What is Medical Coding?
Medical coders act like translators by taking medical reports that are
provided by physicians and turning the information found on those
reports into a set of universal medical alphanumeric codes.
Information on medical reports includes prescriptions, medical
diagnoses, any medical procedures performed on the patient, and the
patient’s condition.
Medical coders are responsible for making sure these codes are
correctly applied during the medical billing process. In addition to
assigning the correct codes, they create a claim to be paid by insurance
providers.
Medical Coding vs Medical Billing
These two healthcare professions are often confused. They are both
involved with administrative tasks, but medical billing and medical
coding require their own unique skill sets.
While medical coders translate patient care into current procedural
terminology (CPT) codes, medical billers create a claim based on the
codes provided by medical coders.
While they have distinct skillsets, there are times when the same
person may perform both duties. Medical coders and medical billing
professionals work together to avoid insurance payment denials. They
both also process a number of medical services and claims each day.
The medical coder’s job is to paint a complete picture of each patient’s
interaction with a physician. It needs to be as specific as possible in
order to avoid the risk of miscommunicating what services were
rendered and capture timely reimbursement for those services. In
order to achieve this goal, medical coders must review clinical
statements and assign the correct standard codes, rather than listing
the actual information.
There are three sets of code medical coders use:
ICD codes – International Classification of Diseases (ICD codes) establish
a uniform vocabulary that describes the causes of injury, illness and
death.
CPT codes – Current Procedure Terminology (CPT codes) document
most medical procedures performed in a doctor’s office. CPT codes are
set by the American Medical Association (AMA).
HCPCS codes – Healthcare Common Procedure Coding System (HCPCS)
is based on CPT codes. They primarily correspond with services,
procedures, and equipment not covered by CPT codes.
The Importance of Medical Coding
Medical coders do not simply list things that take place between a
doctor and their patient, such as procedures, symptoms, and diagnoses.
When a patient’s condition is more complex, the amount of
information that needs to be submitted becomes much greater.
There is a potential of more than a billion doctor visits every year in the
United States. Now imagine multiplying that number by how many
things must be coded for every visit. Suddenly there are billions of
codes that need to be accurately recorded. Not only for reimbursement
but to offer insight into how effective treatment is at a medical facility
and research and analysis.
Since medical codes change all the time, coders face a challenging job.
It requires an understanding of medical terminology and a willingness
to always learn something new. But it’s a rewarding career for those
who consider themselves detail-oriented people.
Looking for a medical coding team you can trust? Contact
MEDIMAXSOL SOLUTION, today!
Call Medimaxsol, Solution. today at (305) 709-0282 or Info@medimaxsol.com and let our team assist you in choosing the right solution. www.medimaxsol.com