The importance of medical coding in healthcare

June 03, 2022 by Pragya Bansal

Medical coding and medical billing are two concepts that have been gaining significant prominence over the past few years mainly owing to the accuracy these concepts provide.

The healthcare sector has, today, empowered patients to now be consumers of the healthcare sector by placing high importance on their wants and demands with the help of medical coders who play an essential part by taking medical reports and prescriptions from doctors and converting them into codes for easier access and record-keeping.

What is medical coding?

Medical coding simply refers to the process of translating important medical information into simple codes for documenting medical records and ensuring accuracy in billing.

Medical coding and billing require skilled professionals who can read, interpret, record, and track complex medical information while maintaining patient confidentiality and attention to detail.

Medical coders are, therefore, responsible for generating uniform medical codes wherein all pertinent medical information is consistently and accurately recorded.

Why is coding in healthcare essential?

Some of the ways in which medical billing and medical coding are essential to modern medicine are have been listed below:

Patient care: After obtaining information related to diagnoses, treatment, procedures, medications, and equipment, medical coders translate them into alphanumeric codes by obtaining information from a large range of sources, including transcriptions, notes, lab results, and pathological assessments.

Medical coding professionals then transfer these codes from the sources to billing systems and patient records from where customers and healthcare providers can directly submit medical claims with insurers and billers, thereby centralizing the process of healthcare.

Having proper medical coding helps ensure that the process of seeking insurance is streamlined.

It also facilitates demographic assessments and studies related to disease treatment and prevention in an accountable manner based on a robust reimbursement system.

Ensuring payment flow: Medical billing ensures a smooth, unhindered process of the revenue cycle. Medical billers are required to understand different medical regulations and private and public insurance plans and policies. Subsequently, they utilize their specialized knowledge of claim follow-up, claim denial resolution, payment posting, bill adjustment, appeal submissions, and collections management to ensure improved revenue flow throughout the process. Medical coding, therefore, becomes essential in ensuring the payment flow continues without much interruptions.

Maintaining a fool-proof record system: In the medical industry, it is important to maintain records of patients over the years. With the rise and development in medical coding, healthcare providers are now pushing for more efficient record-keeping so that doctors will be able to easily access their patient records. The same applies for customers who will be able to keep a track of their past and upcoming appointments, insurance details, and book appointments easily.

How to become a medical coder?

In order to become a medical coder, you would require specialized training and certification. However, the process and time taken to obtain such a certification or specialization is relatively faster and more flexible.

Upon completion of the medical coding program, medical coders are required to earn the Certified Coding Associate (CCA) or Certified Coding Specialist (CCS) credential offered by various universities or training institutes.

Healthcare is an indispensable and ever-growing field and a profitable industry in almost all economies of the world. A combination of healthcare and coding has led to a rapid increase in the demand for medical coders and has provided them multiple opportunities to grow and explore.

Interesting trivia: Medical coding

Accuracy in medical billing and coding is extremely essential to ensure that patients are not accidentally over-charged than mentioned for their medical expenses and procedures. This also facilitates their insurance and mediclaim benefits.

There are primarily three types of medical coding based on their use.
Category 1: Five-digit codes with descriptions corresponding to a service or procedure;
Category 2: An alphanumeric tracking code for execution measurement;
Category 3: Provisional codes for developing technology, procedure, and services

Although medical coding may be difficult, anyone with a bachelor’s or a master’s degree, preferably related to life sciences and an analytical ability to read and analyze the code can become a medical coder.

Unlike several other realms of coding, medical coding cannot and should not be self-taught especially when the person is not already working in the health care field.

While medical coding involves extracting billable information from the medical records and clinical documentation, medical billing uses codes to create insurance claims and bills for patients.