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Top Trends in Medical Billing and Coding

The healthcare industry evolves continuously in correspondence to the new laws and regulations, procedures, and public health concerns – all of which give rise to the recent trends in medical billing. As a professional in healthcare coding and medical billing services, you must stay on top of the latest trends and processes that impact your work.

But what is medical billing and coding?

And

What are the career projections in medical billing and coding services?

Let’s first address the career prospects – medical billing and coding remain in demand as a career choice, with a predicted growth rate of 13 percent by 2026. Working in the coding and billing field offers many employment opportunities in many healthcare settings. These include the following:

  • Hospitals
  • Physician’s offices
  • Insurance companies
  • Medical centers
  • Nursing homes
  • Government medical departments
  • Rehabilitation facilities
  • Urgent care centers

With that out of the way, let’s dive into the latest trends in medical billing and coding.

Trends in Medical Billing

The top six trends in medical billing and coding are as follows:

1. Telemedicine – Virtual Care

Post Covid-19 pandemic, virtual care, especially telemedicine, has grown rapidly. There is a rising trend, higher demand, and utilization of virtual care services. It means healthcare organizations must adopt new care models that facilitate advanced patient care at home. It can include the higher usage of wearable technology and other connected healthcare devices. With the onset of newer devices, there will be a new revenue cycle that will be needed.
With the increasing popularity of virtual care services, medical billers and coders must stay up-to-date with the regulatory changes. This should be about care coverage workers embracing the new work responsibilities. With medical practices pursuing new technologies, billers, and coders must educate providers about billable codes.

2. Blockchain Technology in Medical Billing

The introduction of blockchain technology is one of the latest trends in medical billing. When it comes to healthcare billing, without a doubt, it comes with a lot of challenges, including:

  • Unintentional billings
  • Billing code errors
  • Incorrect filings
  • Duplication of processes

The blockchain is a distributed ledger, helping providers reduce errors with proof of completed transactions. Blockchain technology warrants data integrity and additionally protects patient data-provider data, including:

  • Electronic health records
  • Patient health information
  • Claims data
  • Monitoring systems data

As one of the latest trends in medical billing, blockchain technology stores billing records in a specific manner that cannot be modified until it reaches the recipient. Furthermore, all data is available and saved in a fixed location.

3. Coders Traineeship Programs

Professionals are now turning away from traditional job settings and positions. Most are moving towards remote positions that also pay well. The same scenario fits the healthcare billing and coding field. However, the newly certified coders lack the expertise and experience that most healthcare organizations seek. Consequently, to bridge this gap, medical organizations now offer coder apprentice programs – intending to train and retain the staff efficiently. The said programs also optimize educational solutions while also filling up staffing vacancies.

4. CPT (Current Procedural Terminology) Updates

The new 335 CPT code changes now reflect recent technological advancements. These include remote patient monitoring codes facilitating your connection with patients at home through technology. Furthermore, some inter-professional consultation codes depict the importance of non-verbal technology for patient care. Some other CPT changes consist of:

  • Adaptive behavior analysis
  • Central nervous assessments
  • Skin biopsy
  • Fine-needle

5. ICD Systems

Next up for the latest trends in medical billing, the ICD or International Classification of Diseases assists in analyzing and identifying global trends in the healthcare industry. Consequently, it offers a set of codes and rules that can be used for sharing information with healthcare professionals worldwide. Furthermore, the ICD codes are vital to determine available resources and secure reimbursements for health insurance companies. Moreover, the ICD-11 comes with a significant redesign, which assists in structuring the system more like a database.

The benefits of ICD-11 include:

  • Straightforward coding
  • Flexibility in codes to define conditions in detail
  • A digital format, allowing regular system updates

6. Code Bundling

The latest trends in medical billing also include the code bundling trend. The American Medical Association requested that the editorial panel of the relativity assessment workshop pair several codes. If two procedures with varying codes are often done together, the editorial panel can create their code pair – a bundle. The bundling of codes simplifies the patient billing process; furthermore, the process gets easier for insurance companies. For instance, if you are getting a vaccination, as opposed to having separate codes for the procedure, the vaccine, and the reason for vaccination, you can work with a bundled code, which effectively describes the entire process.

Final Word

The billing and coding outsourcing market is to see exponential growth. Consequently, more hospitals, doctor’s practices, and healthcare systems are following the latest trends in medical billing and outsourcing their billing and coding needs. Third-party billing companies that focus on offering billing services are growing. With the increasing costs associated with in-house billing and complex coding systems, medical organizations rely more on third-party companies. Billing companies do the work for provider practices at a much lower cost, thus increasing the bottom line.

Frequently Asked Questions

The CPT identifying and descriptive codes serve a wider variety of vital functions. The terminology system is a widely accepted medical nomenclature for reporting medical procedures and services under private and public health insurance programs.

Currently, there are 5 medical coding classification systems for identifying and managing medical codes, including:

  • ICD-11
  • ICD-10-CM
  • ICD-10-PCS
  • CPT
  • HCPCS Level II
AI can be used for streamlining the process and thus achieving better efficiency. AI is not slated to replace the medical coder jobs; instead, it is a tool to make the process smoother with increasing accuracy.

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