frequently than whether or not either job is suitable for remote work. In simple English, can medical coding and billing be done at home? In a word, yes.
by Find-A-Code™
You likely know enough about medical coding to have a basic understanding of ICD-10-CM and CPT codes. But have you heard of Place of Service (POS) codes? POS codes do not get as much attention as some of the other code sets, but they are still an intricate part of medical coding and billing careers.
Feb 23rd, 2023
Why You Should Be Looking Up Medical Codes Online
by Find-A-Code™
Medical coders, billers, and auditors all rely on accurate codes to do their jobs. Unfortunately, none of them can get by with just one set of codes. There are multiple sets encompassing tens of thousands of codes covering just about everything in healthcare. That means constantly looking up codes – even among those with excellent memories. The important question is this: where are codes being looked up?
Feb 21st, 2023
Patient Advocacy: The Other Half of the Medical Billing Coin
by Find-A-Code™
When most people hear about medical billing, they think of things like diagnostic codes, HIPAA compliance, and the like. All such things apply to medical billers who spend their days poring over electronic health records and turning them into invoices they eventually send on to insurance carriers. Yet there is another side to medical billing that doesn't get a whole lot of attention. It involves patient advocacy.
Feb 19th, 2023
Medical Necessity: Where ICD-10 and CPT Codes Converge
by Find-A-Code™
Claims submitted by healthcare providers to payers include medical codes that ultimately determine reimbursement rates. As a medical coder or billing specialist, you know that a typical bill includes multiple codes. But were you aware that ICD-10 codes and ICD-11 Codes are often used in conjunction with CPT codes to ensure proper payment? The two code sets converge in something the insurance industry refers to as medical necessity.
Feb 17th, 2023
Important Things Every New Coder Should Know About ICD-10
by Find-A-Code™
The International Classification of Diseases (ICD-11) system is arguably among the most utilized medical coding systems in the world. It is used extensively here in the U.S. As such, medical coders need to be intimately familiar with it. They do not have to memorize every code – that would be impossible anyway – but they do need to understand the basic structure and how to look up codes they don't know.
Feb 17th, 2023
Medical Billing Apps: 5 Questions to Ask Before You Buy
by Find-A-Code™
As the owner of a small medical building company, you work hard to make every penny count. Do not compromise that principle in your search for a new medical billing app. The software you rely on to run your operation is critical to your success. Make the right choice and your company will profit from it. Make the wrong choice and your company could suffer.
Feb 15th, 2023
Do You Know The 4 Primary Tenets Of HIPAA Compliance?
by Find-A-Code™
As a professional medical coder or biller, you have certain obligations to the federal HIPAA rules designed to protect sensitive patient information. The rules are not as complicated for you as they are for some other entities within the healthcare space, but that does not mean that compliance is any less important. To that end, do you know the four primary tenets of HIPAA compliance?
Feb 3rd, 2023
Will 2023 Be the Year of Outsourced Medical Billing?
by Find-A-Code™
Many healthcare providers have chosen to keep medical coding and billing in-house. From HIPAA compliance to the complexity of ICD-10 codes, it has just been easier to keep track of things by not outsourcing medical billing or coding. But things are changing. So much so that 2023 could be the year that outsourced services finally take over.
by Find-A-Code™
Common sense seems to dictate that medical billing codes, like CPT codes for example, are only considered after medical treatment has been provided. After all, the codes are simply a representation of diagnosed conditions and treatment services provided – for billing purposes. But there is a curious relationship between these codes and actual treatments.
by Find-A-Code™
Medical coders play a critical role in determining how healthcare delivery is reported for record keeping and billing purposes. Likewise, the codes they know so well are equally critical. They have been around for decades. They were originally developed and implemented to make reporting and billing easier in a healthcare system that was becoming incredibly more complex. The system is even more complex today.
Jan 27th, 2023
Medical Bill Denials: How Much Are Clinicians Really Owed?
by Find-A-Code™
Imagine owning an auto body repair shop. You and your staff produce millions of dollars of work every year. But then, an end-of-the-year accounting reveals you are only getting 80 cents on the dollar from car insurance companies. How would you feel about that? It turns out that this is exactly what might be happening to individual doctors and independent group practices.
Jan 27th, 2023
Why Knowing Medical Terminology Makes Coding Easier
by Find-A-Code™
You are excited about beginning your training as a professional medical coder. You're expecting to pass the exam and earn your certification. The future is looking bright until, as you are perusing the educational material, you suddenly realize you're going to have to learn medical terminology.
Jan 25th, 2023
How Do Billing Codes Affect Reimbursements And Auditing
by Find-A-Code™
Your job as a medical biller or coder has a direct impact on the jobs other people do. Your work impacts medical reimbursements, auditing, and even research. That's why it's so important that coders and billers get it right. A lot rides on the information behind medical billing codes.
Jan 25th, 2023
How Medical Coders Feel About Jargon Is Worth Knowing
by Find-A-Code™
A fascinating study recently published in the JAMA Network Open journal reveals what many of us have known for a long time: doctors and nurses speak in terms we patients often don't understand. Thus, we are confused by the medical jargon. It would be worth knowing how medical coders feel about it. Do they have trouble understanding clinicians?
by Find-A-Code™
When it comes to medical coding and billing, there are a lot of players in the game. From reception staff to clinical staff and the back office, there are quite a few people involved in generating billable services and then actually billing payers for them. The medical biller is the first and last player in that game.
Jan 23rd, 2023
Coding, MA Risk Scores, and Audits - Medical Coders Beware
by Find-A-Code™
We are all aware of the fact that medical billing codes ultimately determine how much insurance companies and other payers fork out to cover medical costs. We also know that audits are part of the program. That being the case, medical coders need to be aware of increased scrutiny involving Medicare Advantage (MA) risk scores that may be used to inflate reimbursement rates.
Jan 23rd, 2023
CPT Code Basics: What You Need To Know
by Find-A-Code™
It was 1966 when the American Medical Association (AMA) created what is known as the Current Procedural Terminology (CPT), the set of medical billing codes to be used by healthcare providers, facilities, insurance companies, and others to communicate regarding medical procedures and services. Today, CPT codes are not only still in use, but they are also among the most widely used in the industry.
Jan 20th, 2023
5 Medical Billing Trends to Watch in 2023
by Find-A-Code™
No doubt the medical billing industry is changing at breakneck speed. As a medical billing specialist in 2023, you will need to keep up with emerging trends if you want to stay in the game. What should you be paying attention to in the coming year? Check out these five possibilities...
by Find-A-Code™
It is possible to be certified as either a medical coder or biller. Another option is to become a certified health information technician with dual certifications in both billing and coding. Going the health information technician route gives a person greater access to more job opportunities.
Jan 18th, 2023
Outsourced Medical Billing: What's Driving the Recent Trend?
by Find-A-Code™
Medical billing in the U.S. has historically been kept in-house for the most part. Hospitals, private practices, etc. have hired their own medical coders and billers, preferring to maintain tight control over the process. But things are changing, and they are changing in a big way. Outsourcing is the latest trend.
Jan 16th, 2023
Medical Coding: Why Is An 'Easier' System So Complicated?
by Find-A-Code™
Believe it or not, there was a time in this country when paying for medical care was fairly simple. Your doctor rendered services for which you paid at the time of the visit. Medical insurance only offered catastrophic coverage for major medical events. Those were simpler days.
Jan 12th, 2023
Medical Coding Mistakes Happen - But How Often?
by Find-A-Code™
Nobody is perfect. Workers in every industry make mistakes. Even medical coders and billers sometimes get it wrong. But in the medical insurance game, it seems like mistakes are harder to identify and even harder to rectify. One recent case out of Illinois shows that medical coding mistakes do happen. But the case raises the question of how often such mistakes occur.
Jan 10th, 2023
How Much Do Medical Billers and Coders Actually Make?
by Find-A-Code™
To be a successful medical coder or biller, you need to possess a tremendous amount of knowledge. You need to know about things like ICD 11 diagnosis codes, NPI look-up, CPT codes and even HIPAA compliance. The good news is all that knowledge can pay off with competitive pay and benefits. So how much do medical billers and coders actually make? That depends on a variety of factors
Dec 15th, 2022
How Automation Could Impact the Future of Medical Coding
by Find-A-Code™
Automation is a fact of life in the modern world. As digital systems expand and mature, the creators of those systems are bringing more automation to more industries. Medical coding isn't the exception.
Dec 13th, 2022
CPT Codes and Medicare's Relative Value Unit
by Find-A-Code™
A recently published study looking to explain income differences between male and female plastic surgeons suggests that billing and coding practices may be part of the equation. The study focused primarily on Medicare's relative value units (RVU) as applied to surgeon pay. But what exactly is an RVU?
by Find-A-Code™
Many healthcare providers still try to handle medical billing in-house. When they finally abandon such efforts and start looking for an outsourcing partner, they are hoping to find an organization that can take medical billing off their hands. But they also want an organization that can do it efficiently, cost-effectively, and in full compliance with the law.
by Find-A-Code™
Many newly certified medical billing specialists are preoccupied by things like diagnostic code lookup and HIPAA compliance. But for those looking to start their own medical billing services, rather than being employed by someone else, there is also the prospect of taking on new clients. Things can get messy.
Nov 4th, 2022
Why ICD-10 Was Such A Big Step For Medical Billing
by Find-A-Code™
The move to ICD-10 was necessitated by an outdated system that simply didn't contain enough billing codes to cover all the available services, procedures, medical equipment, and drugs medical payers were being billed for. Without enough codes, medical billing was unnecessarily slow and inefficient. The system was sluggish, to say the least.
Nov 2nd, 2022
How Practices Can Increase Medical Billing Efficiency
by Find-A-Code™
Billing is part of running a medical practice. Whether a practice operates independently or as part of a larger group, no one gets paid if billing doesn't occur. The key to doing it right is efficiency.
Oct 31st, 2022
5 Things Capable of Slowing Down Medical Reimbursements
by Find-A-Code™
The U.S. healthcare system relies on a somewhat complex billing and payment system. The system is designed to bridge the gap between patients, providers, and payers. When everything works as it should, reimbursements from payers to providers flow freely. But if just one thing goes wrong, reimbursements can be delayed.
Oct 27th, 2022
Costly Mistakes Every Medical Billing Department Can Avoid
by Find-A-Code™
No business owner likes mistakes. Mistakes cost time and money to fix; they harm a company's reputation; they are bad news all around. Every private practice and healthcare clinic with an in-house billing department knows exactly what we're talking about.
Oct 24th, 2022
Do You Know The Difference Between NPI and PTAN Numbers
by Find-A-Code™
Medicare covers just over 18% of the U.S. population. In 2021 alone, Medicare spent nearly $840 billion covering subscriber medical bills. With that much money going back and forth, fraud is always a concern. Enter National Provider Identifier (NPI) and Provider Transaction Access (PTAN) numbers.
Oct 21st, 2022
HIPAA Compliance is a Must for Medical Billers and Coders
by Find-A-Code™
The medical coding and billing industry is regulated in terms of how it can collect and utilize information. Anyone involved in medical billing and coding, be it as a business owner or employee, must follow all the rules necessary to maintain HIPAA compliance. Needless to say, compliance is a must. Washington doesn't give the industry a choice.
Oct 18th, 2022
Interesting Jobs You Can Get With A Medical Coding Degree
by Find-A-Code™
Medical coding is a fascinating field within healthcare administration. It takes a lot of knowledge and skill to get a degree and pass the certification exam. But once that's done, there is a whole world of opportunities waiting for new coders in need of employment.
Sep 11th, 2022
Who Is The Driving Force Behind The CPT Medical Code Set
by Find-A-Code™
The U.S. healthcare system relies on hundreds of thousands of medical codes to facilitate administration and billing. The codes are divided into different sets, each of which is developed and maintained by a separate entity. Take the Current Procedural Terminology (CPT) code set. The driving force behind it is the American Medical Association (AMA).
by Find-A-Code™
Congress passed the No Surprises Act as part of the 2021 Consolidated Appropriations Act. No Surprises was fully implemented as of the start of this year. With it now being the law of the land, healthcare providers are legally obligated to provide more transparent medical billing so that patients do not receive surprise bills for out-of-network care or in-network care provided by an out-of-network clinician.
by Find-A-Code™
To the medical coding specialist, getting it right is non-negotiable. Coders rely on multiple coding sets to do what they do. The two most commonly utilized sets are as follows: Current Procedural Terminology (CPT) codes and International Classification of Diseases (ICD) codes.
by Find-A-Code™
When it comes to medical billing codes, we take seriously our responsibility to provide accurate data. Whether it is ICD-10 or CPT codes, our clients need to be able to trust that what they find in our databases is accurate. Otherwise, errors are waiting to happen. Those errors can sometimes cost more than just a few dollars.
by Find-A-Code™
The American Medical Association (AMA) updated its coding guidelines in 2021 in an attempt to simplify medical coding for doctors. Ideally, simplified coding would allow clinicians to spend more time taking care of patients and less time trying to figure out codes. But according to a new report, all is not well. The new system is proving problematic in dermatology.
by Find-A-Code™
Though medical billing codes are the main focus here, all of us in the medical billing industry need to be cognizant of HIPAA compliance. In light of that, it is important that medical billers, coding specialists, and the clinicians they work for pay attention to the Right of Access Initiative (RAI). Washington continues to flex its muscles in its enforcement of the initiative.
by Find-A-Code™
It has been said that the healthcare industry is notoriously slow in terms of technology adoption. One need only look at how convoluted medical coding and billing are to know that it needs a technology injection. Specifically, medical coding and billing software desperately needs artificial intelligence (AI).
by Find-A-Code™
Imagine the following scenario: a young person goes to school to earn certification as a medical coder or billing specialist. Upon completion, every job the recent graduate applies for requires experience. But how is this person supposed to get experience without landing that first job? It is a conundrum faced by certificate holders around the country.
Sep 3rd, 2022
Medical Coding And Billing Not The Same Thing
by Find-A-Code™
Medical coding and billing are two careers that relate to translating patient medical data into bills that are ultimately submitted to insurance companies for payment. The two careers overlap to a certain degree, but they are distinctly separate entities. Simply put, medical coding and billing are not the same thing.
by Find-A-Code™
Every job comes with its unique stress factors. Even medical coding, which seems rather benign compared to other jobs, can be stressful at times. One of the biggest causes of stress in our industry is feeling the emotional weight of certain diagnosis codes. Since the start of the COVID pandemic, medical coders have had to deal with this particular stress factor more often.
by Find-A-Code™
It is easy to assume that medical coding only affects the business side of medicine. It certainly does affect billing and payments, but medical coding can also impact diagnosis and treatment. We have known this for a long time. But now, with more people being diagnosed with long COVID, we are again reminded how current coding practices can negatively impact treatment.
by Find-A-Code™
ICD-10-CM's latest round of updates is slated to take effect October 1, 2022. Are you ready? You had better be, as this round of updates numbers pretty close to 1,500.
Aug 11th, 2022
Things to Consider Before Upgrading Medical Billing Software
by Find-A-Code™
Your practice has utilized the same medical billing software for years. The medical billing staff says it is time for a change. You don't necessarily disagree, but you also don't know where to begin your search for new software. There are so many vendors offering so many products that making sense of it all can be challenging.
Aug 10th, 2022
The Joy of Deciphering Medical Billing Codes
by Find-A-Code™
As someone who deals with medical billing codes for a living, you pretty much know what they mean. Even if you don't know the details of every single code you work with, you at least understand how they are structured. Imagine a typical patient who has no idea about how medical billing codes work. Deciphering them is nothing short of a nightmare.
by Find-A-Code™
What is being hailed as the Great Resignation is leading a whole bunch of people to start their own businesses. Some are tired of the rat race and want to work from home. Others just want to be their own bosses. There are plenty of opportunities for starting something of your own, including medical coding and billing.
Aug 4th, 2022
How To Reduce The Friction Inherent To Medical Billing
by Find-A-Code™
Aug 2nd, 2022
An Introduction To Medical Billing Using CPT Codes
by Find-A-Code™
Are you new to medical coding and billing? If so, we understand how easy it is to be overwhelmed by all the information. For instance, you have over 100,000 billing codes to deal with.
by Find-A-Code™
So, you are interested in being trained as a medical billing specialist. You have an affinity for numbers and records, and you think medical billing codes might be right up your alley. Well, there's good news. Medical billing jobs are plentiful right now. Just know that there is a lot to learn. For instance, there are at least seven types of medical codes you will have to learn to land a really good job.
Jul 20th, 2022
4 Reasons Independent Practices Outsource Medical Billing
by Find-A-Code™
Group medical practices have a distinct advantage when it comes to medical billing. The economics of scale make it easier for them to handle billing in-house. The same is not always true of independent practices. For the independent practice, in-house medical billing can be more trouble than it's worth. In such cases, outsourcing quickly becomes an attractive option.
Jul 20th, 2022
Accurate Coding Is The Key To Your Job - Here's Why
by Find-A-Code™
Medical billing codes dominate your day. They are the raw ingredients you use to do your job. But they are more than just numbers on an electronic form. They are also the life blood of the healthcare industry's billing capabilities.
by Find-A-Code™
HIPAA covers nearly every aspect of how medical and personal information is collected, utilized, shared, and stored within the healthcare industry. Title II of the rules is applied directly to medical billing companies and independent coders. The 'Big 2' rules that medical billing companies must adhere to revolve around privacy and security.
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