Jari Davis, the coauthor of her training programs and President
of Meditec.Com, wrote the following valuable information on medical
coding. Meditec.Com offers the Professional Edge Line of courses
for Medical Coding, Medical Billing, Medical Transcription and more.
After years of perfecting and streamlining the mechanics and document
flow of medical transcription, Meditech, as a natural progression,
moved into the area of coding, billing, accounts receivable, and
practice management. The training we provide is based on our knowledge
and experience in doing what we teach.
What is Medical Coding?
Prior to the 1960s, no uniform methods of billing and paying for
medical services existed. Gradually, a system of numbers was developed
to represent various problems and treatments. The treatment codes,
Current Procedural Terminology (CPT-4), are copyrighted by the American
Medical Association. The International Classifications of Diseases
(ICD-9 is the codebook with the problems (diagnoses) numerically
assigned. The ICD codebooks are published by a variety of companies.
The government then got involved and developed their own codes,
called HCPCS, Healthcare Common Procedure Coding System. These codes
go a step further to apply alphanumeric codes to drugs, medical
devices, etc., to allow even more detail for a payer to review and
make more logical determinations for payment.
Let's illustrate their use with an example. A hospital intake form
or charge sheet is batched and arrives on the desk of a coder who
will abstract the following handwritten information, convert it
to code and get it in front of data entry:
year old male with a broken leg
X-ray shows fracture of femur 17 cm above patella
Procedure: Open reduction internal fixation of fracture
From this simple note, several items may be identified, described
and charged. Let's explore a little further. We look at the visit
details and discover that a child has fallen from a horse and has
broken his leg, which is the "problem," (diagnosis). He's rushed
to the emergency room by the camp's nurse where he's seen by an
ER doctor. The doctor whisks the child off to x-ray, which shows
an open transcervical fracture of the femur, which is the diagnosis.
The bone will be set in a procedure called an open reduction internal
fixation (ORIF). When this is complete, the doctor places a cast.
The relevant part of the codes on the data entry form, which will
result in a printed bill and/or insurance claim might look something
like this when the coder has added the codes:
11 year old male with a broken leg- 820.12/ E828.2
X-ray shows fracture of femur 17 cm above patella- 73550
Procedure: Open reduction internal fixation of fracture- 29285/
The text has now been assigned corresponding diagnosis and procedure
When the insurance form is printed (or the statement), the diagnosis
would appear in the diagnosis input field as:
820.12 Transcervical Fracture, Open [and] E828.2 Accident,
820.12 translated = 820 is femur fracture, the .1
means it is an open fracture, and the 2 notes it is the midcervical
section of the femur. The E828.2 is a code describing how
it happened. The 828 tells the payer that it was a result
of an "animal ridden," and the .2 tells that the patient
was the rider.
The 99284, 27236, 29345 and 73550 are all CPT codes describing
the service to the patient.
The information on the claim or bill would appear something like
||ER detailed exam
||X-ray femur - 2 views
For billing purposes, the use of the ICD codes, when juxtaposed
to CPT codes, tells the payer not only what service has been provided
but also lists the diagnosis, symptom, complaint, condition or problem
(e.g., the reason for performing the service). The codes thus help
establish the medical necessity as the first step in third party
The coder determines the codes to be used following each patient
encounter. The reviewer/auditor must determine if the coder has
in fact used the appropriate codes.
With this specialized training and expertise coders find work any
place, any time, any where! In large medical record departments,
experienced medical record coders may function as section supervisors,
overseeing the work of the coding, correspondence, or discharge
sections, for example. Eventually, experienced medical record coders
and health insurance specialist-billers may advance to senior technicians
who specialize in coding, particularly Medicare coding, or in tumor
Training of medical coders and insurance specialists has a wide
range; from two to four years of college earning an associate degree,
a technical school diploma, or certificates from vocational or career
training courses. Upon completion of such training many coders may
seek professional certification.
Individuals working as medical coders,
Health Insurance Specialists-Medical Billers or in medical office
administration are in very high demand among the allied health occupations.
According to the U.S. Department of Labor Statistics, health information
technicians are one of the ten fastest growing allied health occupations.
It is a challenging, interesting career that is compensated according
to the level of training and skills, and how effectively these skills
are used. Such people are employed by hospitals, clinics, doctors'
offices, health maintenance organizations (HMOs), mental healthcare
facilities, insurance companies and government agencies; some work
from home as independent consultants using medical billing and coding
programs and other computer software.
Requires a strong clinical background to analyze
the contents of medical records and must be detail-oriented, analytical,
and have exemplary organizational skills. Prerequisite is a medical
background or our Medical Terminology Course.
Our Professional Edge Medical Coding Training Program will provide
everything you need to learn to code successfully. It includes over
600 patient charts for you to practice on, along with CPT, ICD,
HCPCS medical coding training, and is well known as a simple, comprehensive
and practical way to learn this discipline.
With Meditec's training, the student will receive
a practical, straightforward knowledge of this highly complex and
prestigious area of expertise now a requirement by all payers on
insurance submissions. Opportunities exist in third party auditing,
efficiency consulting, insurance company adjudication, and the list
This program includes the HomeBizBook, to prepare for and find work.
May Coding and Billing be done at home?
it was a little cumbersome since one needed various forms and even
patient charts; however, with the advent of all the new technology
(computerized faxes, scanners, transfer of information back and
forth through the Internet), and accessibility to client computers
and software, it is now possible and acceptable to do the coding
and billing at home either as a contractor or an employee for a
hospital or doctor's office. National companies fill a niche too
and subcontract the work to home-based contractors.
I invite you to visit Meditec.Com
to see their complete description of the Professional Edge Line
of courses for Medical Coding, Medical Billing and Medical Transcription.
Please tell Meditec that medical-transcription-online-training.com