05
July
- Oliver Kyle
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5 latest developments in medical billing coding
Due to recent developments in American health care, exciting changes are anticipated for future health care system. Medical billing system has been called out as one of the many areas of health care that is due for a makeover. While changes will take time to adapt to, it’s important to remember that medical experts will always play a key role in the health care system. Here are some developments that are occurring within the field:
Electronic Health Records (EHRs)
In the decades before software systems became mainstream, medical billing systems were not only hard to regulate, but were also carried out almost entirely on paper. The result was an unorganized medical billing system that was taking physicians time and attention away from the care of their patients. Today, the increasing use of electronic health records (EHR) is helping organize health care documents, reduce errors and cut costs in the health care industry. It’s also changing the medical billing process.
EHRs are used for various purposes, including
Documents individual patientconditions
Pass information among clinicians treating those patients
Justify financial reimbursement from insurance companies
Serve as a comprehensive legal record of medical events
Since they allow for impeccable organization and centralized information storage, the benefits of universal use of EHRs are unquestionable. Doctors will have access to not only their patient complete medical histories, but to databases that store disease information, medications and demographic information. The analysis of this data can be used to improve the quality of American health care.
Updates to the ICD-11 in 2018
In 2018, the 11th revision increased the amount of codes from 14,400 to 55,000. That’s a lot to learn!
Read a factsheet on ICD-10 transition Basics from the centers for Medicare and Medicaid Services.
These updates are reflected in medical billing training courses. Along with classes in medical terminology, anatomy and physiology, you’ll study clinical classification and coding systems, and health care reimbursement methods. Future health care professionals working in the medical billing system must feel comfortable using the new EHR software, be able to effectively analyze electronic health care data and maintain EHR security.
Medical Billing System Affected by Health Care Reform
The industry encouragement of health care providers to adopt EHR technology is the result of these recent developments in health care:
In 2009, the Obama administration pledged $19 billion in American stimulus funds to health care information technology.
In March 2010, President Barack Obama signed legislation to overhaul America’s health care system. Through the patient Protection and Affordable Care Act, an additional 32 million Americans could become insured in the coming years.
To accommodate these newly insured Americans, health care providers will need to utilize the most efficient medical billing system. This will drive the need to hire additional qualified medical professionals.
The Affordable Act
The affordable Care Act (ACA) has made an impact on health care and health care jobs. The most obvious is the influx of Americans now eligible for medical care. That means more people having procedures coders need to document.
For medical coders, the ACA also means that an exceptional eye towards accuracy is required. In fact, one of the benefits of the ACA is a boost in payment accuracy and timelines. Both of those issues come down to medical coders performing their jobs accurately, inaccurate coding can mean billing delays or denials of insurance.
To ensure that coders are doing their best, the ACA has also put some strict rules in place. The rules require health care companies to maintain strict records and documentation, and that those records are reported properly. There are also new rules regarding proper documentation issues such as joint replacement surgery, medical records need to state what steps have been taken to avoid the surgery and thus, why it’s necessary now. That’s where a coder comes in, keeping track of a patient’s procedure so the insurance company can see what’s been done.
CPT Code Updates
Current Procedure Terminology (CPT) codes are descriptive terms or identifying codes that coders use to report medical services or procedures. There are currently thousands of CPT codes in use, but they are not static. CPT code updates occur more frequently than ICD updates. For instance, CPT category III codes are updated every six months. They’re known as the emerging technology codes and are considered temporary unless they’re moved into Category I within five years.
So many updates means that it’s crucial for a medical coder to be up to date on the current CPT codes or risk incorrect coding, delays and backups for doctors and patients. CPT updates usually help the coder because it usually helps us find more appropriate CPT codes to report for the providers.