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What Are The Standardized Code Sets?

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HIPAA as we have all learned by now stands for the Health Insurance Portability and Accountability Act. HIPAA mandates providers and contractors to use approved standardized code sets so as to ensure the ebb and flow of our health care system can continue to improve and become more efficient. Let's look at it another way. You have hundreds of thousands of medical facilities all coding their bills. Imagine if they all did things differently and all used different code sets how much harder it would be for insurance companies to pay out in a timely manner.

When HIPAA became enacted in 1996, they set standards for how electronic billing should be handled within covered entities (a covered entity as we should all know are health plans, …show more content…

The structural base for them are not quite the same. The setup for the manual, the formatting of codes and even some of the guidelines are different (not to mention ICD-10-CM has around 70,000 codes while ICD-9-CM has only about 16,000 codes).

ICD-9-CM contained procedural codes in volume 3, ICD-10-CM does not contain any as they are now implemented within ICD-10-PCS.

ICD-9-CM procedure codes had about 3,000 codes, ICD-10-PCS has over 72,000 codes. The way the new system has been set up this number has the ability to grow as well.

ICD-9-CM diagnosis codes were 3 to 5 characters in length, ICD-10-CM codes are 3 to 7 characters in length.

ICD-9-CM codes are the majority numbers only with the exception of those supplemental V and E codes, ICD-10-CM codes are all alphanumeric.

Remember, ICD-9-CM was implemented and in use since 1979, so updating terminology and new classifications were also changed with the upgrade of ICD-10-CM/PCS.

ICD-9-CM codes could before be labeled in just one code, now with more clinical detail to sort through, ICD-10-CM have many more codes to choose from that are much more detail oriented and specific.

I'm actually really excited to be starting this month's course and learn the ICD coding process. I am nearing the end of my college experience soon and will be beginning my externship after next month's course. When I am done I will graduate with a certificate in Medical billing and coding. I will be

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