Link the diagnosis code to the related procedural code by medical necessity. For third-party billing purposes, logically linked diagnosis codes supporting the necessity of services performed by the physician are less likely to be identified and rejected as frivolous, according to the University of Florida.Continue Reading
Introducing the Health Insurance Portability and Accountability Act, HIPAA, presented a need for medical coding in treatment facilities. The International Classification of Diseases, 9th Edition, Clinical Modification, ICD-9-CM, is a system of numerical diagnosis codes relating to the symptoms and injuries of the patient. Regulated and routinely update by the American Medical Association, the Current Procedural Technology System (CPT) is also a numerical code related to the description of service. Choosing one of the two available volumes of CPT, assign the codes according to the stated medical criteria for that code, says the University of Florida.
Relating the medical equipment to the medical service provided is covered under a third system called Healthcare Common Procedures Coding System, HCPCS. Ensuring that the charges for the use of medical supplies, equipment and devices provided to the patient are accurately and logically assigned, the HCPCS codes are alphanumeric and administered by CMS, according to the American Speech-Language-Hearing Association.
Regulated by CMS, medical coding shows the third-party billing agency that the services performed are essential, says the American Speech-Language-Hearing Association. The recommendation is that those responsible for linking codes in the medical facility be trained and credentialed for these complex tasks, explains the University of FloridaLearn more about Health Insurance