What is Medical Coding?

Obviously, to check the price of a Hoyer lift is very different from checking medical insurance claims. Medical coding is the conversion of diagnosis in healthcare, medical procedures and services, as well as apparatuses into medical alphanumeric codes that is universal. The codes on diagnoses and procedures are obtained from documentation of medical records, like transcription of doctor’s or physician’s notes, radiologic and laboratory results, and more. Medical coders are professionals who help in making certain that the codes are properly and precisely applied throughout the process of medical billing, which involves extracting the facts and figures from documentation, records, delegating the applicable codes, and generating a claim to be funded or paid by carriers of insurance carriers.

Medical Coding And Medical Billing – Are They Similar?

A medical coder’s major responsibility is to examine and assess medical or clinical statements and appoint standard codes utilizing ICD-10-CM , CPT®, and HCPCS Level II classification systems. On the other hand, medical billers handle, check on and follow up claims forwarded to companies of health insurance for reimbursement or refund of services executed by a healthcare provider. Medical coders and medical billers may work with hand in hand to make certain that invoices are correctly and properly paid and to get around denials in insurance payment. It is also possible that a person may have the responsibilities of both the medical coder and medical biller. To aid in upholding a smooth and efficient process of coding and billing, the coder examines the medical documentation or record of a patient to confirm and validate the medical procedures done.

On a day-to-day basis, both the coder and the biller process and handle a multiplicity of services and procedures done by a physician as well as claims. It is essential and a must that these medical codes communicate the patient’s complete and uncut encounter with the physician and need be as detailed and precise as possible in favors to gaining reimbursement for the services rendered.

Proper education and hands-on training is the major requirement to grow into a skillful, accomplished, and efficacious medical coder. The initial prerequisite that soon-to-be coders must possess is a comprehensive familiarity and understanding of anatomy and medical terminologies. It’s also imperative to become knowledgeable with the codebook resources as well as their coding systems, equivalent guidelines and parameters and which codes are acknowledged by insurance plans, which administration and payer protocols to abide by, and how to be compliant whilst coding.