History of Medical Coding and Billing

2509 WordsMay 3, 201311 Pages
History and Future Of Medical Coding and Billing John F. McMahon BU480, Central Methodist University Abstract Medical coding and billing affects everyone during their lifetime and yet the regulations of medical coding and billing are extremely complex. Examining the history, evaluation, and effect of new regulations and their cost shed light on an already complex industry. We will review government regulations, technological advancements, and requirements that providers will face in the near future. We will examine our current systems and how they evolved through time and what they may be in the future. We have reviewed articles from the Medical Billing and Coding Association, the…show more content…
The ninth edition of the ICD codes were developed and pushed in a direction so that the codes could be used for billing instead of just disease classification. (Department Health and Human Services, 1998) Medical coding after 1976 became the standard for health care providers to set cost and bill for procedures based on the ICD codes. The ICD codes are taken from the different sources within patients’ health care record, physician notes, lab results, x-rays. Procedures performed on body parts are all taken into consideration when assessing a value for services rendered. The fees associated with each procedure are regulated by the U.S. Department of Health and Human Services and by state governments. Before this system of billing, physicians charged whatever they thought was appropriate and in many instances bartered for their services. (Department Health and Human Services, 1998) Government and insurance standards also regulate the cost of procedures that have been identified by the coding system. The responsibility of making sure that accurate billing takes place falls to the coder that use the ICD-9 and ICD-10 codes. These codes then tell the biller what to bill. Reimbursement rates for procedures are controlled the US Department of Health and Human Services and state governments. (Department Health and Human Services, 1998) Commercial payers such as Aetna, Blue Cross and Blue Shield, and United Health Care attempt to control pricing by
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