Medical coding and billing play a crucial role in medical practice and in-hospital settings. These two important forms of medical practice ensure accuracy to facilitate patient safety, efficient medical operation, and quick payment. Medical coding requires expert and professional staff to read, interpret, track, record complicated healthcare information and maintain confidentiality in patient records. 

What do you mean by Medical Coding? 

Medical coding is an important aspect of insurance reimbursement and includes creating unique codes for every medical procedure and patient diagnosis. Medical coders translate the procedure and diagnosis into universal codes that help healthcare professionals process billing jobs accurately. 

Medical coding allows the government to maintain complete medical records database, which allows policymakers to draft medical policy and get statistical data. It is a prerequisite for medical filing, billing, and making claims for health insurance. It emphasizes the conversion of medical services into codes. Medical coders gather data from patients’ health records and transfer the information into industry-standard medical codes to process claims with third parties.

Importance of medical coding in a healthcare setting

  • Patient Care 

  • The field of medical coding collects data related to treatment, diagnosis, medication, medical procedures, devices and then converts the information into a range of alphanumeric codes. The information is gathered from diverse sources relating to medical notes, lab results, electronic records, and transcriptions. The medical coding experts transfer such codes from these sources to the patient record and medical billing system. This medical coding is important as it affects patient care indirectly as it is associated with insurance reimbursement. It is important to send medical claims to the insurers and medical bills for patients and insurers. 

  • Regulatory as well as Contractual Compliance

  • Medical coding and billing fall under several federal and state guidelines. The most important is HIPAA (Health insurance portability and Accountability Act) which safeguards patient secrecy/ confidentiality about their medical information. This act covers ICD 10 and electronic medical records issued by WHO. Contracts with the insurance companies bound medical professionals, and details about negotiated rates for medical treatment and procedures are included in these contracts. Appropriate coding makes sure that all practices take place in contractual compliance. 

  • Ensuring Smooth Payment Flow

  • Medical coding is a critical part of practices that ensure smooth and seamless revenue cycle operation. The medical coders understand the diverse healthcare regulations and public and private insurance policies. These experts acquire special knowledge about claim follow-up, bill adjustment, claim denial resolution, collection management, posting of payments, and appeal submission. These components, when are efficiently managed, improves revenue flow in the practice.

  • Important to Hospitals and Clinics 

  • Medical coding and billing are crucial components for upkeeping records in medical offices and hospitals. Medical coding should be done accurately and ensures that medical costs come through reimbursement instead of the consumer’s pocket. Medical services and facilities heavily rely on insurance providers and other medical programs for funding. 

  • Save Lives

  • Medical coding helps to ensure life-saving medical occupations. Accurate medical coding helps to prevent billing errors and unfair treatment. Specialized coders verify insurance coverage to avoid delays and further harm. They help in ensuring that all work is done promptly.

    CPC Training Hyderabad offers medical billing and coding specialized programs. Medical Coding Training is an extensive coding and billing training program that offers students worldwide to acquire skills needed for making a successful career in either outpatient setting or inpatient setting. We help in preparing the student for their fulfilling career in medical coding.

    Author's Bio: 

    Dr Santosh Guptha, CEO – MEDESUN is a dynamic leader in Healthcare Information Management, an expert in the field of coding analysis, EM auditing, and ICD-10-CM, ICD-10-AM Coding with a career span of more than a decade. He was instrumental in developing various ICD-10 coding tools, guides and has authored various ICD-10 training programs, blockchain technology in healthcare etc. Dr.Santosh Guptha has extensive knowledge in all areas of HIPAA, privacy and security, and the application of HIPAA requirements in physician’s offices and facilities settings.