What Are My Sources for Medical Billing Codes for Medicare?

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.

 

This begs the question of where a medical coder or biller turns to for Medicare-friendly billing codes. Fortunately, they have plenty of resources to choose from. We recommend Find-A-Code as one of the best online sources.

 

While we are quick to point out the benefits of online code lookup, we recognize the fact that some coders and billers prefer to have digital documents just in case online access is temporarily interrupted. That being the case, one can go directly to the source of the billing codes Medicare utilizes. Just visit the CMS website.

 

On the official CMS website, you will find downloads for all Healthcare Common Procedure Coding System (HCPCS) codes. You'll also find annual updates published by year. Note that some of the files are in PDF format while others are plain text files or spreadsheets.

 

The CMS website also provides limited links to Common Procedural Terminology (CPT) resources. Just understand that CPT codes are the domain of the American Medical Association (AMA). The AMA retains control over the code set.

 

Medical coders and billers should be aware that Medicare does not rely exclusively on HCPCS codes. Instead, a combination of HCPCS and CPT codes are utilized. The latter is intended for the most common medical services and procedures while the former accounts for additional services and supplies not covered by the CPT code set.

 

Also note that some insurance claims require information that is not found in either of the code sets. It is up to billers and coders to know which sets to use in order to provide the necessary information.

 

Medical coders and billers can rely exclusively on documents obtained from the CMS website for the codes Medicare requires. In addition, multiple publishers offer hard copies of nearly every code set in use today. Hard copies and digital files are good, but online lookup may be better for day-to-day work.

 

Online lookup is more streamlined. It is more efficient and faster. For a medical coder or biller with a firm grasp on the most widely used code sets, looking codes up online drastically reduces the amount of time spent preparing each case for billing.

 

It goes without saying that choosing an online source is a big decision. One of the main priorities is finding an online provider whose code sets are kept up to date. Code sets change annually, at the very least. Semi-annual changes are not out of the question for certain sets. It is critical that billers and coders always work with the most current set.

 

As much as we support online code lookup, we also encourage medical coders and billers to either download digital documents or purchase hard copies. Let's face it, sometimes the internet goes out. With digital or paper records to look at, a biller or coder doesn't have to stop working when there is no internet access.

 

Once again, digital files are available for download on the CMS website. If you want to look up CPT and HCPCS codes online, look no further than Find-A-Code. Check out our demo and see for yourself just how easy it is to look up the codes you need for Medicare claims.