Medical Coding: Job role which merges coding and medicine.
Medical coding - as part of the medical team, medical coder reviews the patient’s file and translates everything from that file into universal codes required by insurance companies. It’s the medical coder’s responsibility to make sure the right code is used every single time. It’s the only way to ensure the insurance companies are billed properly.
The challenge, however, is that there are thousands of conditions, diseases, injuries, and causes of death. There are also thousands of services performed by providers and an equal number of injectable drugs and supplies to be tracked. Medical coding classifies these for easier reporting and tracking. And in healthcare, there are multiple descriptions, acronyms, names, and eponyms for each disease, procedure, and tool. Medical coding standardizes the language and presentation of all these elements so they can be more easily understood, tracked, and modified.
Medical codes translate that documentation into standardized codes that tell payers the following:
- Patient's diagnosis
- Medical necessity for treatments, services, or supplies the patient received
- Treatments, services, and supplies provided to the patient
- Any unusual circumstances or medical condition that affected those treatments and services
Nearly every single health care provider uses coded documentation and records. A single hospital may have 50 coders working at any given time, but hospitals are just one of the potential work environments. Inpatient and outpatient facilities, urgent and semi-urgent care facilities, clinics, nursing homes, sports medicine offices, mental health facilities and, of course, doctor’s offices are just a few of the places where well-trained, reliable coders can find a career.
A medical coder is different from a medical biller. A medical biller processes the insurance claims and follows up on them. They do not determine what codes are used in the insurance billing.
Top technical skills employers are seeking:
- ICD-10
- Customer billing
- Health information technology
- CPT coding
- Inpatient coding
- Outpatient coding
- ICD-9
- Anatomy
- HCPCS coding
- Clinical documentation
