Radiology requires accurate coding for providers to be reimbursed properly.
Medical billing comprises two coding systems that must be used together accurately to receive proper compensation. For insurance purposes, benefits are determined based on the combination of the two. An unauthorized procedure or non-qualifying diagnostic code can result in a denied claim.
ICD-9 Codes
The World Health Organization (WHO) developed the ICD diagnostic system in association with the American Medical Association (AMA). These codes consist of three digits, with additional qualifying digits added, if necessary, after a decimal point. For example the ICD-9 for rheumatoid arthritis is 714.0, whereas joint pain in the shoulder is 719.41.
CPT codes
The current procedural terminology (CPT) coding system was introduced in manual form in 1966. It indicates the procedure being done and is used in conjunction with the diagnostic codes for proper billing. It is a five-digit code and for radiology these procedures range from 70010 through 79999.
V Codes
Diagnostic codes known as V codes are used to indicate a personal history or family history of illness. These can be used to indicate a past illness no longer present or the higher risk to develop certain illnesses genetically. For example, V16.3 indicates a family history of malignant neoplasm of the breast. In addition, V codes are used for after-care or followup.
E Codes
E codes indicate external causes of injury. This code begins with the letter E and is followed by three digits. Unlike other ICD-9 codes and V codes, there are no decimals used in an E code. For example a motor vehicle accident would be coded from E810 to E825.
Tags: codes used, family history, three digits, used indicate
