If you’ve asked the question “what is medical coding?” and would like to know more about the career, here we’ll talk about their job description, education requirements and the difference between medical coding and medical billing. We’ll also learn more about the coding manuals used in the field and the education options available. Every time health care is provided in a hospital, physician’s office or other type of medical facility, the physician will be required to document the services that were provided. The biller will work by using the information from the provided documentation and assign a code, creating a claim that needs to be paid by the patient or their insurance provider.
How Medical Coding Differs From Medical Billing
The medical coder and biller might be the same person or they will work closely together in order to make sure billing invoices are paid properly. The coder is responsible for assigning the correct codes on a claim. To accomplish this, a coder has to check different sources in the patient’s medical record so they can verify the services that were provided. A coder assigns ICD9 codes, CPT codes or HCPCS codes to report procedures that have been performed and in order to provide the biller with the required information to process the claim in order to reimburse services provided.
The Medical Coder Responsibilities
As a coder you will need to have a thorough understanding of medical terminology and anatomy. It’s also important to be familiar with the different types of insurance providers and their plans and regulations. Coders use resource books such as the HCPCS, ICD9 and the CPT, assigning correct codes in order to record the service levels of the services provided and so they can account for the supplies that were used to treat the patient during a session with a physician. The codes used for the procedure should correspond with the physicians diagnosis and medications administered or treatments performed during the session. 
In addition to assigning codes the coder can also be involved in different coding related activities. They can audit or re-file appeals for claims that have been denied or they can educate providers, recommending appropriate application of federal mandates that will require a provider to use specific billing and coding standards through auditing charts. They can also act as an advocate for an insurance provider and patient for issues such of coverage and medical necessity.
As a coding professional you can strengthen your career by obtaining your bachelor’s degree or master’s degree, neither of which is required for a career in coding. A solid understanding of physiology, medical terminology and anatomy are required.
There are also certificate programs that can be completed in one to two years or the associate’s degree that can be completed in two years. These programs can help prepare the student for taking the certified professional coder exam in order to gain licensure as a coder. Having certification as a coder will assist you in landing a job quickly as certified coders are in high demand due to employers knowing these individuals can perform their job with upmost proficiency. Now that you’ve learned the answers to ‘What is medical coding?” you can get started on earning your education for this health care field.
