• Types of medical billing codesmedical text image by funkatronik from Fotolia.com
  
  Medical services, whether performed in a medical office, hospital or lab, are billed for using medical codes. The codes are placed on the claim that the insurance company receives to consider the charges for payment. It is important to use the correct codes and modifiers when performing medical billing. It can mean the difference between a claim being paid or denied.
  
  

Current Procedural Terminology (CPT)

• The American Medical Association (AMA) put into place the Current Procedural Terminology (CPT) codes to define the services rendered in medical offices and hospitals for insurance companies. CPT codes consist of a five digit number. These include codes that report anything done to the patient, such as surgical procedures, office visits, lab tests and x-rays. A claim form may contain several CPT codes for the same day if several procedures are done.
  
  

International Classification for Diseases (ICD)

• The International Classification for Diseases (ICD) developed a list of codes to report medical conditions and diseases. An ICD-9 code is also present on the insurance claim form. For each CPT code there is a diagnosis or ICD-9 code. ICD-9 codes start as a three digit number and can contain up to two decimal places. A diagnosis may be used more than once on a claim form.
  
  

Modifiers

• On a claim form, when a CPT code is used a modifier may be required. A modifier is added to the end of the CPT code and is used to distinguish between sides or parts of the body such as LT for left if an x-ray is done on the left hand. Also, a modifier may explain why a specific CPT code is being used. Some modifiers are not so straightforward; modifier 78 means that the patient has returned to the operating room on the same day after a procedure.
  
  

Corrected Claim

• If a claim is filed with the incorrect CPT or ICD-9 code, the insurance company has the right to deny the claim. The CPT or ICD-9 code can be corrected and billed again. This is called a corrected claim, which the insurance company then reviews for payment.