How does medical coding work?
Every service (test, office visit, injection, surgical procedure, etc.) in the provision of medical care has a numerical code associated with it so that the companies who pay the claims (health insurance companies, HMOs, etc.) can easily identify the patient’s condition, the service, and can then reimburse the service provider on a predetermined basis. Medical coding exists for an office call, a simple check of the urine, right on to the most detailed brain surgery. By the same token, all diagnoses and even patient complaints (headache, upset stomach, etc.) have numerical codes. The combination of using these numbers tells the payer what was diagnosed and what service was performed. The physician’s computerized billing software sends information showing what was done and the insurance company’s software interprets it accurately, since they use the same medical coding system. This speeds up the reimbursement process so doctors are paid faster and more accurately – if the medical coding
