Medical Coding Professional

 

 

Medical coding professionals provide a key step in the medical billing process. Every time a patient receives professional health care in a physician’s office, hospital outpatient facility or ambulatory surgical center (ASC), the provider must document the services provided. The medical coder will abstract the information from the documentation, assign the appropriate codes, and create a claim to be paid, whether by a commercial payer, the patient, or CMS.

Is Medical Coding the same as Medical Billing? 

No. While the medical coder and medical biller may be the same person or may work closely together to make sure all invoices are paid properly, the medical coder is primarily responsible for abstracting and assigning the appropriate coding on the claims. In order to accomplish this, the coder checks a variety of sources within the patient’s medical record, (i.e. the transcription of the doctor’s notes, ordered laboratory tests, requested imaging studies and other sources) to verify the work that was done. Then the coder must assign  a CPT code, ICD-9 (until 9/30/2014)  / ICD-10 ( Begin use 10/01/20014 ) and HCPCS Coding Set to both report the procedures that were performed and to provide the medical biller with the information necessary to process a claim for reimbursement by the appropriate insurance agency.

What Does a Medical Coder Do?

Coders work in a variety of settings and their individual workdays differ based on size of facility, type of physician, etc..  

The following example outlines what may be a typical day in the life of a Medical Coder: 

After settling into work and grabbing a cup of coffee the medical coder usually begins the workday by reviewing the previous day’s batch of patient notes to be coded. The type of records depends on the clinical setting (outpatient or facility), and may require a certain degree of specialization. (Larger facilities may have individuals who focus on medical specialties while coders who work in smaller, or more general offices, may have a broad range of patients and medical conditions.)

Selecting the top patient note or billing sheet on the stack, the coder begins reading the documentation to understand the patient's diagnoses assigned and procedures performed during their visit. Coders also abstract other key information from the documentation, including physicians' names, dates of procedures, etc..

Relying heavily on the ICD -9 ( until 09/30/2014 ) / ICD-10 ( Begin Use 10/01/2014 ) and the CPT coding set coders begin translating the physician’s notes into useful medical codes.

 

Accuchecker is your solution to the everyday needs of Medical Billing.

 

HPP – AccuChecker

5201 Blue Lagoon Drive

Suite 815

Miami, Florida 33126

305-227-2383