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Understanding Your Medical Bills: What Do Those Codes Mean?

medical bills

It’s no secret medical bills are difficult to translate. Often, it can seem as if the hospitals and billing professionals are trying to cheat you out of money.

It shouldn’t be the patient’s job to decipher medical bills so they can stay afloat. Yet it is, and it’s a difficult task for many. If you find yourself on the receiving end of these medical bills, keep reading. We’re going to decode a few of these meanings so you’re no longer in the dark.

What Happens With Medical Bills

Before your medical bill makes it to you, it has to go through others first. There are people who have to claims scrub your medical bill. This means medical clearinghouses have to go over your bill and make sure there are no errors.

Providers choose from the top 10 medical clearinghouses to find the right one for them. You can be sure it’ll be one with great credentials to help oversee your bills.

Decoding Medical Bills

Health insurance bills have certain codes that could be tripping you up when you read them. Here are some tips on reading them you might find useful when you get the next bill in the mail.

First Things First

Getting the wrong medical bill isn’t uncommon. Spelling errors and misinformation happen and can cause a lot of trouble.

That’s why it’s always good to check the name, address, and date of the procedure. If something isn’t right, you should call your provider or the hospital to find out what to do next. If all the information is correct, you can move on.

CPT and HCPCS Codes

Your health insurance bill will have itemized codes on it. These codes will give you an idea of what the bills are for and why you’re being billed.

One of the most common codes is the CPT. CPT stands for “Current Procedural Terminology” and translates across most insurance types. They represent the types of services they gave you. HCPCS codes are related and often used by Medicare and Medicaid.

If you don’t know what a CPT code means, call your doctors office and ask your medical bill questions. You can also look them up in a database.

ICD-10

ICD-10 codes represent a diagnosis and stands for International Classification of Diseases. These are universal codes linked to the CPT code to ensure the diagnosis and procedure match.

Revenue Codes

You may see these codes and wonder what they mean. Revenue codes relate to the amount linked to the procedure. Unlike the other codes, these are only used at the hospital in which you had the procedure.

More Curious Topics

Medical bills and their coding can be more annoying than trying to read the fine print. Sometimes it’s a good idea to get help reading them so you don’t end up missing something important. Don’t hesitate to call your provider or look them up on the internet. There are all kinds of answers on the web.

Like reading about medical and other related topics? Browse our Health and Wellness category for more.

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