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Rehabilitative Behavioral Health Services Provider ManualManual Updated 07/01/18SECTION 3BILLING PROCEDURESTABLE OF CONTENTS
GENERAL INFORMATION1USUAL AND CUSTOMARY RATES..............................................................................................
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What is procedural coding?
Procedural coding refers to the process of assigning numerical codes to medical procedures and services based on specific coding systems, such as the Current Procedural Terminology (CPT) and the Healthcare Common Procedure Coding System (HCPCS).
Who is required to file procedural coding?
Healthcare providers, such as physicians, hospitals, and other medical entities, are required to file procedural coding when submitting claims for reimbursement to insurance companies and government healthcare programs.
How to fill out procedural coding?
To fill out procedural coding, a provider must accurately select and assign the appropriate codes based on the services provided, ensuring that all necessary documentation supports the codes selected, before submitting the coding to insurers.
What is the purpose of procedural coding?
The purpose of procedural coding is to standardize the reporting of medical services and procedures, facilitating communication between providers and payers, ensuring proper reimbursement, and maintaining comprehensive records for healthcare.
What information must be reported on procedural coding?
Information that must be reported includes the specific codes for the procedures performed, the date of service, patient demographics, provider identification, and any relevant modifiers or additional details to clarify the services rendered.
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