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What Is Medical Coding? What Is Medical Coding? Medical Coding Professionals Provide a Key Step in the Medical Billing Process

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What Is Medical Coding? What Is Medical Coding? Medical Coding Professionals Provide a Key Step in the Medical Billing Process Training Certification Continuing Education ICD-10 Jobs Networking Resources Store Log In / Join Certification Overview Medical Coding Certification Medical Billing Certification Medical Auditing Certification Medical Compliance Certification Practice Manager Certification Locate Exam Prepare for Exam Exam Tips Credential Verification FAQ Home > Medical Coding > What is Medical Coding? What is Medical Coding? Medical coding professionals provide a key step in the medical billing process. Every time a patient receives professional health care in a physician’s office, hospital outpatient facility or ambulatory surgical center (ASC), the provider must document the services provided. The medical coder will abstract the information from the documentation, assign the appropriate codes, and create a claim to be paid, whether by a commercial payer, the patient, or CMS. Prepare for certification and a career in medical coding Validate your knowledge, skills, and expertise with medical coding certification Is Medical Coding the same as Medical Billing? No. While the medical coder and medical biller may be the same person or may work closely together to make sure all invoices are paid properly, the medical coder is primarily responsible for abstracting and assigning the appropriate coding on the claims. In order to accomplish this, the coder checks a variety of sources within the patient’s medical record, (i.e. the transcription of the doctor’s notes, ordered laboratory tests, requested imaging studies and other sources) to verify the work that was done. Then the coder must assign CPT® codes, ICD-9 codes and HCPCS codes to both report the procedures that were performed and to provide the medical biller with the information necessary to process a claim for reimbursement by the appropriate insurance agency. There is a great deal of diversity among the numerous claims a medical coder processes on a daily basis. While codes vary a great deal in breadth and specificity, the following article represents what a sample medical coding transaction may look like. Article: What Does a Medical Coder Do? It takes a good deal of education and training to become a skilled medical coder. To begin, coders must have a thorough knowledge of anatomy and medical terminology. It is also important to become familiar with different types of insurance plans, regulations, compliance, and the coding community’s three critical resource books: CPT®, HCPCS Level II and ICD-9-CM along with their corresponding codes and guidelines. Using code books the medical coder assigns correct codes to record the service levels for the procedures performed and to account for supplies used to treat the patient during an encounter with the physician. Proper assignment of ICD-9-CM codes corresponds with the physician’s diagnoses and completes the “story” of the patient’s illness or injury. On October 1, 2014 the United States will adopt the latest version of medical codes by updating to ICD-10. Last updated in 1977 the new ICD-10 will increase the number of codes from approximately 13,600 to more than 144,000. Read More: How the Transition from ICD-9 to ICD-10 will Affect Coding and the Medical Community. In addition to assigning ICD-9, CPT®, and HCPCs codes, today’s medical coder may be involved in a wide variety of coding-related activities. The coder may audit and re-file appeals of denied claims. The coder may also educate providers and recommend the appropriate application of federal mandates and compliance that require providers to use specific coding and billing standards through chart audits. He/She may also act as an advocate for the provider and patient in issues of coverage and medical necessity. Starting a career in medical coding opens a number of coding-related jobs like Certified Professional Medical Auditor (CPMA®), Certified Professional Compliance Officer (CPCO™), and Certified Physician Practice Manager (CPPM®). RELATED ARTICLES: What Medical Coding Training is Required to Become a Coder? What Does a Medical Coder Do? What Education and Medical Coding Training is Required to Become a Medical Coder? While many coding professionals have strengthened their career by earning their bachelor’s degrees and master’s degrees, neither is required for a career in medical coding. What is required is a solid understanding of anatomy, physiology and medical terminology. It is also highly recommended for serious coders to complete a medical coding course of study, pass the CPC exam and earn their certification as a Certified Professional Coder, or CPC®. Certified Professional Coders, or CPCs®, are in high demand because employers know that these individuals can perform the job of medical coder with the utmost proficiency. Today more than 126,000 medical professionals are members of AAPC. This professional association provides a variety of opportunities to elevate the standards of medical coding by developing training, professional certification, opportunities to network with other related medical professionals and a variety of job search database and career building opportunities. Learn more about AAPC and take advantage of the workshops, on-demand webinars, regional and national conferences, and the monthly magazine, Coding Edge to develop your skills and stand out in your field. As a member of AAPC you will also be able to meet other coding professionals by participating in the coding discussion forums, Facebook group, or one of more than 550 local chapters throughout the United States and outlying areas. AAPC members also enjoy huge savings on medical coding books as well as a variety of other members-only exclusive discounts. Since its inception more than 20 years ago AAPC has developed a wide variety of professional credentials allowing its members to stand out amongst their peers and validate their expertise in a variety of fields. Coders may choose to broaden their skills by extending into medical auditing, compliance, out-patient practice, or practice management. Others may choose to complete a medical coding training course or specialize by earning one of AAPC’s specialty credentials. The AAPC credential is recognized nationally by employers, medical societies and government organizations. They are a great way to start a career in medical coding and the recent medical coding salary survey suggests that AAPC certified coders earn significantly more than non- credentialed coders. Where Do I Begin? If you are interested about what you have read so far about AAPC and opportunities pursuing medical coding, medical auditing, practice management, compliance, or one of the other specialized credentials you can start your new career by joining AAPC or by registering for one of the medical coding training courses today. USEFUL CODING LINKS: Medical Coding Career Survey – Discount Coding Books – Medical Coding Training and Education – Medical Coding Certifications – Certified Professional Coder (CPC®) – Coding Specialties – Online Forum – Medical Terminology and Coding Glossary – Find Coding Jobs in Your Area Medical classification From Wikipedia, the free encyclopedia Jump to: navigation, search Medical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers. The diagnoses and procedures are usually taken from a variety of sources within the health care record, such as the transcription of the physician's notes, laboratory results, radiologic results, and other sources. Diagnosis codes are used to track diseases and other health conditions, whether they are chronic diseases such as diabetes mellitus and heart disease, to contagious diseases such as norovirus, the flu, and athlete's foot. These diagnosis and procedure codes are used by government health programs, private health insurance companies, workers' compensation carriers and others. Medical classification systems are used for a variety of applications in medicine, public health and medical informatics, including: statistical analysis of diseases and therapeutic actions reimbursement; e.g., based on diagnosis-related groups knowledge-based and decision support systems direct surveillance of epidemic or pandemic outbreaks Contents 1 Classification types 2 WHO Family of International Classifications o 2.1 Reference classifications o 2.2 Derived classifications o 2.3 Related classifications 3 Other medical classifications o 3.1 Diagnosis o 3.2 Procedure o 3.3 Other . 3.3.1 Library classification that have medical components 4 ICD, SNOMED and Electronic Health Record (EHR) o 4.1 What is SNOMED? o 4.2 What is ICD? o 4.3 SNOMED CT vs ICD o 4.4 Data Mapping of SNOMED and ICD 5 Clinical Coding in Australia o 5.1 What is clinical coding? o 5.2 What does clinical coder do? o 5.3 What is coded data used for? 6 See also 7 References 8 External links Classification types Many different medical classifications exist, though they occur into two main groupings: Statistical classifications and Nomenclatures. A statistical classification brings together similar clinical concepts and groups them into categories. The number of categories is limited so that the classification does not become too big. An example of this is the International Statistical Classification of Diseases and Related Health Problems (known as ICD). It groups diseases of the circulatory system into one "chapter" (known as Chapter IX, covering codes I00–I99). Within this chapter, there is for instance, code I47.1. The code title (rubric)
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