Diagnostic and Procedural Coding
What is diagnostic and procedural coding?
Health service providers that bill medical schemes utilise specific codes for medications, equipment and patient care. The procedural code refers to what was done to assist the patient, such as the medical equipment used on the patient, the types of surgeries performed and the medications administered. Every year, new codes are added, some taken out, and new codes used to replace old ones. A codebook is the primary source of information for identifying diagnostic and procedural codes. Codebooks may be purchased or taken from a medical or academic library. Various publishers offer codebooks, and the published ones vary in terms of content. For example, a few versions include a list of expired and current codes, while other versions may only include new, updated ones.
What types of diagnostic and procedural codes exist in healthcare data?
Diagnosis codes are present in all claim-level files, which include inpatient and outpatient care, home health, hospice care and durable medical equipment. Since 2011, institutional health service providers have been allowed to enter up to twenty-five diagnostic codes, whereas only ten were allowed before this. This increase in the number of codes allowed reflects the growing complexity and diversity of patient conditions and treatments. In contrast, non-institutional health providers were only allowed to enter a maximum of eight diagnostic codes and are presently allowed to submit up to a total of twelve.
With our diagnostic and procedural coding expertise, we are equipped with the foundational knowledge, attributes, and competencies to analyse clinical codes and use them for claim submissions within the healthcare industry. We systematically access, critically analyse, and assess existing data within the clinical coding field. As a result, we allocate diagnostic and procedural codes, acquire and store data, and capture, audit, and analyse data.
Our understanding and analysis of diagnostic and procedural coding is not just a task, it's a key component of our role in evaluating claims data. Our knowledge in this area is highly relevant, empowering us to make confident decisions and ensuring the accuracy of claims data.
FAQ
services
- Registration with Medical Aids and Hospitals
- Patient Data Capturing
- Diagnosis and Procedural Coding
- Claim Submission – Electronic and Manual Submissions
- Payment Follow-Up
- Recovery of Outstanding Amounts
- Reconciliation of Remittances and Private/Gap Cover Accounts
- Monthly-end Reports / Schedules
- Medical Aid Motivations
- Injuries on Duty (IOD)
- SANDF and RMA Billing
Why Choose Us?
With years of experience in the industry, our dedicated team ensures accuracy, efficiency, and professionalism in every aspect of our service. Trust us to streamline your billing processes, allowing you to optimise your practice and improve cash flow. By choosing Complete Billing Solutions, you can expect increased service revenues, reduced cost overheads, stabilised cash flows, more time for patient care, and access to a professional accounts enquiry help desk.