Medical Coding

What exactly is medical coding?

Medical coding is used to process insurance claims more efficiently. Medical insurance claims coders generally work in hospitals, clinics, physicians' offices, health maintenance organizations, mental health care facilities, nursing homes, and other health care facilities and review forms and related documents for completeness and accuracy before transmitting them for insurance processing.

How does medical coding work?

Every service (test, office visit, injection, surgical procedure, etc.) in the provision of medical care has a numerical code associated with it so that the companies who pay the claims (health insurance companies, HMOs, etc.) can easily identify the patient's condition, the service, and can then reimburse the service provider on a predetermined basis.

Medical coding exists for an office call, a simple check of the urine, right on to the most detailed brain surgery. By the same token, all diagnoses and even patient complaints (headache, upset stomach, etc.) have numerical codes. The combination of using these numbers tells the payer what was diagnosed and what service was performed.

The physician's computerized billing software sends information showing what was done and the insurance company's software interprets it accurately, since they use the same medical coding system. This speeds up the reimbursement process so doctors are paid faster and more accurately - if the medical coding and billing is done correctly. The Office of the Inspector General may review medical coding of evaluation and management services, physician credit balances and correct use of diagnosis codes (ICD-9-CM). Doctors may be fined up to $10,000 for each item or service incorrectly billed. Is it any wonder they want to make sure that the person doing their medical billing, CPT and ICD-9-CM coding knows how to do it accurately and effectively?

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The Reimbursement-Codes.com database is updated monthly. Prices for Reimbursement Codes are updated at the close of business on the last day of the month reflecting price changes through the 15th of the month.

medical coding | medical billing | icd 9 codes | hcpcs codes