Q How does HIPAA pertain to coding and billing?

A When you think of HIPAA, you probably think of privacy and security, not coding and billing. It's easy to forget that the government enacted HIPAA to streamline medical billing and payment processes. Currently in the United States, about 400 different coding-related formats, both paper and electronic, are used. HIPAA aims to standardize these formats and eliminate or greatly reduce paper forms by establishing eight electronic formats. Effective Oct. 16, you and your payors must do all of your reimbursement-related communications on these forms.

The bad news? The forms are complicated (see "A Sample 835 Transaction" below). The good news? Your payers can no longer say that they won't pay the claim because they don't "recognize" the codes you've sent them. Everyone must now use the same forms and codes.