Can we talk about medical coding and billing for a minute? (How's that for clickbait? 😉 )
For context, I've been neck deep into AAPC chat forums trying to figure out which codes might be applicable for a service that doesn't require MD level credentials, but somehow cannot be billed in many cases by the clinical professional who does have the appropriate training and scope of practice to deliver that service. (I'll let that sit for a moment and maybe we can address this nonsense in a future rant.)
A few observations from this experience:
1. I feel pretty unsatisfied by the fact that I am crowdsourcing reimbursement options for a valuable clinical service in a forum that is not too dissimilar from an AOL chat room in 1997 (IYKYK - shoutout to my fellow elder millennials). And this is not the first time I've been down this coding rabbit hole.
2. AAPC recommends several prerequisites for a medical coding course, including fundamentals of medicine, anatomy, and pathophysiology. Apparently, practical training in a healthcare setting may exempt candidates from these prerequisites. I probably do not qualify for exemption.
3. The investment for the course and exam to become a certified professional biller and coder (after prerequisite classes) is 32 weeks and $6-10k.
4. Even with CMS documentation, training courses, pages upon pages of payer memos randomly updating covered services and coding expectations, you can often still find no clear guidelines for how to code a service so that you reliably get reimbursed. (I came across the words "no one in the universe knows for sure" on these chat forums re: the code set I was researching.)
That is all to say: we need collective action (e.g., enforced standardization, regulation, storming of the streets) to make this work more straightforward! And maybe we need to institute a professional coder appreciation day. At the very least, take a moment to thank the professional coder in your life for wading through this dumpster fire of "requirements" (and apparently for knowing about as much about anatomy and pathophysiology as an incoming med school student).
Also sincere thanks to @AAPC for their Codify product (not sponsored; just a fan).
Assistant Manager - Revenue Cycle Management (RCM).
9moAmazing