What is Medical coding?

The Basics of Medical Coding

Medical codes are essentially the language of the health care field. From a routine doctor’s visit to complex surgeries, every condition, disease and procedure is given a numeric code. The purpose of these codes is two-fold first; they are used by medical professionals to communicate with each other and to track a patient’s history. The second part has everything to do with the business of medicine, the payment process. Health care provider institutions like physician’s offices and hospitals utilize these codes to bill insurance companies and Medicare. Insurance companies and Medicare use these codes to ensure proper reimbursements are made and that they only pay for procedures which are covered under the patient’s insurance.

Medical coding has unified medical care around the world establishing a universal code to streamline the billing and payment process. In conjunction with EHR (Electronic Health Records) medical codes are allowing doctors to communicate with one another in real time globally.  Instant access to these electronic medical codes are helping doctors provide the best possible care, by making fully informed decisions about the best course of action based on a patent’s medical history

Types of Medical codes

While there are numerous types of medical classifications the majority of them are broken down primarily into procedural codes, diagnostic codes, pharmaceutical codes and other health care field specific codes.

The Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) systems are associated with procedures. While diagnoses fall under the International Classification of Diseases (ICD) which is maintained by Centers for Medicare & Medicaid Services and the National Center for Health Statistics (NCHS). The US is currently operating under the 9th edition of these codes, but the 10th edition will be integrated into the American health care system in 2013.

Within the HCPCS there are two main sections. The first is used mainly to document provider services, and outpatient procedures. These are the codes which doctors and hospitals use. The second level however, is used mostly by medical suppliers and equipment vendors.

Pharmaceutical codes are an ever growing section of medical coding as the need, and number of drugs available continues to increase. This industry utilizes both the Anatomical Therapeutic Chemical Classification System (AT, or ATC/DDD), regulated by the World health organization and National Drug Codes (NDC) which are maintained by the Food and Drug Administration.

As the medical field has expanded the number of coding systems has increased as well.  Dentists now use the Code on Dental Procedures and Nomenclature (CDT). While Mental health professionals utilize the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) to document metal health disorders. 

The medical coding process does seem more complicated than it actually is. The codes are very well organized and categorized. The main reason this specialty requires a medical billing and coding certification is because of the sheer scope of the field. It is important to be able to distinguish the different types of codes and where to look to get the correct codes and answers. Accuracy here is crucial, because in this business one wrong number can cause severe problems.

Jenna Russell, writes frequently for Medical billing and coding training. Her background includes considerable experience writing and working with health education programs.

1 comment:

John Martin said...

This is excellent information for anyone who is contemplating a career in medical coding or is plain curious about it. Taking off from where the author left off, the codified documents generated by medical coding specialists are then used by medical billers to file insurance claims with private carriers as well as the government.

A typical training program includes courses in both medical billing and coding. To know more about curriculum, timeframe, tuition and fee of such a course, you can check out the medical billing and coding program FAQs on the website of online vocational school Career Step. It will help you understand what you can expect from vocational courses in the field.

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