Each time you receive a bill from your doctor, it contains the codes that describe your illness (CPT) and the related diagnosis codes (ICD). If you ever wondered what your particular diagnoses are, here’s a way for you to find out.
Go to the American Medical Association website:
- Find the End-User License. In essence it tells you that you may look up these codes only for your personal information and explains the limitations.
- The next page will be where you search. Choose your state and city. If your city isn’t there, there find the nearest one to you.
- If you know the code (looking at your bill), input the 5-digit CPT code in the field, hit SUBMIT, and you’ll see your answer which will include the RVU (Relative Value Units) which calculate how much the insurance payer will pay for the care or procedure. If you do not have the CPT code, but you know what the procedure or service was, you can do a search to try to figure out the right code. If you can’t find it, try to look for the medical words related to whatever the procedure is, like appendectomy,” or appendicitis.”
- If you key in the diagnosis or the code into any search engine, you will also find lots of results that talk about the various codes used.
- Using RVUs to Determine How Much Your Provider Was Paid
Each CPT code is assigned a value, (time, intensity, how serious, etc.) tied to the amount of money Medicare will pay based on averages and other factors, such a geographic area. If a value is listed for code Z as 1, it would be $100, 1.2 would be $120. Since these are Medicare payment amounts, they are lower than private insurance will pay typically. At least you will have an idea.
If you’re not sure how to read a medical bill, here is a site at AARP that will show you how.
It is important to learn more about how the various systems track patient information, how the care is billed and of course, how it is paid.
Inform yourself and pay attention. For timely information on coding for the healthcare industry, visit us at www.med-certification.com