CPT 2015 Codes: Should you train your Staff or Outsource Medical Billing?


The American Medical Association (AMA) publishes the CPT coding manuals on an annual basis. In its 2015 release, the AMA has released a total of 542 CPT code changes. 505 of these changes have already been brought into effect as of January 01, 2015.

For 2015, the AMA has published 266 new codes, revised 129 codes and also deleted 147 codes. The CPT code changes can be majorly seen in pathology / laboratory services, surgical services, and radiology.

The AMA has created 107 new codes for the Pathology and Laboratory section, revised 27 codes and has deleted 49 codes. For the Surgery section, it has added 84 new codes, deleted 42 and revised 62 codes. Radiology will see 15 new codes in 2015 and removal of 23 codes at the same time. The AMA has revised four codes for Radiology services. Performance category II saw the least amount of changes this time with removal of only one code.

Here are a few factors which should be considered before taking a decision either on outsourcing medical billing services or training the current staff.

Keep up with Code Updates

Outsourced billers keep themselves up-to-date diligently with the changing regulations and insurance requirements. They keep up with the latest industry regulations, procedures, and the annual updates on ICD and CPT codes. They are trained on the 2015 CPT code updates which ensure smooth transition to new codes.

Effective Use of Electronic Health Record (EHR)

Outsourcing medical billing means effective use of EHR. This can help avoid down-coding as the health record system will recommend certain CPT codes based on what occurred during the patient visit. It has been estimated that most physicians lose more than $10,000 per year due to undercoding.

Accurate Capture of Critical Information

The in-house billing staff may not be competent enough to capture critical patients and procedure-related details perfectly, which could lead to claims denials. Professional billers submit accurate medical bills and file the claims on time.

Outsourcing Reduces Cost

Outsourcing medical billing results in a dip in the operating cost for medical service providers. By outsourcing billing, they just have to pay for the basic operations and the billing company takes care of the coding and claims filing procedure. They also do the needful for updating all the billing-related software or infrastructural maintenance demands.

Outsourcing Reduces Claims Denials

Professional billing providers submit accurate medical bills and file claims on time. Billing experts capture and accurately report the information, resulting in a considerable drop in the processing time. With expert billers, there would be minimal coding errors which would lead to reduced claims denials.

Outsourcing Increases Revenue

By outsourcing hospitalist billing, experts will look after the accounts receivables (AR). They ensure continuous business operations which results in steady flow of claims submissions. By outsourcing their billing, providers can save thousands of dollars in the form of annual salaries and benefits that an in-house billing team demands.

Billing companies such as MedicalBillersandCoders.com have a team of certified coders who are well-trained in switching to these coding changes and revisions. Coding specialists at MBC have been helping physicians from 42 medical specialties overcome revenue challenges caused by the CPT code changes every year. They provide denial-free billing and coding services to ensure maximum revenue returns for providers.

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