Distinction Between Medical Coding and Billing


Frequently mistakenly assumed is the same, medical billing and medical coding are a couple of very clearly separate jobs. Although there are lots of similarities backward and forward and small healthcare settings may trust an individual for doing both tasks most medium and enormous healthcare facilities have different individuals accountable for the 2 different jobs. These two jobs belong to medical records and health information technicians. To be able to comprehend the variations between medical coding and medical billing, let’s explore the responsibilities of these two job profiles.

Medical Coding

Medical coding is worried with assigning the appropriate code towards the various treatments provided to someone, to facilitate their insurance claims. Medical coders read the patient’s medical records to look for the procedures performed around the patient through the physician, surgeon, nurse along with other people from the healthcare team. They look into the doctor’s transcriptions, laboratory test results along with other documentation concerning the patient’s treatment. If no further details or clarification is needed, the medical coder assigns the right diagnosis or procedure code for that corresponding service provided to the individual and helps to create the states be compensated by the insurer. The codes are assigned while using Current Procedural Terminology (CPT) for procedures received through the patient and also the Worldwide Classification of Illnesses (ICD) for that physician’s proper diagnosis of the individual.

It’s very crucial for the medical coder to become accurate within the coding process because this information is utilized by insurance providers when processing patient claims. Medical coders frequently need to interact and coordinate along with other healthcare and staff people either to gather more data concerning the patient’s treatment in order to tell them regarding the kind of information and data needed within the patient’s medical file to make sure that the coding process becomes smooth and efficient.

Medical Billing

Medical billing is worried with examining the assigned medical codes and transmitting the claim. Using special software designed to input the codes assigned through the medical coder along with other relevant insurance information, the medical biller forwards the insurance coverage claim that they can facilitate the payment. When the claim continues to be forwarded, the medical biller remains in contact with the individual and the insurer to make sure that the claim continues to be compensated. In situation of delays, rejected or denied claims, the medical biller must liaison between your patient and the insurer to work through the problem and resubmit the claims with necessary adjustments if needed by the insurer.