CPT & ICD-9-VOL III

by Antoinette Vendlinski
(Glendale, AZ)

Should all payers be required to make standardized rules for coding or should each payer be allowed to designate the types of codes they require for each type of patient status?

Can you help me with this question as I am in school for Medical billing and coding and I just need some general answers or maybe you can direct me to someplace I can get this information.

Response:

Wow - that's a tough one! Great question. As a biller having standardized coding rules would remove a lot of uncertainty.

I'll be the first to say that I'm not an expert on this - and welcome any comments below on this.

I'm not aware of any standardized initiatives by payers - at least commercial payers.

The only government entities I'm aware of that could mandate such coding standardized rules would be an agency like the Department of Health and Human Services, or the Centers for Medicare and Medicaid Services. And I sense that any effort to regulate would encounter opposition and lobbying against by the payers. That may be an effort a government agency wouldn't want to take on.

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