Medical coding is the process of translating medical information and diagnoses into alphanumeric codes for documentation and billing purposes. A medical coder will take a doctor's report of a patient's symptoms, tests, diagnoses, and treatments and translate each piece of information into the appropriate medical codes. Proper medical coding is important for accurate medical billing and reimbursement. The coded medical information is then passed to the medical biller to create claims to submit to insurance companies for payment.

1. Medical Coding

2. Medical Coding -
Introduction
 Thisreferstotheprocessof translatingmedicalinformationintosimple
codesforthepurposeofthedocumentingmedicalrecordsandinforming
accuratemedicalbilling.
 Medical Coding is the transformation of healthcare diagnosis,
procedures, medical services and equipment into universal medical
alphanumericcodes.
 AAPC–AmericanAcademyofProfessionalCoders.

3. Medical Coding -
Introduction
 Thedoctorwillofficiallyreportthisdiagnosis.
Why Medical Coding is needed?
 Visit a doctor with symptoms like fever, sore throat and enlarged lymph
nodes , these will be recorded along with the procedures the doctor
performsandthemedicinethedoctorprescribes.
 The portion of that report that will be coded contains a diagnosis, a
procedure,andaprescription.

4. Medical Coding -
Introduction
 There are number of sets and
subsets of code that a
numerical code must be
familiarwith.
Why Medical Coding is needed?
 It’s the medical coders jobs to translate every bit of relevant
information patient’s visit into numeric and alphanumeric codes,
whichcanthenbeusedinthebillingprocess.

5. Medical Coding -
Introduction
 Importantconsideringthehundredsofmillionsofvisits,procedures,and
hospitalizationsannually.
Why Medical Coding is needed?
 Apatient’sdiagnosis,testresults,andtreatmentmustbedocumentfor
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,thatsignify apre-existingcondition,needtobeaplacedinavery
particularorder.
Why Medical Coding is needed?
 Thecoderreadsthehealthcareprovidersreport.Translateeachbitof
informationinto acode.
 Everycodesethasitsownsetofguidelinesandrules.

8. Medical Coding -
Introduction
Why Medical Coding is needed?
 Themedicalcoderenterstheappropriatecodesintoaformorsoftware
program.
 Oncethereportiscoded,itspassedonthemedicalbiller.
 Codingaccuratelyandwithinthespecificguidelinesforeachcodewill
affectthestatusofaclaim.

9. Medical Coding -
Introduction
What is Medical billing /Claim?
 Medicalbillerstaketheinformationfromthemedicalcoderandmakea
billfortheinsurancecompanycalledaclaim.
 Themedicalbillertakesthecodes,createsaclaim outoftheseusinga
formoratypeofsoftware.
 Thebillerthensendsthisclaimtotheinsurancecompany,which
evaluatedandreturnsit.
 Thebillerthenevaluatethisreturnedclaimandfiguresouthowmuchof
thebillthepatientowes,aftertheinsuranceistakenout.