There’s a lot of confusion about coding right now and for good reason. Beginning a few weeks ago, June 1st to be exact, many insurance carriers began accepting and processing preauthorization requests containing ICD-10 codes for services scheduled on or after October 1st - the upcoming mandated ICD-10 compliance date. As with ICD-9 codes today, providers and suppliers are still required to report all characters of a valid ICD-10 code. However, ICD-10 diagnosis codes have different rules regarding specificity and providers/suppliers are required to submit the most specific diagnosis codes based upon the information that is available at the time.
Hayes' Healthcare Blog
Current Procedural Terminology (CPT) codes and diagnosis codes impact how insurance companies adjudicate claims and determine patient responsibility amounts. Healthcare providers can greatly impact the amount that the patient is liable for based on how services are coded and reported to the insurance company. Hospital and physician office staff who collect money from patients need to understand the basics regarding these procedure codes in order to minimize collection errors up front and reduce the likelihood of credit balances and claim re-work. So how can you help your front desk understand the impact of coding?