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What’s the Difference Between Medical Billing & Medical Coding?

The Difference Between Medical Billing & Medical Coding

differences between medical coding and billing

Medical Billing and Medical Coding are two separate skills but both are needed as one cannot function successfully without the other. They are the go-to person who communicates with the healthcare office where they are working to the health insurance companies.

Medical Coding

The medical coder is primarily responsible for abstracting and assigning the appropriate coding on claims. The coder must check various sources within the patient’s medical records:

  • The transcription of doctor’s
  • Laboratory test results
  • Imagining studies

 

The code must then assign the following codes accordingly

  • CPT Codes
  • HCPCS Codes
  • ICD-9 Codes
  • ICD-10 Codes

 

A medical coder will be involved various tasks throughout their career. They may have to audit and re-file appeals of claims. They will communicate with the healthcare providers but hardly ever interact with the patients. They must be able to identify and apply up 144,000 different codes and communicate with the medical biller with the appropriate information necessary to process and file the claim with the insurance company.

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Medical Billing

A medical biller is the person who processes, submits and follows up on claims with health insurance companies in order to receive payments for the services given by a healthcare provider. It is a tedious process that requires constant communication with the medical coder (if they are not the same person).You will need to understand medical insurance, the claims process, the appeals process and the impact on the practice’s revenue to successfully be able to optimize revenue performance.

Medical Billing and Coding Together

Medical billing and coding is often advertised as one skill purely because you cannot do one without the other. You cannot accurately bill someone without making sure all the codes are correctly addressed on insurance claims. That is why it is a synchronized skill. When you are considering the best schools to attend to learn medical billing and coding in Florida, from Pembroke Pines to Orlando, there is only one to consider, click here to find out.

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