Medical coding - introduction

Medical coding

1. Medical Coding

2. Medical Coding -
Introduction
This refers to the process of translating medical information into simple
codes for the purpose of the documenting medical records and informing
accurate medical billing.
MedicalCodingisthetransformationofhealthcarediagnosis,
procedures,medicalservicesandequipmentintouniversalmedical
alphanumericcodes.
AAPC –American Academy of Professional Coders.

3. Medical Coding -
Introduction
Thedoctorwillofficiallyreportthisdiagnosis.
Why Medical Coding is needed?
Visitadoctorwithsymptomslikefever,sorethroatandenlargedlymph
nodes,thesewillberecordedalongwiththeproceduresthedoctor
performsandthemedicinethedoctorprescribes.
Theportionofthatreportthatwillbecodedcontainsadiagnosis,a
procedure,andaprescription.

4. Medical Coding -
Introduction
Therearenumberofsetsand
subsetsofcodethata
numericalcodemustbe
familiarwith.
Why Medical Coding is needed?
It’sthemedicalcodersjobstotranslateeverybitofrelevant
informationpatient’svisitintonumericandalphanumericcodes,
whichcanthenbeusedinthebillingprocess.

5. Medical Coding -
Introduction
Important considering the hundreds of millions of visits, procedures, and
hospitalizations annually.
Why Medical Coding is needed?
A patient’s diagnosis, test results, and treatment must be document for
reimbursement.

6. Medical Coding -
Introduction
What codes depict?
What kind of visit this is
Symptoms that patient is showing
What test the doctor does
What the doctor diagnoses the patient with

7. Medical Coding -
Introduction
Codes, that signify a pre-existing condition, need to be a placed in a very
particular order .
Why Medical Coding is needed?
The coder reads the health care providers report. Translate each bit of
information into a code.
Every code set has its own set of guidelines and rules.

8. Medical Coding -
Introduction
Why Medical Coding is needed?
The medical coder enters the appropriate codes into a form or software
program.
Once the report is coded, its passed on the medical biller.
Coding accurately and within the specific guidelines for each code will
affect the status of a claim.

9. Medical Coding -
Introduction
What is Medical billing /Claim?
Medical billers take the information from the medical coder and make a
bill for the insurance company called a claim.
The medical biller takes the codes, creates a claim out of these using a
form or a type of software.
The biller then sends this claim to the insurance company, which
evaluated and returns it.
The biller then evaluate this returned claim and figures out how much of
the bill the patient owes, after the insurance is taken out.