Why has medical coding and billing become so important today? Well, for the simple reason that one must be able to correctly recognize/identify and then appropriately bill every single medical service that has been provided to the patient. The health care provider/physician is then paid for the service provided. To better understand the need for medical coding let me give a similar and more familiar example of coding.

 

Supermarkets are well organized with various segregations / sections from grocery to books to dresses and all we do is just pick up the required things and put them into the shopping cart and roll it towards the cash counter. With so many different items and rates how is the billing managed at the supermarket? It is the barcode sticker on each of these items has the entire story of the product. Thus all that the cashier at the supermarket needs to does is hold the item in front of the barcode reader. Thus as he scans each item, its price / and all the other required details of any product that we picked up is automatically incorporated and the bill amount is calculated and generated by the computer depending on the quantity and other details.

 

It is very similar with medical coding and billing. Before the medical bill is prepared it is first necessary to identify the exact type of service that is given. With so many different medical specialties, procedures, and medications how are we to identify and determine the rate that has to be charged? That is why it has to undergo the medical coding process which is now a universal standard that has been developed and is being perfected. Every single process/visit by the patient whether it be for some laboratory test, for consultation with a specialist or for a surgery has been categorized and has been assigned with a standard charge/price tag. Today the complete bill or a  percentage of the medical bill amount is paid by the insurance companies. The medical coding /billing companies have the responsibility of rightly identifying each category and make sure that the billing is perfectly done after the right codes have been assigned. Any discrepancies or mistake in coding /billing can usually result in the denial/delay of the claim. So what are the major categories and codes? They are,

 

 

While the diagnostic codes categorizes the various disease the procedure codes are about the different therapies / procedures like surgery etc. All drug/medication information comes under pharmaceutical codes and the topographical code indicates which part of the human body is involved.  

The author of this article is Ricci Mathew of OSI (Outsource Strategies International ), a US based company that offers services in Medical Coding, Medical Billing and Medical Transcription for clients across the US.