Changing of the Codes; ICD-10 and CPT Codes

Bonnie J. Flom • February 4, 2019
Medical Billing

Changing of the Codes; ICD-10 and CPT Codes

 

Welcome to Billing Buddies YouTube and Podcast series.

In this episode, we will be discussing the annual changing of the codes; particularly, the ICD-10 and CPT codes.

Healthcare professionals, medical billers and payers rely on several types of codes sets in order to communicate pertinent information about patients.  These code sets include TOS (Type of Service); POS (Place of Service), and NPI (National Provider Identifier) to name a few.  In this writing, I will address the codes that are updated annually, the ICD-10 and CPT Codes.

The ICD-10 codes are specifically called either ICD-10 CM or ICD-10 PCS.  The ICD-10 CM codes are used for all healthcare settings except hospital inpatient settings where ICD-10 PCS codes are used.  For the purposes of this writing, I will be referring to ICD-10 CM codes and abbreviate them to ICD-10.  Each year on October 1 st , the ICD-10 codes have revisions, additions and deletions.  These codes are copyrighted and maintained by the World Health Organization.  The ICD-10 codes define the diagnosis of the patient.   There are many free resources online for healthcare professionals and billers to find the updated codes.  One of my favorite sites is the www.icd10data.com.   On this site, you can see the added, deleted and revised codes.   Codes with red arrows next to them signify codes that are non-billable/non-specific codes.  These codes cannot be used for billing purposes.  Codes with green arrows next to them signify codes that are billable codes.  It is important to note that diagnosis codes should be coded to the highest specificity.  Besides free online resources, ICD-10 coding books may also be purchased from several publishers.

CPT codes are copyrighted and maintained by the AMA.  CPT is the acronym for Current Procedural Terminology.  The CPT codes define the services and procedures received by patients.  Each year on January 1 st , the CPT codes have revisions, additions and deletions.   The CPT coding updates need to be purchased either in books or an online subscription.   Many of the CPT codes are addressed in payer policies and can be read for free online, but for a complete resource, it is best to purchase an updated manual or online subscription.

It’s important to note that HIPAA defined which codes sets are used to communicate.  Prior to HIPAA, many payers defined their own codes sets.  For example, in some specialties, like chiropractic, codes varied by payer.  Medicare, worker’s compensation and commercial insurance each had their own code sets.  HIPAA streamlined the coding processes by defining one code set for each data element.

In summary, whether you use online resources or purchase manuals, it is important to note that ICD-10 codes update each year on October 1 st and CPT codes update each year on January 1 st .  You want to stay updated to the most current codes to be compliant with your coding and billing and to reduce denials from payers.

This was brought to you by Billing Buddies.  Billing Buddies is a medical billing and consulting service established in 1994.  We offer services to a variety of specialties across the United States.  For more information, please call or text 612.432.2366.  Thank you for listening to Billing Buddies YouTube and Podcast Series and remember to “Buddy Up with the Best”, Billing Buddies.   Have a great day!

 

Billing Nightmares with ARHMS in Minnesota? Here’s the Real Fix Nobody Talks About

By Bonnie Flom • April 21, 2025
Fact: ARHMS providers across Minnesota – especially in Minneapolis – are spending more hours than ever on billing, and it’s affecting client care. Between compliance rules, rejected claims, and slow payments, many teams are overwhelmed. But what if ARHMS billing didn’t have to be a full-time job? Table of Contents: ● The Real Problem with ARHMS Billing Today ● What Makes ARHMS Billing in Minneapolis Especially Challenging ● How Outsourcing Isn’t Just Easier — It’s Smarter ● What Billing Buddies Does Differently ● Quick Comparison: DIY Billing vs. Partnering with Billing Buddies ● Final Word + How to Connect The Real Problem with ARHMS Billing Today Let’s be real: ARHMS billing is no longer just about submitting claims. It’s about understanding state-specific codes, documenting every move correctly, and constantly adjusting to DHS updates. If you're still relying on manual methods or a stretched-thin team, the odds of losing revenue go up fast. What Makes ARHMS Billing in Minneapolis Especially Challenging? Minneapolis is fast-paced, and so is the demand for mental health and habilitation support. But here’s the kicker — more clients mean more billing. More billing means more room for error. If even one code is off or a note is missing, your claim can get stuck for weeks. Providers here aren’t just looking for help — they need speed, accuracy, and someone who actually gets local systems. How Outsourcing Isn’t Just Easier — It’s Smarter? Outsourcing ARHMS billing isn’t just about handing off tasks. It’s about: ● Reclaiming Time: So your team can focus on what they’re best at — client care. ● Reducing Stress: Say goodbye to rejections, late filings, and compliance fears. ● Improving Cash Flow: Claims are submitted right, the first time. What Does Billing Buddies Do Differently? We’re not a generic billing company. We’re local experts who specialize in Minnesota Medicaid systems — especially ARHMS. With Billing Buddies, you get: ● A team trained in Minnesota-specific ARHMS codes and DHS guidelines ● Fast turnaround on claims and re-submissions ● Clean reporting so you always know where your money’s at ● Support that’s personal — we work with your staff, not around them We work with providers throughout Minneapolis and beyond — helping small teams grow by giving them their time and cash flow back. Quick Comparison: DIY Billing vs. Billing Buddies

Is Your Mental Health Practice Losing Money? Here’s How Credentialing Services Can!

By Bonnie Flom • April 21, 2025
Over 40% of mental health professionals in private practice report delays or denials in insurance reimbursements due to credentialing issues. Without proper credentialing, therapists and counselors risk being excluded from insurance networks—directly impacting patient access and practice revenue. That's where credentialing services for mental health come in. For providers in Minnesota and beyond, working with a dedicated billing partner like Billing Buddies can make the difference between reimbursement success and financial stress. Table of Contents: What This Blog Will Cover What Is Credentialing in Mental Health? Why Is Credentialing So Important? Common Challenges in the Credentialing Process How Billing Buddies Simplifies Credentialing for Mental Health Providers Benefits of Outsourcing Credentialing Services Credentialing vs. Re-Credentialing: Know the Difference The Minnesota Advantage: Why Local Expertise Matters Conclusion + CTA What is Credentialing in Mental Health? Credentialing is the process of verifying a provider’s qualifications—including licenses, education, training, and work history—to ensure they meet the standards of insurance networks. It’s mandatory if you want to be reimbursed by insurers like Blue Cross, Medica, UCare, or UnitedHealthcare. Why is Credentialing So Important? Without proper credentialing: ● You cannot accept insurance. ● Your claims may be rejected. ● You miss out on a major client base. And here’s the kicker—credentialing takes time (30-120 days) and must be accurate to avoid denial. Common Challenges in the Credentialing Process Challenge: Incomplete Applications Missed Deadlines Lack of Follow-Up Misunderstanding Payer Requirements Confusion Between Credentialing & Contracting Impact: Delays or denial in approval Need to restart the process Long waiting periods without updates Leads to rework and frustration Payment delays or lost payer relationships How Billing Buddies Simplifies Credentialing for Mental Health Providers? Billing Buddies offers personalized credentialing services tailored for mental health practices. Our team: ● Prepares and reviews all documents. ● Submits applications to insurance networks. ● Tracks application status with regular updates. ● Handles payer communication. ● Maintains re-credentialing timelines. You focus on patients. We focus on paperwork. Benefits of Outsourcing Credentialing Services When you work with credentialing pros like Billing Buddies, you: ● Speed up approvals ● Reduce errors and rejections ● Improve insurance payouts ● Save administrative time ● Avoid burnout from non-clinical tasks It's a smart move for solo providers and group practices alike. Credentialing vs. Re-Credentialing: Know the Difference Credentialing is the first-time process of getting approved by an insurance network. Re-credentialing happens every 2-3 years to verify that your information is still accurate. Both are necessary—and both are time-sensitive. The Minnesota Advantage: Why Local Expertise Matters? When you choose Billing Buddies, you're not just getting generic credentialing services. You’re partnering with a team that understands mental health billing in Minnesota , including local payer systems, Medicaid requirements, and state-specific nuances. We’ve helped therapists across Minnesota get credentialed quickly and keep their payments flowing. Don’t Let Credentialing Hold You Back Whether you're launching your private practice or expanding your network, proper credentialing is essential. And with so many moving parts, it’s easy to get overwhelmed. That’s where Billing Buddies steps in—to take credentialing off your plate and help you focus on what really matters: patient care. Let Billing Buddies handle the paperwork so you can focus on healing. Also, learn more about our expert solutions for mental health billing in Minnesota today!

Why Mental Health Billing Is a Nightmare—and How to End It for Good?

By Bonnie Flom • April 18, 2025
Fact: Nearly 60% of mental health providers say that insurance billing and credentialing slow down their ability to focus on patient care. Between changing payer rules, claim rejections, and the exhausting credentialing process, providers often find themselves spending more time on admin work than therapy sessions. That’s where specialized mental health billing and credentialing services come in—and Billing Buddies is leading the charge. Table of Contents Why Mental Health Billing Is So Complex What Credentialing Means (and Why It’s a Game-Changer) Benefits of Outsourcing to Billing Buddies Mental Health Billing vs. Medical Billing: What’s Different? Our Process: How Billing Buddies Simplifies It All Summary Table: What You Get with Billing Buddies Final Thoughts + How to Get Started Why is Mental Health Billing So Complex? Unlike general medical billing, mental health services involve unique codes, session limits, and pre-authorizations. Even small errors in time-based coding or failing to include proper documentation can lead to claim denials. Key challenges include: ● Frequent insurance changes ● Limited sessions per year ● Confusing modifiers and CPT codes ● Authorization requirements ● Varied payer-specific rules What Credentialing Means (and why it’s a Game-Changer)? Credentialing is the process of verifying a provider’s qualifications with insurance companies so they can join a payer network. It involves paperwork, follow-ups, and long wait times—anywhere from 60 to 180 days. If you’re not credentialed, you can’t bill insurance. And if you’re improperly credentialed, delays and rejections will keep stacking up. Benefits of Outsourcing to Billing Buddies When you hand off your billing and credentialing tasks to Billing Buddies, you save hours weekly—and potentially thousands of dollars monthly. Perks include: ● Fewer claim denials ● Faster reimbursement ● Error-free submissions ● Up-to-date compliance ● Full credentialing support ● More time for patient care Mental Health Billing vs. Medical Billing: What’s Different?