Lesson 1: Get started with Medical Billing & Coding

What is Medical Billing & Coding?

Medical Billing & Coding is actually the financial field of the healthcare industry. Medical billing and coding are two closely combined processes that form the backbone of the healthcare industry's financial system. They work together to ensure that healthcare providers are accurately and efficiently compensated for the services they render to patients.

 

Medical Billing & Coding is divided into following main fields:

1. Medical Coders / Medical Coding
   
2. Medical Billers / Medical Billing

What is Medical Coding & Coder?

Medical coding is the process of translating healthcare diagnoses, procedures, medical services, and equipment into universal alphanumeric codes. These codes are used for billing purposes, statistical tracking, and medical record keeping. Medical coders play a vital role in ensuring accurate documentation and reimbursement within the healthcare industry.

Here's an example to illustrate the role of medical coding and a medical coder:

Imagine a patient visits a healthcare facility for a routine check-up. During the visit, the healthcare provider diagnoses the patient with hypertension (high blood pressure) and performs an electrocardiogram (ECG) to monitor the patient's heart activity. Additionally, the patient receives a prescription for hypertension medication.

After the visit, the medical coder reviews the patient's medical record, including the diagnosis of hypertension and the procedures performed (ECG). The coder then assigns specific alphanumeric codes to each diagnosis, procedure, and service provided during the visit.

For instance:

    The diagnosis of hypertension might be assigned the ICD-10 code I10.
    The electrocardiogram procedure might be assigned the CPT code 93000.
    The prescription for hypertension medication might not be coded directly but would be documented in the patient's medical record.

Once the medical coder has accurately assigned the appropriate codes, this information is used for billing purposes. The coded data is submitted to insurance companies or government payers for reimbursement. Additionally, coded data is used for statistical analysis, research, and public health monitoring.

What is Medical Billing / Biller?

 Under construction please wait...