Medical coding is the procedure in which coders allocate numerical codes to healthcare processes and diagnoses to bill insurance firms for reimbursement claim.
For coding and medical billing, there are three major coding manuals that contain all codes that a coder can add for reimbursement claim. They include:
ICD-9: This diagnosis code is relevant to the international classification of medical diseases with 9th revision.
CPT: It is named as current procedural terminology that refers to the services and procedures performed on patients for treatment.
HCPCS: It is known as healthcare common procedural coding system that refers miscellaneous supplies and drug supplied to the patients in the setting of healthcare mode.
Medical coders combine three coding sets on the claim of insurance and refer them to insurance firms for reimbursement. Here Is a detail what they make use of them:
ICD-9 diagnosis codes are useful in explaining to the insurance firm why the patient needs medical treatment.
CPT tells the insurance firm what processes were applied to the treatment of the patient.
HCPCS codes are used for the representation of other miscellaneous supplied or services given to patients on the day of their arrival.
A medical provider
He or she bills for HCPCS and CPT codes because they are representative of supplies and actual services provided to the patient.
Each medical code provided an individual charge is reimbursed separately by the insurance firm. It means that provider does not bill for, and insurer firm will not make payment for diagnosis codes.
Because of medical coding nature, it is simple to code for the wrong process accidently. It is known as abuse or fraud and is a serious offence that requires punishment by fines and sending jail. Due to this, it is vital for coders to produce a solid protection against coding abuse and fraud.
One major safeguard is the understanding of different medical terminology, diagnosis, and procedure description in a better way. This understanding gives you confidence that correct codes are sent, and the patient is having the right treatment.
There is a need for good education in proper coding and medical terminology to support the coding process quickly and permits coders to tackle more clients.
Normally, physicians code their claims, but coders should check the medical codes to ensure that everything is billed correctly. In settings, medical coders need the translation of patient charts into codes.
In summary, medical codes help the coder and the doctor to report the right information. The provider will market the correct coding information on the bill and coders enter it into computer software, named as practice management application. This software allows the biller to send their claims to the insurer firms. In every condition, medical coders are responsible for the correct codes entering based on the patient health care services. There is good news for coders because they are different job opportunities for them with a medical coding knowledge. Sometimes, these coders play the role of medical billers. In their dual role, they file the insurance claim of the patients, assign codes and start the process of billing. Look for medical billing service website to get more information about billing and coding process.