By
Ricci Mathew
Submitted On March 27, 2008
Why has medical coding and billing become so important today?
Well, for the simple reason that one must be able to correctly
recognize/identify and then appropriately bill every single medical
service that has been provided to the patient. The health care
provider/physician is then paid for the service provided. To better
understand the need for coding let me give a similar and more familiar
example of coding.
Supermarket have various segregations / sections from grocery to books to dresses and all we do is just pick up the required things and put them into the shopping cart and roll it towards the cash counter. With so many different items and rates how is the billing managed at the supermarket? It is the barcode sticker on each of these items has the entire story of the product. Thus all that the cashier at the supermarket needs to does is hold the item in front of the barcode reader. Thus as he scans each item, its price / and all the other required details of any product that we picked up is automatically incorporated and the bill amount is calculated and generated by the computer depending on the quantity and other details.
It is very similar with medical coding and billing. Before the medical bill is prepared it is first necessary to identify the exact type of service that is given. With so many different medical specialties, procedures, and medications how are we to identify and determine the rate that has to be charged? That is why it has to undergo the medical coding process which is now a universal standard that has been developed and is being perfected. Every single process/visit by the patient whether it be for some laboratory test, for consultation with a specialist or for a surgery has been categorized and has been assigned with a standard charge/price tag. Today the complete bill or a percentage of the medical bill amount is paid by the insurance companies. The medical coding /billing companies have the responsibility of rightly identifying each category and make sure that the billing is perfectly done after the right codes have been assigned. Any discrepancies or mistake in coding /billing can usually result in the denial/delay of the claim. So what are the major categories and codes? They are,
Supermarket have various segregations / sections from grocery to books to dresses and all we do is just pick up the required things and put them into the shopping cart and roll it towards the cash counter. With so many different items and rates how is the billing managed at the supermarket? It is the barcode sticker on each of these items has the entire story of the product. Thus all that the cashier at the supermarket needs to does is hold the item in front of the barcode reader. Thus as he scans each item, its price / and all the other required details of any product that we picked up is automatically incorporated and the bill amount is calculated and generated by the computer depending on the quantity and other details.
It is very similar with medical coding and billing. Before the medical bill is prepared it is first necessary to identify the exact type of service that is given. With so many different medical specialties, procedures, and medications how are we to identify and determine the rate that has to be charged? That is why it has to undergo the medical coding process which is now a universal standard that has been developed and is being perfected. Every single process/visit by the patient whether it be for some laboratory test, for consultation with a specialist or for a surgery has been categorized and has been assigned with a standard charge/price tag. Today the complete bill or a percentage of the medical bill amount is paid by the insurance companies. The medical coding /billing companies have the responsibility of rightly identifying each category and make sure that the billing is perfectly done after the right codes have been assigned. Any discrepancies or mistake in coding /billing can usually result in the denial/delay of the claim. So what are the major categories and codes? They are,
- Diagnostic codes
- Procedural codes
- Pharmaceutical codes
- Topographical codes
The author of this article is Ricci Mathew of Outsource Strategies International (OSI), a US based company that offers services in Medical Coding, Medical Billing, Medical Transcription for clients across the US.
Article Source:
http://EzineArticles.com/expert/Ricci_Mathew/20828
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