2023 Medical Billing and Coding Changes

Medical billing and coding are two distinct systems that work hand in hand in the healthcare industry. 

Billing refers to the process of listing all medical services and treatments to charge patients appropriately. It also includes the processing of healthcare claims that will be submitted to insurance companies, which could be private or government-based, as in the case of Medicare and Medicaid. 

Coding involves working with a set of established codes that help make the billing process easier for billers and coders. It is essential to standardize procedures and medications for uniformity and prevent mistakes. 

Medical codes help streamline the overall process. 

What are the Medical Billing Codes?

Three major code groups are used in medical billing and coding:

Current Procedural Terminology (CPT)

CPT is used to identify diagnostic, medical, and surgical procedures. All entities concerned, from physicians to healthcare organizations, insurance companies, and accreditation organizations, use the same set of codes. 

They are used in conjunction with the International Classification of Diseases. 

International Classification of Diseases (ICD)

The World Health Organization has established a set of codes for clinical terms, which is accepted and recognized globally. It is an international language used for health statistics, so the global organization can efficiently collate mortality and morbidity for every disease. 

And for healthcare facilities worldwide, using these codes prevents inaccuracies and miscommunication. 

Healthcare Common Procedural Coding System (HCPCS)

Developed by the Centers for Medicare and Medicaid Services, the HCPCS identifies hospital services, medications, and supplies administered to patients. Unlike the ICD, the HCPCS is only recognized in the U.S. 

Every year, new diseases and treatments are discovered. Codes must be updated to reflect these changes. 

The American Medical Association (AMA) publishes the changes annually. Knowing the differences among the codes and their changes is essential in the healthcare industry. 

Overview of 2023 Changes in Medical Billing and Coding

These Medicare 2023 changes were implemented during the year:

• Reduction of runaway costs of prescription drugs

• Behavioral healthcare is now available to Medicare beneficiaries

• Adjustments in monthly charges

Other changes were reported, and those in the industry must be updated with the developments to become better medical billers. 

Aside from insurance coverage updates, medical billers and coders must also apprise themselves of the 2023 coding guidelines changes. 

Here are some of them:

Modifiers

At the start of 2023, drug providers and suppliers had to use the new modifiers JW and JZ for used or unused drugs. JW pertains to the number of drugs discarded or administered to patients, while JZ is used when no drugs are discarded or distributed. 

These modifiers are for healthcare personnel and authorities to easily identify drug usage and track where they are located. This ensures drugs are only accessed by those authorized to do so. 

Evaluation and Management Coding

Several changes were also implemented in the evaluation and management (E&M) coding. 

The following codes went through revisions:

• 99242-45

• 99252-55

• 99221-23

• 99231-39

• 99281-85

• 99304-10

• 99315-16

• 99324-38

• 99339-41

• 99344-45

• 99347-50

• 99358-59

• 99415-17

Some codes were also removed. 

Key Updates to ICD-10-CM Codes in 2023

How many new ICD-10 codes for 2023? The CDC issued 1,176 new healthcare codes under this system. That’s a lot of codes for the healthcare industry to note, but they are needed to provide the best service to clients. 

Mistakes and errors in codes could lead to rejection and denial of insurance claims. Worse, the wrong diagnostics, medication, and treatment codes could be a health threat. 

A robust and accurate medical billing system is critical in all healthcare facilities. Medical billing software like BillPro could make billing, coding, and healthcare operations simpler and more efficient. 

Changes in the ICD codes are easily applied through software. 

In the latest updates, many of the changes covered the following healthcare issues:

• Dementia

• Endometriosis

• Head injury

• Pregnancy and maternal care

New CPT Code Additions and Revisions

As for 2023 CPT code changes, around 100 new codes were introduced by AMA. Another 68 codes were deleted, and 87 were revised. 

Here are some of the procedures affected by these changes:

• Cardiovascular system

• Digestive system

• Integumentary system

• Musculoskeletal system

• Nervous system

• Respiratory system

• Surgery

• Urinary system

Navigating HCPCS Level II Code Modifications in 2023

What about HCPCS changes? The Centers for Medicare and Medicaid Services announced updates to the HCPCS Level II code set. It had the latest changes, as updates were posted in the last quarter of 2023. 

Some 47 new codes were introduced under Medicare billing for services and supplies. Two codes were deleted, two codes were revised, and descriptions of four codes were edited. 

How to Keep Track of All These Changes?

As technology is constantly evolving, it is vital to keep up with cutting-edge tools and trends in medical billing and coding. It pays to always have ears on the industry, as technology can take your business a long way. 

As mentioned, medical billing software will help with accurate and quick processing. And the best software providers will provide regular updates to their systems that will reflect changes in the industry, including medical codes. 

Storing information in the cloud will also increase efficiency when filing new codes, revising them, or deleting them based on new updates. 

Conclusion

Medical billing has undoubtedly changed by leaps and bounds. It is your responsibility to keep up. 

Get BillPro today—the leading medical billing software to increase business efficiency and proficiency.