Medical billing tools
Claim coding references for US medical billers and coders.
These seven follow one claim through its life. You code it, you submit it, it comes back paid or denied, and then you work out whether to appeal. Each tool sits at one of those points.
Before submission, the ICD-10 checker catches the diagnosis codes that will deny because they are category headers rather than billable codes, and the FY2027 page covers what changes on 1 October, including the codes that keep their number but stop being billable. The place of service lookup decides which Medicare rate the claim selects, facility or non-facility.
After it comes back, the denial decoder starts from the group code rather than the reason code, because the group code is what says whether you write the adjustment off or bill the patient. The 835 reader opens a remittance and reconciles it; the 837 checker validates the envelope structure of a claim file before a clearinghouse rejects it.
What is deliberately missing is CPT. Procedure code descriptions are copyrighted by the AMA and licensed per organisation, so no tool here shows them. The 837 checker works on structure alone and shows codes without descriptions, which costs nothing in practice: you already know what you billed, and the check is about whether the file is well formed.
7 tools in medical billing
- 835 Remittance ReaderRead an 835 ERA in the browser, decode every CARC and RARC, and check it balances to the deposit including the PLB adjustments that usually explain why it does not.Open
- 837 Claim CheckerCheck an 837 before submitting: claim totals against service lines, NPI check digits, and diagnosis pointers that resolve to a diagnosis actually on the claim.Open
- Denial DecoderPaste an adjustment line from a remittance and get the group code, reason code and remark codes explained, starting with whether the amount is a write-off or billable to the patient.Open
- HCPCS Code LookupPaste supply, drug and equipment codes and get the CMS description, the Medicare coverage status, the pricing methodology, and whether the code was valid on your date of service.Open
- ICD-10 Code CheckerPaste a whole claim of ICD-10-CM codes at once. Says which are billable, which are category headers that will deny, what to send instead, and what changes on 1 October.Open
- ICD-10 FY2027 ChangesEvery ICD-10-CM code added, deleted, reworded or reclassified for FY2027, including the ones that keep their number but stop being billable.Open
- POS CheckLook up any of the 52 assigned Place of Service codes and see whether Medicare pays the facility or non-facility rate for it, with the conditional rules CMS states separately.Open