While medical billing and coding are sometimes performed by the same healthcare professional, they’re actually two separate functions.

Medical coding is a very important part of the medical billing process.

In order to receive payment for their services, a healthcare provider and/or healthcare facility must create the patient’s medical bill, which is also called a medical claim. The claim should accurately reflect the specific types of care and health services a patient receives.

Medical codes are used to help create a claim that is accurate and as specific as possible, when describing the services and care given to a patient.

The American Medical Association created Current Procedural Terminology–or CPT–codes that are used for this purpose. CPT codes are one of the most important parts of the medical billing and coding process.

In some cases, the medical coding and billing are completed by the same person. However, in some facilities, the coding and billing are performed by different people.

Coding has to be completed before the medical claim can be submitted to the person or organization responsible for payment of the claim. In order for the coder to correctly assign CPT codes to all care and services the patient received, a review of the patient’s medical record has to be completed. Especially when the patient has received lengthy or complicated care, this process can be challenging.

Once the correct codes have been assigned to the healthcare services that were provided to the patient, the medical claim can be sent to the person or organization responsible for payment of the claim. The medical billing process doesn’t end at that point, though.

Even when the CPT coding is finished,the claim is completed and the billing has been filed, the process of collecting the payment can become very lengthy. For example, if an insurance company denies the claim, the medical billing specialist must review the denial. Usually, the claim is resubmitted to the insurance company. This process can be repeated a number of times before payment is either received or permanently denied.

Knowledge, skill and attention to detail are all needed to correctly complete the process of medical billing, and coding is a crucial part of that process.