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GMO120

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Mechanical Engineering

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Apr 3, 2024

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docx

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GMOA115 medical billing class Mrs.Adeleye Discussion question 1 week 3 The use of outdated coding manuals vs. new ones when working in a healthcare facility could lead to several problems. I have listed a few of the potential issues that I feel could lead to issues for all parties, healthcare facility, provider, and patient. 1. Incorrect billing- Medical billing and coding is used to translate a patient’s care services into specific codes that translate into the billable units that a physician’s office can bill for. If the coding manuals are outdated the codes used might not accurately represent the services provided, leading to incorrect billing or denial in paid claims. 2. Compliance issues- The standard regulations by various bodies, and the non-compliance can lead to possible penalties. Outdated codes could potentially violate these regulations this is why it’s important to use updated coding manuals. 3. Unhappy patient’s- If claims are denied due to incorrect billing this could lead to dissatisfaction amount our patient’s. This could then impact the reputation of both the doctor and the practice. 4. Inefficiency-Outdated coding manuals might not include possible new procedure or treatment codes causing the inefficiency in the coding process. Discussion question 2 CPT codes provide a way for healthcare providers to provide services and procedures to patient’s while maintaining documentation. When a patient interacts with the healthcare system, they typically receive a range of services and interventions during a single visit. A new code book is needed each year to accurately identify all patient care acurately. It’s also important to keep the CPT code book and CMS book on hand for 2 years just in case insurance companies conduct an audit for the last 2 years.
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