What is medical coding and billing?


Quick Answer

Medical coding takes the details of services provided to a patient and assigns codes to them to be used to create a bill. Medical billing is the task of changing a health care service into a billing claim to submit to an insurance company or the patient.

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Full Answer

When patients are seen by a medical professional, every procedure or evaluation must be documented. Medical coding uses these documents and assigns a code to each step. Medical coding uses several different types of codes including Current Procedural Terminology (CPT), International Classification of Disease (ICD-9) and Healthcare Common Procedure Coding System (HCPCS) codes. There are different codes used depending on the level of care provided, as well as equipment or supplies needed to provide the service. These codes provide the basis for a medical bill or claim to be created.

Medical billing takes the codes assigned during the medical coding process and changes them into charges to be billed to insurance companies or the patient. Medical billing follows the charges to insurance companies to make sure the medical facility receives reimbursement for the services provided. This may require getting clarification from physicians about diagnoses or procedures to ensure the proper billing and to minimize rejection from insurance companies.

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