Surgery Center Billing Codes
If you've ever had surgery, you know that there are a lot of steps involved - pre-op, the surgery itself, and post-op. And while you might not think about it, each of these steps has its own corresponding billing code. As an office manager, payor, or claims adjuster, it's important to understand these codes in order to accurately process medical claims. In this blog post, we'll take a look at the most common surgery center billing codes and what they mean.
What are the most common billing codes for surgery centers?
Surgery centers increasingly use CPT (Current Procedural Terminology) codes for billing purposes. These CPT codes provide important information about the surgical procedure being performed, including the place of service and global period encompassed by that CPT code. In addition to CPT codes, billing information must include a diagnosis code as reported by a surgeon or other qualified healthcare provider. As such, when it comes to billing codes for surgery centers, CPT codes are the most commonly used. Furthermore, having access to the right combination of CPT and diagnosis codes can result in a smooth and swift payment process.
How do these codes differ from hospital billing codes?
Medical codes, like diagnosis codes and place of service codes, are an important part of the coding process used in health care. They provide information about each patient's experience and enable the processing of claims for services rendered. These codes differ from hospital billing codes in a few key aspects. For example, place of service codes indicates whether a service was provided inpatient or outpatient while hospital billing codes typically detail the exact place where services were obtained. Furthermore, referral codes are added along with hospital billing codes to indicate an additional reason why treatment was necessary in order to receive payment. It is clear that these two types of medical coding processes are quite different but both are integral to ensuring health systems receive appropriate payments for their services.
CPT 94760 Billing Code Explanation
Surgery centers usually use billing codes in order to accurately record and track the materials used by each procedure they perform. The five most common billing codes used by surgery centers are Global Surgery Package, Tremor Procedure, CPT Code Set 94760, Anesthesia Services, and Diagnostics. Global Surgery Packages cover a wide range of services that may be needed, such as pre-operative exams and follow-up care. Tremor Procedure consists of treatments for neurostimulation such as Medtronic DBS or NeuroPhase. CPT Code Set 94760 is typically used for lab tests and clinical office visits. Anesthesia Services involve the administration of anaesthetic agents or substances - either local or general - to prepare patients before surgery. Finally, Diagnostics includes tests that measure the biological functions of a patient in order to accurately diagnose and treat disorders or diseases. This is just a small sampling of the wide array of codes used in surgery center billing systems; there are many more complex ones that require expertise and experience to understand and utilize correctly.
How to Avoid top surgery center coding mistakes
Knowledge is Queen!
Surgery centers are facing increased difficulty when it comes to medical coding. To ensure correct patient billing and minimize potentially costly mistakes, they must be aware of the common blunders that happen. The top five mistakes surgery centers should avoid are not selecting a coding specialist with experience in surgical claims, not having an understanding of government regulations, ignoring the importance of compliance, making assumptions about codes before verifying them with payers, and relying solely on software to complete medical coding paperwork. Without an experienced team of coders familiar with the specifics of surgery centers, claims may be denied or delayed leading to financial difficulties for the center. To remain compliant, it is wise to have an understanding of constantly changing regulations as well as new technologies being utilized and accepted by payers for medical coding purposes. Diligence is needed in terms of verifying codes as assumptions can result in incorrect patient billing. Lastly, software must always be supplemented by manual review procedures conducted by qualified professionals in order to maximize efficiency while avoiding costly errors.
AI Coding Software is Essential
AI medical coding software such as iVecoder is a great tool for healthcare providers looking to increase their efficiency. The automated system quickly and accurately reviews a patient’s record for errors, inconsistencies, or coding issues which could result in a denial when billing payers. Additionally, it helps to reduce physician burnout because the burden of manual medical coding is eliminated and collectors can focus on other areas that require attention. The software can even alert a collector of potential under coding so they can make adjustments before submitting a claim thus increasing the chances of a faster reimbursement. This innovative technology helps ensure healthcare providers comply with ever-changing rules while collecting more accurate payments in a timely manner.
Conclusion
Surgery center billing codes can be tricky to navigate. However, taking the time to understand what your codes mean and how they differ from hospital billing codes is essential if you want to make sure you're getting the accurate code for your procedure. Moreover, other factors such as geography, procedure type, and taxes also affect surgical center bills. Overall, it's undeniable that surgery center billing is an incredibly complex process, and understanding what goes into it will help you stay informed about your healthcare costs. If this blog post has left you with more questions than answers, give us a call and demo our FREE IVECoder today! Our professional team ensures that our clients receive the highest quality coding optimization solution on the market so that you can get ahead of the coding curve.
References
iVECoder was used for statistics and data in this article. iVECoder has an annual license with AMA and is compliant with Medicare and state medicaid rules, regulations, and standards.
