To understand what is medical coding, let us consider an example. A patient visits the doctor’s clinic with sore throat. After assessment, the doctor diagnoses it as “pharyngitis”. It is then translated into universally recognized code of pharyngitis i.e. 462. The billing professionals use it in claim form to reimburse the doctor for treating him. In fact, there are three types of alphanumeric codes used to describe the medical diagnoses and procedures performed on the patient.
Now we will concentrate on what is medical coding and its importance in healthcare industry.
What is medical coding?
Medical coding is often referred to as medical classification. The coding professionals are appointed by healthcare providers to transform every medical report generated during patient’s visit. A medical report comprises of patient’s sign and symptoms, doctor’s diagnosis, medical tests and whatever procedures and treatments that are executed by the doctor or healthcare provider. A certified medical coder, who is familiar with the conventions and rules of diagnosis and procedural coding, can easily convert medical report into a set of codes. Various government health programs, private companies dealing with health insurance and others accept these codes to reimburse healthcare providers for the services rendered.
Importance of medical coding in healthcareA question arises in our minds as to why we require medical coding. If we look at any healthcare provider, we’ll see hundreds of patients arrive here for treatment and this condition will give rise to huge amount of medical data piled everyday in their office. Suppose you visit the doctor with high fever, cough and cold. Your medical conditions will be noted inclusive of the other processes that are performed by the doctor and also the medicines advised by the doctor. The doctor will give his report of the diagnosis. The part of the report that needs to be coded will consist of a diagnosis, a prescription and a procedure. This is relatively a simple case of doctor’s visit. Some patients come with more than one condition or may have complicated injuries. Therefore, multiple diagnosis codes need to be integrated into medical claim form to get back payment from insurance companies.
Here we can mention a statistics received from the Centers for Disease Control (CDC). Last year, over 1.2 billion patients visited physician’s offices, hospitals and other healthcare facilities for treatment. If we assume only 5 pieces of diagnosis and procedural codes are generated per visit, then the number would reach to 6 billion and this amount of information are transmitted every year. In the coming year, this number will go on increasing. The significance of medical coding is that it enables transmitting of large amounts of information.
Another good point regarding medical coding is that it enables consistent documentation between medical facilities. The medical code for sore throat is similar in New York and also in New Jersey. The advantage of having consistent data is that it enables logical research and investigation that is used by health and government agencies to keep the track of health tendencies. Medical coding enables administrations to see the possible cause of treatment in their establishment. This is highly significant to big medical facilities such as hospitals.