Medical coding is usage of standardized codes to diagnose the services rendered to a policyholder. Every possible injury and diagnosis is assigned a universal code that is readily understood by both healthcare providers and insurance companies so these parties are operating under the same umbrella of information. This process has become particularly useful, in terms of efficiency, ever since the claims process moved over to a largely digitized format.
For example you can see the format of report of medical coding :
- Date of Procedure: 6/09/20xx
- Patient Name: Garima Sharma
- DOB: 17/24/19xx
- HPI: Garima is a 27-year-old male who states met with an accident and her left hand get fractured
- Diagnosis: fracture of left hand
- Procedure: Splint
Workers on the administrative side of healthcare and insurance may be prone to misunderstanding the technical terms in this document. Therefore, after the diagnosis and procedures are complete, this medical statement is given to the medical coder, who looks at this report and sifts out the most crucial information that needs to be reported to the insurance company.
The medical coder then hands the converted data to the medical biller, who sends the claim to the policyholder’s insurance company. Often, the medical coder and the medical biller are the same person.
- Medical coding takes the descriptions of diseases, injuries, and health care procedures from physicians or health care providers and transforms them into numeric or alphanumeric codes to accurately describe the diagnosis and the procedures performed.
- This system was developed because, as we all know, medicine is not always exact, and there are many paths to take in preventing, diagnosing, and treating different ailments, all of which must be recorded and accounted for.
Proper medical coding is important on many levels, from ensuring accurate payment for physicians to creating a valid record of patient care history. In addition to aiding the medical billing process for procedures administered and helping expedite the payment of services for physicians, medical codes also serve the purpose of comparing projects and planning for under-served health care areas, aiding in administrative functions, as well as identifying symptoms that must be addressed and referenced by other physicians.
Medical coding can be a complex operation, so quality and accuracy in providers should be top priorities for any health care organization.
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