Laboratory Billing Service

Laboratory Billing Services Billing Service

Medical laboratory billing uses two main code sets. The first is known as the International Classification of Diseases, or ICD, which is maintained by the World Health Organization (WHO). Recognized as an international diagnostic and epidemiological standard, it provides a coding tool, which basically provides medical abbreviations for diagnostic codes that classify diseases, signs and symptoms, external causes of disease or injury, and other ailments. Insurance providers expect the code to be consistent with the conditions and care provided.

The second set of codes is known formally as the Current Procedure Technology Code Set and informally as the CPT and is provided by the American Medical Association. This identifies the service provided, not a diagnosis. The CPT code set is used to report medical, surgical, and diagnostic procedures and services to health care professionals such as doctors, health insurance companies, and accrediting organizations.

Healthcare is a dynamic industry – regulations change to adapt to fluctuating government requirements, insurance payers, and changes in technology and science. The Centers for Medicare and Medicaid (CMS) also enforces strict billing guidelines, which require medical billers to stay abreast of changes that may affect the billing service for a facility.