Medical Billing and Coding and Healthcare Reform: What you Need to Know

March 28, 2013

Medical Billing and Coding and Healthcare Reform: What you Need to Know

Medical billing and coding lays the foundation for any successful healthcare provider. Cash flow management depends on timely reimbursements and billing follow up. Regulatory reform in the healthcare industry may leave you asking how the medical billing and coding world will change, but the goals and responsibilities remain the same: handling accounts receivable and revenue cycle management. 

The only things that change are the processes for handling reimbursement requests, the complexity of the needed coding and privacy requirements mandated through HIPAA. Fully-integrated medical billing and coding systems improve management of the cash flow cycle. Modern medical billing and coding training includes all new coding requirements, allowing new graduates a unique opportunity in the job market.

What is Medical Billing and Coding? New Coding Explained

Until recently, ICD-9 was the standard for coding reimbursement requests. Today’s medical billing and coding schools teach ICD-10. With over five times as many codes, going from 13,000 to 68,000, the ICD-10 system offers much more specificity when labeling treatments. The increased information available using this more complex system streamlines the reimbursement process, reducing the amount of paperwork necessary to gain claim approval.

Under the older coding system, there was no way to distinguish between treatments performed on the left or right side of the body. A patient that received treatment for a cut on the right hand would have the same codes for a later cut on the left. That would then cause delays in payment processing as insurance companies requested more information to ensure that the second reimbursement request was not a duplication error. The new system includes ways to code for right and left, first and follow-up visits and other clinical information required for reimbursements.

Choosing Medical Billing and Coding Schools

The best medical billing and coding schools cover both ICD-9 and ICD-10 coding systems. While ICD-10 is becoming the new standard, many providers still use ICD-9 coding, making it important for employees to be fully versed in both. Additionally, exposure to healthcare IT allows students to enter the workforce with full confidence in their ability to successfully perform their job responsibilities. Healthcare IT includes an overview of commonly used healthcare management software platforms. Hands-on training using the software gives students the practical experience needed to streamline a transition into a new career path.

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The views expressed herein are those of the author and do not necessarily reflect those of Ultimate Medical Academy.

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