INTRODUCTION MEDICAL CODING
Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The diagnoses and procedure codes are taken from medical record documentation, such as transcription of Doctor’s notes, laboratory and radiologic results, etc. Medical coding professionals help ensure the codes are applied correctly during the medical billing process, which includes abstracting the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers. Medical coding process begins every time when a patient consults a Doctor and He would review the patient complaint and medical history, makes an expert judgment of what’s wrong and how to treat the patient and documents the visit.
MEDICAL CODING PROCESS
Medical Coding requires the ability to understand anatomy, physiology, and details of the services, and the rules and regulations of the payers to succeed. The main task of a Medical Coder is to review clinical statements and assign standard codes using CPT, ICD -10 CM and HCPCS level II classification systems. Medical Coding work process includes,
- Patient's diagnosis
- Medical necessity for treatments, services, or supplies the patient received
- Treatments, services, and supplies provided to the patient
- Any unusual circumstances or medical condition that affected those treatments and services
IMPORTANCE OF MEDICAL CODING
The healthcare revenue stream is based on the documentation of what was learned, decided, and performed. A patient’s diagnosis, test results, and treatment must be documented, not only for refund but to guarantee high quality care in future visits. A patient’s personal health information follows them through subsequent complaints and treatments, and they must be easily understood. This is especially important considering the hundreds of millions of visits, procedures, and hospitalizations annually in the United States. The challenge, however, is that there are thousands of conditions, diseases, injuries, and causes of death. There are also thousands of services performed by doctors and an equal number of injectable drugs and supplies to be tracked. Medical coding classifies these for easier eporting and tracking. And in healthcare, there are multiple descriptions, Abbreviations, names for each disease, procedure, and tool. Medical coding standardizes the language and presentation of all these elements so they can be more easily understood, tracked, and modified.
MEDICAL CODER
Successful Medical Coders know anatomy, physiology, medical procedures, and payer rules and policies. To become a Medical Coder, you must attend training and get certificated. Afterward, finding a job in the field is easier if you have a professional credential. Ideal Medical Coding Academy (IMCA) is providing both online and offline training classes provided by best-in-class trainers who have 15 years’ experience in medical coding sector (including field work + training experience)
RCM CYCLE
RCM Cycle is one of the important processes when we describe about Medical Coding Process.
Key players that are indulged in this process are