Medical Coding

    Medical coding, at it’s most basic, is a little like translation. It’s the coder’s job to take something that’s written one way (a doctor’s diagnosis, for example, or a prescription for a certain medication) and translate it as accurately as possible into a numeric or alphanumeric code. For every injury, diagnosis, and medical procedure, there is a corresponding code.

    There are thousands and thousands of codes for medical procedures, outpatient procedures, and diagnoses. Let’s start with a quick example of medical coding in action.

    A patient walks into a doctor’s office with a hacking cough, high production of mucus or sputum, and a fever. A nurse asks the patient their symptoms and performs some initial tests, and then the doctor examines the patient and diagnoses bronchitis. The doctor then prescribes medication to the patient.

    Every part of this visit is recorded by the doctor or someone in the healthcare provider’s office. It’s the medical coder’s job to translate every bit of relevant information in that patient’s visit into numeric and alphanumeric codes, which can then be used in the billing process.

    There are a number of sets and subsets of code that a medical coder must be familiar with, but for this example we’ll focus on two: the International Classification of Diseases , or ICD, codes, which correspond to a patient’s injury or sickness, and Current Procedure Terminology , or CPT, codes, which relate to what functions and services the healthcare provider performed on or for the patient. These codes act as the universal language between doctors, hospitals, insurance companies, insurance clearinghouses, government agencies, and other health-specific organizations.

    The coder reads the healthcare provider’s report of the patient’s visit and then translates each bit of information into a code. There’s a specific code for what kind of visit this is, the symptoms that patient is showing, what tests the doctor does, and what the doctor diagnoses the patient with.

    Every code set has its own set of guidelines and rules. Certain codes, like ones that signify a pre-existing condition, need to be placed in a very particular order. Coding accurately and within the specific guidelines for each code will affect the status of a claim.

    The coding process ends when the medical coder enters the appropriate codes into a form or software program. Once the report is coded, it’s passed on to the medical biller.

    FEATURED ONLINE MEDICAL CODING PROGRAMS

    Medical Billing

    On one level, medical billing is as simple as it sounds: medical billers take the information from the medical coder and make a bill for the insurance company, called a claim.

    Of course, as with everything related to the health care system, this process isn’t as simple as it seems.

    To get a better look at medical billing, let’s rewind the example we used earlier. Our same patient has a cough, a fever, and is producing lots of mucus. This patient calls the doctor and schedules an appointment. It’s here that the medical billing process begins.

    The medical biller takes the codes, which show what kind of visit this is, what symptoms the patient shows, what the doctor’s diagnosis is, and what the doctor prescribes, and creates a claim out of these using a form or a type of software. The biller then sends this claim to the insurance company, which evaluates and returns it. The biller then evaluates this returned claim and figures out how much of the bill the patient owes, after the insurance is taken out.

    If our bronchitis-afflicted patient has an insurance plan that covers this type of visit and the treatment for this condition, their bill will be relatively low. The patient may have a co-pay, or have some other form of arrangement with their insurance company. The biller takes all of this into account and creates an accurate bill, which is then passed on to the patient.

    In the case of a patient being delinquent or unwilling to pay the bill, the medical biller may have to hire a collections agency in order to ensure that the healthcare provider is properly compensated.

    The medical biller, therefore, acts as a sort of waypoint between patients, healthcare providers, and insurance companies. You can think of the biller, like the coder, as a sort of translator—where the coder translates medical procedures into code, the biller translates codes into a financial report. The biller has a number of other responsibilities, but for now you should simply know that the biller is in charge of making sure the healthcare provider is properly reimbursed for their services.

    What is mean by medical billing and coding?
    Medical Coding. Involves communicating with physicians, nurses, and other healthcare professionals to categorize the services a patient has received. Medical Billing. Submitting insurance claims to insurance companies. Medical Coding. more
    Can you bill without a diagnosis code?
    Common Circumstances Where No Diagnosis May Be Reached Preventive care services are often covered by a patient's insurance and can be billed under the appropriate code for the visit. more
    Did Bill Gates write code?
    Bill Gates, together with Paul Allen, developed a programming language. The programming language they produced was a version of BASIC, which stands for Beginner's All-Purpose Symbolic Instruction Code. They created it for the MITS Altair microcomputer, and it was the first product they sold at Microsoft. more
    Who can bill CPT code 99050?
    “[A] physician's office may be open from 9 a.m. to 5 p.m., Monday through Friday. A physician treating a beneficiary in that office at 7 p.m. on a Thursday may bill for CPT code 99050 in addition to the evaluation and management code for the visit.” more
    What was Bill Gates code?
    Bill Gates, together with Paul Allen, developed a programming language. The programming language they produced was a version of BASIC, which stands for Beginner's All-Purpose Symbolic Instruction Code. They created it for the MITS Altair microcomputer, and it was the first product they sold at Microsoft. more
    Does Bill Gates write code?
    Bill Gates recently took part in his ninth Reddit AMA. Ever wondered if Bill Gates could still write the code that made him a billionaire? As the co-founder of Microsoft, Bill Gates is considered to be one of the pioneers of today's home computing, but he admits that his programming skills are now a little "rusty". more
    What is bill code Type?
    Type of bill codes are four-digit alphanumeric codes that specify different pieces of information on claim form UB-04 or form CMS-1450 and is reported in box 4 on line 1. Type of Bill (TOB) is not required when a Physicians office reports claim on a CMS-1500. more
    What did Bill Gates code?
    Bill Gates, together with Paul Allen, developed a programming language. The programming language they produced was a version of BASIC, which stands for Beginner's All-Purpose Symbolic Instruction Code. They created it for the MITS Altair microcomputer, and it was the first product they sold at Microsoft. more
    Did Bill Gates write code for Windows?
    Did Bill Gates actually write code for Microsoft? Yes, among other things he and Paul Allen co-authored Microsoft BASIC, one of the first Microsoft products. more
    How does Bill Gates learn to code?
    In 1968, Gates and his friends spent hours playing with the computer and learning its programming language: BASIC, or Beginner's All-purpose Symbolic Instruction Code. Soon, Gates was creating programs. Gates's first attempt at programming involved a popular game. more
    Can Bill Gates code?
    Bill Gates recently took part in his ninth Reddit AMA. Ever wondered if Bill Gates could still write the code that made him a billionaire? As the co-founder of Microsoft, Bill Gates is considered to be one of the pioneers of today's home computing, but he admits that his programming skills are now a little "rusty". more

    Source: www.medicalbillingandcoding.org

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