The Process of Medical Coding in the Field of Health Care - Essay Example

Like almost all other office jobs, the field of medical coding and billing requires devoted individuals who pay essential care to the minutest details. The reason behind maintaining accuracy is that a single wrong entry or incorrect data can result in a very drastic impact on the health of the patient. Thus in my paper, I will discuss the importance and role of the medical coding and billing professional and what are the hiring procedures for a medical coder. Introduction: Individuals responsible for medical coding in healthcare deliver an essential step in medical billing operations.

The role of a medical coder is quite intricate. The medical coder has to document and keep track of all the facilities, treatment and professional healthcare an individual receives at a doctor's clinic, hospital, casualty service, or surgical centre. The task of a legal medical coder is to gather all the information which needs to be documented; the coder then assigns the desired encryptions and thus develops the required claims which need to be funded. The funds can be claimed by the individual, commercial financer, sponsor, patient or CMS.

(Aalseth, 2006) Difference Between A Medical Coder And Biller It needs to be mentioned here that the role of a medical coder is not the same as a medical biller. However, a medical coder can be responsible for performing the task of a biller as well or can be closely linked so that it is ensured that all invoices are regularly claimed on time without any errors. "Physician documentation is the basis for complete, accurate coding." (Diamond, 2006) The medical coder's job is to extract and assign the bills' codes.

Thus, to perform the task, the coder has to deeply evaluate the patient's medical history, that is, his laboratory test, clinical OPDs, radiology details, prescriptions etc., to check on the work that has been done. "Then the coder must assign CPT codes, ICD-9 codes, and HCPCS codes 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." (AAPC) Requirement for a Medical Coder: To become a medical coder, a significant amount of skill and education is required.

This job requires the professional to be aided in administrative skills, anatomy, and medical terms. Apart from this, the medical coder needs to be aware of the evolving medical schemes, insurance, compliance policies etc., to deal with any situation that comes their way. Further, he should be well equipped with the medical code books to assign the correct codes required to keep track of the facilities and tools used during a particular medical procedure.

If the codes are assigned appropriately, then they can not only aid in billing but also helps to match the analyses by the doctor and the details of the ailment. The ICD-9 is a prompt system effectively used in the world of coding. (Kelly-Farwell, 2008) Apart from this, the coder is also responsible for auditing and filing unpaid claims. They can also help individuals if they need any help with the billing or provide them with adequate details. "Starting a career in medical coding opens a number of coding-related jobs like Certified Professional Medical Auditor, Certified Professional Compliance Officer and Certified Physician Practice Manager." (AAPC)

I would like to mention the requirements for hiring a legal medical coder. Firstly, it must be clear that many individuals nowadays opt for bachelor's and master's degrees to establish a career in medical coding. These degrees are not required when it comes to medical coding. The most critical requirement to become a professional in this area is thorough knowledge and an in-depth understanding of anatomy, medical terms and physiology. Those serious about medical coding as a career must take courses designed to study this subject. After this, when they are prepared, they must take the CPC examination through which they would be awarded the certification as a Certified Professional Coder on passing the exam. These are the education requirements that will help you get hired in the professional world by physicians or hospitals. Furthermore, those who take on internships also help when they apply to be hired. Some organizations require prior work experience as well.