It’s one of the fastest growing fields in the US and it pays really, really well…
But at the end of the day:
What actually is medical coding?
Well, simply put, medical coding is a practice of transforming healthcare diagnosis, medical services, procedures and treatment into universal alphanumeric codes. These transcriptions are then passed on to medical billers who create claims based on the available information and submit the claims to respective insurance companies. The insurance companies then reimburse the doctors accordingly.
To better understand the concept of medical coding, consider the following example.
Suppose a patient visits a doctor complaining of a sore throat and symptoms like trouble eating and fever. The doctor performs the diagnosis and prescribes a treatment to the patient. All details of the visit are recorded in the patient file. The file is then forwarded to a medical coder, who, using standard codes, translates each part of the patient’s visit. The translated information is shared with a medical biller who creates a claim for reimbursement. The claim is then sent to the patient’s insurance company and the doctor is reimbursed accordingly.
But why code in first place? Why make everything so complicated? Why not just use simple plain English for communication?
If we don’t code it, the information would simply be too comprehensive to be communicated effectively. There will be long notes detailing every aspect ofa patient visit. The important information can get lost, or the admin department may not accurately be able to understand all the information. This can lead to inaccuracies.
Furthermore, representation of medical data may vary across states and countries. As a result, there is always risk of miscommunication and misinterpretation. Coding allows for uniform documentation between the involved stakeholders.
What are the standard codes a medical coder has to work with when transcribing patient records?
A medical coder works with various coding schemes to create an accurate transcript. The three most important and commonly used coding schemes are:
- ICD codes, used to describe the causes of illness, injury and death
- CPT codes, used for describing medical procedures performed in a medical facility.
- HCPCS codes, used for describing procedures that are not covered under the CPT coding scheme.
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