When it comes to medical bills and the billing it's complex, fmost of us have been there and have felt the confusion when reading them. Let alone the cost disparities throughout medical providers nationwide. Every medical bill is heavily relied upon billing codes. If one digit is off it will throw your medical bill into a tale spin. Nonetheless each of these codes must coincide with each other otherwise your tale spin just got worse.
I won't get into the specifics regarding all of the medical codes and there definitions, however below are the mainly used codes when having a medical procedure, treatment, or being diagnosed with a symptom etc.
Healthcare Common Procedure Coding System (HCPCS) - Is used by Medicare & Medicaid Services (CMS) as a coding system for describing specific items and services for the delivery of healthcare. This coding is necessary for Medicare & Medicaid and other health insurance programs to ensure health claims are properly processed in an accurate and orderly manner. HCPCS includes the following levels of code:
Current Procedure Terminology (CPT) - The (CPT) medical code set is maintained by the American Medical Association. It describes diagnostic services, surgical, and medical. This information about medical services is used by many identities (physicians, patients, coders e.g) throughout the healthcare industry.
International Classification of Diseases (ICD) - Some ICD code sets pertain to procedure codes (inpatient settings), however mostly are diagnosis codes for claims.
Where There's a Bill There's a Way
Price transparency in healthcare has been a closed book up until recently (2013) when CMS released the first massive data set of Medicare procedure costs. Though these charges and quality indicators include Medicare only, it’s a good start in the direction of there’s a way. The aggregation of other all payer claims data sets, structure, grouping, and relevancy of data are all important factors for a optimal output so that healthcare consumers can have a user-friendly way to navigate through.