As you and your medical coders know far too well, staying on top of your coding is essential to keep it accurate and conducive to prompt reimbursement. However, when it comes to successfully running your practice, professional fee coding is a topic that doesn’t get the attention it deserves.

This is a fairly unfamiliar term, and you may be thinking “what is pro fee coding?” Well, in a nutshell, profee coding is a specialized type of professional coding that focuses more on the professional services surrounding the healthcare industry. This extends to things like office visits, any consultations you may have, and certain procedure code too.

While it’s useful to keep your business running optimally, it’s worth remembering that pro fee coding requires a fairly nuanced understanding of the topic to get the most out of it.

So, in this article, we’ll be covering all the basics of this topic, from explaining its significance to giving you a few essential insights, you’ll soon be able to master profee coding services with ease.

What Is Pro Fee Coding?

As a small medical practice owner, you may have heard the term “pro fee coding” being thrown around, but what exactly does it mean?

In essence, pro fee coding refers to the various codes and billing that’s attached to and professional services that are rendered by any of your healthcare providers. This includes a few different types of medical staff, such as physicians, any of their assistants, and nurse practitioners.

Examples of Pro Fee Services

Let’s take a brief look at all the different services that are covered by pro fee coding.

– Evaluation and management (E/M) visits
– Consultations
– Surgical procedures
– Diagnostic tests
– Radiology exams
– Lab tests
– Outpatient surgeries
– Other medical services provided in an outpatient or inpatient setting

To focus more on that last point we mentioned, it’s worth noting that there’s a range of examples that cover other healthcare services, including things such as:

– Chronic care management
– Behavioral health services
– Home health visits
– Telehealth services

These kinds of services are becoming increasingly popular between patients and healthcare providers these days, so it’s vital that all your coding staff understands how to properly code and bill for all of them.

When you’re staying up-to-date with all of the latest changes to coding and billing guidelines, it’s a lot easier for your practice to give your patient a wider range of services than you could otherwise.

Not only that, but you’re also able to stay compliant with various insurance carriers and government programs so you can avoid any random fees or denials.

What Is Pro Fee Coding Doing Differently From Other Services?

While you may have heard of both facility coding and technical coding before, pro fee coding differs from these in a few key ways. Firstly, while facility coders focus their attention on the resources being used during procedures, like equipment and supplies, pro fee coders are more concerned with the professional side of healthcare services

This means that a pro fee coding clinic requires a deeper understanding of medical jargon and what’s needed for the documentation.

On the other hand, facility coding is normally done by a team of hospital coders, and they’re responsible for accurately coding all the supplies and services that were used during procedures, which then get billed to the patient or their insurance carrier.

Furthermore, professional fee coding also differs from other types of coding when it comes to the reimbursement rates. In general, pro fee services are typically reimbursed at a higher rate than other facility or technical services. This is due to the higher level of training and expertise required by pro fee coders, so they’re typically done by healthcare providers who have completed extensive education and training.

How Can Small Medical Practices Ensure Accurate Pro Fee Coding?

In order to ensure you’re fairly compensated for any of the services you’ve rendered, it’s essential that you’ve got accurate professional fee coding. However, let’s be honest, this type of coding can be extremely complex, especially for smaller practices. This is where outsourcing to PMN can help!

PMN’s team specializes in all types of coding and physician services, including pro free coding for small medical practices in the US. Their team of certified coders are always aware of the latest coding software and insight, so expect nothing short of attention to detail and compliant coding.

In addition, they’re also an effective way of reducing costs around your own practice, as hiring a range of in-house coders and expensive software can seriously stretch your budget. Comparatively, PMN are cheaper and provide many other services too, such as A/R management, patient collection services, and medical billing and coding audits for your practice.

If you’d like to learn more about PMNs services, get in touch with them today by visiting their lovely office in Laguna Hills, Orange County, California! Alternatively, you can give them a call at (949) 215-5055 if you prefer chatting over the phone.

FAQs

What Are Some Common Mistakes In Pro Fee Coding?

Some of the more common mistakes in this type of coding are things such as

– Upcoding: Assigning codes that reflect a higher level of service than what was actually provided.
– Unbundling: Separating components of a service that should be coded together as a single code.
– Insufficient documentation: Not providing enough information to support the codes assigned.
– Using outdated codes or guidelines: Failing to stay up-to-date with the latest coding guidelines and code changes.

What Is Pro Fee Coding Useful For?

There’s a few main reasons it’s important to stay on top of professional fee coding (or just coding services in general), such as:

– Reimbursement: Proper coding ensures you’re accurately paid for the services you’ve provided.
– Compliance: It helps ensure that your practice is in compliance with all the regulations and laws related to medical coding.
– Data analysis: Coded data can be used to analyze things like healthcare utilization, outcomes, and trends.