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Medical Billing Code Books

     Billing Code Books are a necessary part of medical insurance billing.   You will find that you are frequently looking up codes and you need up to date code books to accomplish this.  Medical billing codes change every year and when they are outdated, the insurance companies will no longer accept them and your claims will be denied for the codes.

     What billing code books are available and required?  CPT4, ICD9, HCPCS, and RBRVS are all available.  

    CPT Code Books - or Current Procedural Terminology.  Services and procedures performed by physicians are described by the use of CPT codes.  CPT code books are listings of all procedure codes with an explanation of each code.  They are listed both by number and alphabetically. 

     These codes are updated annually and it is important to be aware of the changes each year.  Sometimes the changes are minimal, but sometimes there are a lot of changes and it impacts a provider greatly.  

     CPT  Code Books also contain a list of modifiers.  Modifiers indicate that a service was altered in some way from the stated CPT descriptor without changing the definition. The American Medical Association (AMA) CPT modifiers are two-digit numeric codes listed after a procedure code .



ICD9 Code Books - or The International Classification of Diseases, 9th Revision, Clinical Modification.  The ICD9 coding system is an international classification system which groups related disease entities and procedures for the purpose of reporting statistical information.  It is a system of descriptions and codes used to record the occurrence of medical diagnoses.

     ICD9 Billing Code Books list diagnoses both alphabetically and numerically.  These codes are also updated annually.  Again, the updates are very important.  If you use outdated ICD9 codes your claims will most likely be denied.  

    


     HCPCS Code Books - or Healthcare Common Procedure Coding System.  HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office.

     As with the other billing code books, HCPCS are also updated annually.  Unless you are a provider, or a billing service who bills for a provider, who supplies patients with services or supplies not covered in the CPT4 code book, you will not use these codes.



You can also purchase specialized code books.  We've seen them for anesthia coding, chiropractic coding, physical therapy  and allergy coding.
If you are a specialty office, or you are a billing service who bills for only a small group of specialty providers, you may want to look into these.  They are usually less expensive and contain data only relative to that specialty.

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