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.

Any comments by other visitors on this question? Please feel free to correct me or offer your comments by clicking on the link below.

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Feb 26, 2013
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MEDICAL BILLING BLOG
by: Anonymous

Yes - because the insurance company should provide the correct form to use during the medical records and billing.

Oct 15, 2012
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Should all payers be required to make standarized rules for coding......
by: Anonymous

I also am Havng this question to answer and I will say It is the Insurance companies that is the payers and I think it should be up to them which form of coding they would feel more comfortable with, understand better, or want to use!

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