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Monday, April 7, 2014

"Are you a god?"

And that famous line from the classic Ghostbusters came to mind today while I was asked, for the second time in a week, if I'm a certified medical coder.

And the answer, "Actually, yes, I am."

It's really the only answer to the question.

Honestly, how hard is it to read a list of symptoms and mark the right number down?  And if you don't see your specific symptom, you give the generic symptom for that category.

It isn't brain surgery, here (which is ICD-9 #348.99)- it's just looking stuff up in a freakin' table.

And it's on Wikipedia.

Something I did find out, though, that you should also know:

1. Doctors charge their time against CPT codes.  This is a different list of codes that summarizes the amount of time and "thinking" that they had to do while treating you.

2. Hospitals and clinics charge their facility time against REV codes.  It's the same type of thing- it summarize the amount of time and equipment that you used while in their facility.

3. Insurance pays on the diagnosis code (ICD-9 or ICD-10) that is submitted to them.  In other words- what, in the end, were you treated for?

And, no, you're not allowed to see the specific billing information between these companies for your account.  You can ask each to audit their billing against your medical records, but you can't even have them confirm that they have the right medical records unless you take them to court.

Also, as any programmer will tell you, using different codes for the same thing creates all sorts of anomalies...which is EXACTLY what they want to do.  If they wanted to make it straight forward and honest, each of them would use the same code.



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