Introduction to Medical Billing
Probably the one thing that we all dread while in residency is filling out the billing sheet after each visit. You know, you look at the sheet and you think: “maybe i’ll give him a level 3 visit today” because today you feel like it. then you think “I’ll give him this diagnosis” without thinking about it much. You then sign your name and move on. Bad mistake right?
One of the things that is lacking in a lot of residency programs is learning about billing. This will ultimately either keep your practice successful or bankrupt. And its probably something that we should practice on while in residency when if we do make mistakes, there is someone else watching out for you and its not like you’re getting paid anyway. I’ve decided to write out a slow introduction to the coding system that we have currently. I hear that the ICD-9 code will soon become the ICD-10 coding system. Well… at least learning about the current ICD-9 code will help when the 10 system comes out. Hopefully this exercise will help me learn about it as well so that I don’t make the mistake of either fraudulently overcharging my patients or leaving a lot of money on the table.
- What is the ICD-9 classification? It stands for the international statistical classification of diseases and related health problems. It is based on the World Health Organization’s International Classification of Disease which is used for statistics work. The ICD-10 is actually currently being used for statistics work and has been since 1994. I think that using it for medical billing however hasn’t been fully implemented yet.
- When is the ICD-10 going to be implemented? It is scheduled for compliance by 10-1-2011. The reason why the ICD-10 is implemented is because the ICD-9 is supposedly running out of new diagnosis codes because new diagnoses are coming out constantly.
- What is the ICD-9-CM? It stands for ICD-9 Clinical Modification. This is the one that we use for inpatient and outpatient care.
- How is it broken up? Well, the codes go from 001-999 and is broken up by different areas of medicine. Codes 001-139 are infectious and parasitic diseases. For Ophthalmology, the codes we use are 360-389 - or diseases of the sense organs. The code for blepharitis is 373.0. So the number 373 is the code for inflammation of eyelids and the additional .0 is the code specifying blepharitis. If we used 373.2 it would be a chalazion.
Hopefully this gives you all a somewhat of an idea of what the billing system is and why we have it the way we have it.
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Comment by Jerry
Proper and smart billing is huge part of successful practice because it is what leads insurance companies to actually pay for the visit. Many great docs struggle because they don’t manage the billing element of their job effectively.
Jerry
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I came across your site and this article because i was intrigued by President Obama’s plan to overhaul the medical industry’s inefficient practices of billing and hopes to streamline it with more electronic methods. Your piece gives me more insihgt and now i understand better what is oging on underneath.
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Comment by santosh
Medical Coding and Billing has very good future, The top reasons are
1. ICD-10 , New codes implementingfrom 2013
2. ICD 9 has 16,000 codes and ICD 10 has 200,000 codes
3. The Medical Care is important, Physicians can provide if they are paid well and in time, new code changes will bring more requirement for resources.
4. Requirement of New claim for, Now we use CMS 1500 form, new form is required for new codes
5. Medical Necessity Issues, All procedure codes are mapped to Diagnosis codes, now, new codes linking is a big challenge.
6. Existng Coders and Billers need to prepare for this challenge.
The only way to grab this is PREPATION IS KEY TO SUCESS.
Choose a good medical billing training school.
Dr Guptha
http://www.medicalcodingexperts.com
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http://www.icd10codingtraining.com
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