Bill Code Structure and Facility
Bill Code Structure Overview
The Bill Code Structure is a standardized system used to categorize and identify healthcare services, procedures, and supplies for billing and reimbursement. It ensures consistency and accuracy in claim submission across healthcare facilities and insurance payers.
Coding Systems Used
Medical billing relies on several code sets to standardize and streamline reimbursement. ICD-10-CM codes identify patient diagnoses, CPT codes describe medical procedures, and HCPCS codes cover additional services and supplies. Revenue Codes specify the facility department providing care, while DRG codes classify inpatient stays for reimbursement under Medicare and similar programs.
Revenue Cycle Integration
The bill code structure links directly to the Revenue Cycle Management (RCM) process — influencing claim submission, payment posting, denial management, and reporting. Clean coding leads to faster payments and fewer rejections.
