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- เผยแพร่เมื่อ 25 ก.ย. 2024
- Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codes are similar in function, but with important differences.
These two coding systems both handle medical procedures and services. However, HCPCS classifies those procedures and services, while CPT codes describe them.
Understanding the difference between these codes is essential for many reasons. This is true, especially in the world of medical billing. The financial health of your healthcare organization falls in the hands of those who work with your patient invoices. With accuracy, comes a faster turnaround and a lower percentage of claim denials. Here are a few examples of why having your team familiar with these codes can help your practice.
1. Accurate Billing and Reimbursement
Being able to accurately and confidently code for a wide range of services means your billing team is less likely to have issues with underpayment or overpayment of invoices. From medical procedures to equipment, each corresponding code ensures that healthcare providers are accurately reimbursed for their services without long periods of waiting due to claim denials.
2. Efficient Communication
Utilizing these codes properly strengthens the standardized language for documenting and communicating medical services. Understanding the differences between HCPCS and CPT codes facilitates this communication between healthcare providers, insurance companies, and patients. With better communication practices come lower chances of denied or delayed claim submissions. Therefore, faster reimbursement!
3. Data Analysis and Research
Using these codes correctly also helps medical researchers collect public health data. Both coding systems function as essential tools which help to identify trends in healthcare services. They also assist in tracking the prevalence of specific procedures as well as studying the cost of healthcare across the country. Data gathered from this process can help inform policy decisions as well as contribute to the bettering of the healthcare industry as a whole.
4. Regulatory Compliance
All organizations that work with protected health information (PHI) must comply with the Health Insurance Portability and Accountability Act (HIPAA). Using HCPCS and CPT codes enables organizations to safely communicate this PHI within the company and to other covered entities.
HIPAA’s billing and coding standards require the use of both sets of codes for all electronic healthcare transactions. Non-compliance can lead to issues with collecting your revenue and even worse potential legal consequences.
Knowing the difference between HCPCS and CPT codes is essential. Your billing staff can use this knowledge to ensure they are using the most accurate of billing practices, and therefore gathering revenue efficiently.
Remember, CPT codes cover most medical procedures and services covered by insurance. HCPCS codes report medical supplies, equipment, and services that aren’t included in CPT codes. Understanding how each code works with the other will help you continue to collect your claims and keep your revenue cycle healthy.
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