Medical Billing Codes

By 2029, the healthcare industry is expected to add 2.4 million jobs in the U.S.1 This includes roles in the field of medical billing and coding. In fact, according to the U.S. Bureau of Labor Statistics, employment of medical records and health information technicians is expected to grow much faster than the average for other career areas.2

Applying the correct medical billing codes is a critical role in the healthcare industry as it ensures proper documentation of patient treatments and accurate processing of medical claims. Physicians, hospitals and healthcare facilities all depend on medical billers to help facilitate a seamless flow of information – a critical part in efficient operations, payment, reimbursement and even patient safety.

Did you know that medical billing codes are also used for research? When accurately documented, codes can be used to identify patterns and evaluate new treatments for efficacy. It’s yet another example of how essential medical billing and coding is in healthcare operations.

If you’re interested in a career in this field, understanding medical billing codes – such as CPT codes – is a good place to start.

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What is CPT Coding?

CPT coding is an important step in the medical billing process. CPT codes are the universal language used by insurance companies and other processors to identify medical procedures and services. While varying healthcare providers may call treatments something different, CPT – or Current Procedural Terminology – codes provide a systematic way to sort treatment and supplies for payment.

CPT codes are used to describe evaluations, tests, outpatient procedures, surgeries and more. There are thousands of codes, which are updated from time-to-time by the American Medical Association. As a coder, you would look at the healthcare provider’s diagnostic statement, look up the code and assign it before submitting a form.

Most Commonly Used Medical Billing Codes

Since some healthcare providers are specialized and others – such as family practitioners – provide more generalized services, it’s no surprise that the most commonly used CPT codes may vary from one provider to another. However, some are more basic than you may think. For example, there are CPT codes to cover services such as a new patient office visit or an emergency room visit.

While CPT medical billing codes let insurers know what procedures were provided, medical billing and coding professionals also work with a second set of codes called ICD-10 codes. International Classification of Diseases codes, or ICD-10 codes, detail the symptoms or diagnosis. The World Health Organization publishes the ICD code list to standardize how diagnosed diseases are classified worldwide. The information gathered is used to conduct research on diseases, underlying causes and treatments.

An ICD code will explain a patient’s symptoms while the CPT code will document what procedures or services were provided based on the diagnosis.

Types of CPT Codes

There are three categories of CPT codes and each provides a way to accurately describe treatments and procedures or help provide information for evaluation.

Category I CPT Codes

Category I CPT medical billing codes are assigned to medical procedures that are considered standard practices in the U.S. These codes represent treatments that are generally effective at treating specific diagnoses and are supported by the medical profession or medical literature. They are also treatments that are approved by the Food and Drug Administration (FDA) or the Centers for Medicare and Medicaid Services (CMS).

These codes are divided into sections in the CPT codebook, including:

  • Evaluation and Management
  • Anesthesiology
  • Surgery
  • Radiology
  • Pathology and Laboratory
  • Medicine

Within each section, there are sub-sections organized by particular fields or procedures.

Category II CPT Codes

These codes are supplemental tracking codes used for performance measurement. While optional, Category II CPT medical billing codes are also used to help with data collection for compliance with state or federal laws.

Often, these codes are used to more quickly sort data rather than having to review charts for key performance measures or to monitor internal performance.

Category III CPT Codes

These CPT codes are temporary codes that are assigned for new or emerging technology, services or procedures. Category III CPT codes last for five years. After five years, a decision is made to convert it to a standard Category I CPT code or be rejected.

Category III codes allow for more specificity in coding and help agencies and healthcare facilities track the effectiveness of new medical treatments and procedures.

Medical Billing and CPT Code Classes

At DeVry University, we offer undergraduate certificate programs in medical billing and coding. Enrolling full-time, you can complete your coursework and hands-on training in less than a year. Our medical billing and coding program is 100% online and new classes start every eight weeks.

The courses you take will help you develop a wide range of medical billing and coding skills including:

  • Translating medical terms, treatments and services into medical billing codes
  • Understanding the insurance billing process
  • Gaining hands-on training using real medical data in a virtual laboratory setting

Depending on the program you choose, you’ll also be prepared to take the Certified Coding Associate (CCA®), Certified Coding Specialist (CCS®) or Certified Professional Coder (CPC®) exams.

If you choose to continue your education, nearly all the courses from your medical billing and coding program can apply toward an Associate degree in Health Information Technology or Bachelor’s in Business with a specialization in Health Information Management.3

Get Started in Medical Billing

Enrolling at DeVry University can help you pursue your personal goals and prepare for a career in medical billing. Want to learn more or get started?

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1Growth is on a national level. Local growth will vary by location. https://www.bls.gov/ooh/healthcare/home.htm
2Growth is on a national level. Local growth will vary by location. https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm
3At the time of application to the next credential level, an evaluation of qualifying transfer credit will occur and the most beneficial outcome will be applied.