EHRs are bringing changes to medical billing and coding

Although medical billing and coding still has a critical role to play in making sure that the American health care system runs smoothly and efficiently, the introduction of electronic records and the Affordable Care Act will bring about noticeable changes in the next few years.

Medical billers and coders use the International Classification of Diseases to process claims and bill insurers. The system contains tens of thousands of codes, and when it switches from ICD-9 to ICD-10 in October 2014, the number of codes will increase from 13,600 to 69,000.¹

Those numbers may seem overwhelming, but anyone who has completed a medical billing and coding training program need not fear. The change is coming in large part due to the switch to electronic health records that many health care providers are making and will, in the long run, make the lives of medical billers and coders easier. Still confused? Don’t worry! We’ve answered a few FAQs:

What are EHRs?

Electronic health records help organize paperwork, reduce errors in patient care and cut costs throughout the health care industry. Medical billers and coders can use EHR systems to justify financial reimbursement from insurance companies and maintain a legal record of medical events. Because EHRs contain a detailed record of patient care from tests and procedures to diagnoses, they can be used along with a patient’s policy details to generate bills.²

Do I have to learn ICD-10?

Yes. Although the date for compliance was pushed back to Oct. 1, 2014, all health care providers covered by the Health Insurance Portability and Accountability Act of 1996 must be able to successfully complete transactions using the ICD-10 code by that date. This includes health care providers that have chosen not to switch to an EHR system.³

How does ICD-10 compare to ICD-9?

There are a variety of differences between ICD-9 and ICD-10, not the least of which is the sheer volume of codes. Although it is true that codes change every year, the structure between ICD-9 and ICD-10 is completely different. While ICD-9 codes are mostly numeric and consist of three to five digits, ICD-10 codes will be a combination of three to seven numbers and letters, allowing for a more descriptive system. The new codes will also be separated into categories, providing more accurate information for the treatment of patients and billing of insurers.⁴

¹ AAPC, ‘ICD-10 FAQ,’ 2013 – http://www.aapc.com/icd-10/faq.aspx
² Healthcare Information and Management Systems, ‘Electronic Health Records,’ 2013 – http://www.himss.org/library/ehr/?navItemNumber=13261
³ American Medical Association, ‘ICD-10 Code Set to Replace ICD-9,’ 2013 – http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page
⁴ Centers for Medicare & Medicaid Services, ‘FAQs: ICD-10 Transition Basics,’ July 2012 – http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10FAQs.pdf