What Is Medical Coding?

Medical coding is just the process of assigning a series of numbers and/or letters — a code — to a medical procedure or service that is then sent to an insurance company for payment. Medical coding technicians are also referred to as health information coders, coding specialists, medical record coders, or even "abstractors." But they all mean the same thing. Medical coding technicians are a vital part of the health-care system. Medical coders assign a special code to each diagnosis or procedure performed at a hospital, and that code then places the patient into one of several possible groups. The patient’s group is then used to determine how much the health-care provider will be reimbursed by Medicare, Medicaid, and private and public insurance companies. Medical coding technicians provide a valuable service to the health-care system by streamlining the diagnosis and payment processes. Medical coding is also an effective way for different doctors, insurance companies, and other health-care entities nationwide to communicate with each other in a clear-cut, universal language. There are actually a few different coding systems used by medical coders. For instance, the American Medical Association maintains the CPT (Current Procedural Technology). Those codes are numeric and are used to describe outpatient procedures and those procedures performed in physicians’ offices. There’s also the HCPCS (Healthcare Common Procedure Coding System), overseen by the Centers for Medicare and Medicaid Services. The HCPCS codes are alphanumeric and include a variety of services not covered in the other coding system, like ambulance services. Medical coding technicians who work with Medicare or Medicaid need to be well-versed in HCPCS. In addition, medical coding covers a variety of classifications, including diagnostic codes, procedural codes, pharmaceutical codes, and topographical codes. Diagnostic codes are used to identify diseases and disorders, while procedural codes are identifiers of specific actions taken by health professionals. Pharamceutical codes identify medication, and topographical codes indicate a certain part of the patient’s body. All these codes work together to identify the health problem and the various solutions. Medical coding is also a vital safeguard against fraud, since it provides a uniform method of labeling and classifying medical procedures, as well as providing health-care facilities with a helpful tool to monitor internal services and perform quality checks on diagnoses and procedures.

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