What’s New in Medical Billing?

What’s New in Medical Billing?

Working in the healthcare system is a trendy thing to do. Everyone knows someone who is a medical assistant, nurse, or medical biller. Because the healthcare industry is growing, it is important for you to stay on top of trends. Right now, there are four healthcare trends affecting medical billing and coding.

ICD-10 Transition

The transition from ICD-9 to ICD-10 is the biggest issue medical billers and coders are facing right now. The current system for reporting diagnoses and procedures is the International physicians billing serviceClassification of Diseases, Ninth Revision (ICD-9). These codes range from vital records to death certificates. Because this system is outdated, the federal government is pushing agencies to change to the new revised system: ICD-10.

The ICD-10 system provides the coder with much more description to the medical coding, and gives them unlimited ways to describe an encounter or hospital stay. The new system has 71,924 procedure codes and almost 70,000 diagnosis codes. Many doctors complain that they do not get adequately reimbursed due to inaccurate coding, so changing to ICD-10 can correct this problem.

The Affordable Care Act

The Affordable Care Act (ACA) has made an impact on the healthcare industry. More Americans are now eligible for medical care, which means more procedures and more billing and coding. For medical coders, ACA means that accuracy is more important now than ever. In fact, one of the benefits of this act is a boost in payment timeliness and accuracy. Both of these issues come down to correct, paffordable-care-actrecise medical coding.

To ensure that medical billers and coders are doing their best, the ACA has stringent rules and regulations. This means healthcare companies have to maintain accurate records and follow strict documentation guidelines. Medical records must show a need for every procedure, and describe the procedure in detail.

CPT Code Updates

Current Procedural Terminology (CPT) codes are identifying codes and descriptive terms that billers and coders use to report healthcare services and/or procedures. There are thousands of CPT codes in use, but these codes are not static. CPT code updates are occurring frequently, and billers must keep up with changes.

Many CPT coding changes and updates mean that it is vital for medical coders to be up-to-date on current terminology or risk payment delays, claim denials, and serious reimbursement issues. CPT updates help the medical billers find more appropriate codes to report for healthcare reimbursement cycles.

A Variety of Technology

Healthcare agencies and facilities now have a variety of technology for medical billing and coding. Medical coding uses software known as encoders. These programs assist with assigning numeric and alphanumeric codes to diseases, treatments, services, and procedures. After input of procedure diagnosis or text into the system by the medical coder, associated codes show up on the screen, provided by the encoder. In addition, medical coding technology offers decision support.

Some of the various types of medical billing and coding software available include:

  • Ingenix – This software offers many benefits, such as helping cut down on medical medisoftexpenses, recognizing savings opportunities, and applying the rules of Medicare to the healthcare claims.
  • Medisoft – This system has been around quite a while. Medisoft carries out many different billing functions, such as tracking payments, generating invoices, and reporting past-due accounts.
  • Lytec – This is a very popular billing software that maintains an encrypted database for medical information privacy. Lytec offers many special features, such as alerting users when a sum of money is owed from the insurance company or patient.

Medical Practice Management Resources offers state-of-the-art technology and adaptability to help practices nationwide capture the highest level of revenue possible. They have software available, including the ability to utilize a VPN into the practice’s software if necessary.

Contracting, credentialing and operations assistance are offered too. Call us today!

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