MEDICAL CODING
AIM:
To study medical coding. Medical coding is the transformation of healthcare diagnoses, procedures,
medical services, and equipment into universal medical alphanumeric codes. The diagnoses and
procedure codes are taken from medical record documentation, such as transcription of physician's
notes, laboratory, and radiologic results, etc. Medical coding professionals help ensure the codes are
applied correctly during the medical billing process, which includes abstracting the information from
documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.
Medical coding happens every time you see a healthcare provider. The healthcare provider reviews
your complaint and medical history, makes an expert assessment of what’s wrong and how to treat
you, and documents your visit. That documentation is not only the patient’s ongoing record, it’s how
the healthcare provider gets paid.
Medical codes translate that documentation into standardized codes that tell payers the following:
Patient's diagnosis
Medical necessity for treatments, services, or supplies the patient received.
Treatments, services, and supplies provided to the patient.
Any unusual circumstances or medical condition that affected those treatments and services.
Like a musician who interprets the written music and uses their instrument to produce what's
intended, Medical Coding requires the ability to understand anatomy, physiology, and details of the
services, and the rules and regulations of the payers to succeed.
WHY IS MEDICAL CODING NEEDED?
A patient's diagnosis, test results, and treatment must be documented, not only for reimbursement but
to guarantee high-quality care in future visits.
A patient's personal health information follows them through subsequent complaints and treatments,
and they must be easily understood.
The challenge, however, is that there are thousands of conditions, diseases, injuries, and causes of
death. There are also thousands of services performed by providers and an equal number of injectable
drugs and supplies to be tracked.
Medical coding classifies these for easier reporting and tracking.
In healthcare, there are multiple descriptions, acronyms, names, and eponyms for each disease,
procedure, and tool.
Medical coding standardizes the language and presentation of all these elements so they can be more
easily understood, tracked, and modified.
