Medical Billing and Coding
Medical Billing and Coding
Corinthea Madden
CISS 109/3296
Professor Stanton
March 24, 2012
Corinthea Madden
Professor Stanton
CISS 109/3296
March 24, 2012
Medical Billing and Coding
Medical billing and coding is the process of receiving and submitting error free claims to insurance companies to receive payment for services by a health care provider. Billing and coding is almost like story telling. Attention to detail and familiarity with anatomy, medical terminology and diseases enhance the coder’s ability to retell the events during a patient’s encounter by using diagnosis codes. The medical billing process is the interaction between health care providers and the insurance companies. The entire process is known as the billing cycle. It can take anywhere from several days to several months to complete and require several interactions until a resolution is reached.
Billing and coding is not a new IT field and has been around for many decades. For several decades medical billing was done almost entirely on paper. The need for standardized information has grown since the beginning of the Medicare program in 1965. As new systems for reimbursement were developed, a need for specialized information grew and several types of coding methods were created, in addition to one that was already in existence. The International Classification of Disease (ICD) was developed and published by the World Health Organization (WHO) about seventy-five years ago to classify disease and diagnoses. This is currently used throughout the world and has been through 10 different modifications. The U.S. is now using the ICD 9-CM (ninth clinical modification), while many others countries have switched to ICD 10. Other coding systems used with ICD 9-CM are CPT 4 (Current Procedural Terminology, 4th Revision) which is used for coding operations and diagnostics procedures and HCPS(Healthcare Common Procedural Coding Systems), used for coding medication, supplies and other
Corinthea Madden
CISS 109/3296
Professor Stanton
March 24, 2012
Corinthea Madden
Professor Stanton
CISS 109/3296
March 24, 2012
Medical Billing and Coding
Medical billing and coding is the process of receiving and submitting error free claims to insurance companies to receive payment for services by a health care provider. Billing and coding is almost like story telling. Attention to detail and familiarity with anatomy, medical terminology and diseases enhance the coder’s ability to retell the events during a patient’s encounter by using diagnosis codes. The medical billing process is the interaction between health care providers and the insurance companies. The entire process is known as the billing cycle. It can take anywhere from several days to several months to complete and require several interactions until a resolution is reached.
Billing and coding is not a new IT field and has been around for many decades. For several decades medical billing was done almost entirely on paper. The need for standardized information has grown since the beginning of the Medicare program in 1965. As new systems for reimbursement were developed, a need for specialized information grew and several types of coding methods were created, in addition to one that was already in existence. The International Classification of Disease (ICD) was developed and published by the World Health Organization (WHO) about seventy-five years ago to classify disease and diagnoses. This is currently used throughout the world and has been through 10 different modifications. The U.S. is now using the ICD 9-CM (ninth clinical modification), while many others countries have switched to ICD 10. Other coding systems used with ICD 9-CM are CPT 4 (Current Procedural Terminology, 4th Revision) which is used for coding operations and diagnostics procedures and HCPS(Healthcare Common Procedural Coding Systems), used for coding medication, supplies and other
Cited: [ 1 ]. (Center for Medicare and Medicaid Services, 1997 Documentation Guideline, p. 1).