What is coding?

In healthcare, medical coding is the process of assigning a specific number to services or supplies that a patient receives from a healthcare provider or a health facility; such as a hospital, clinic, office or treatment center.

Medical coding is an extremely important part of the process of billing for medical care.

In order for healthcare facilities to receive payment for their professional and medical services, a bill–or a “claim”–has to be created. Once the claim is complete, it’s sent to the person or organization responsible for paying for the patient’s medical care. For example, the medical claim may be sent to the patient’s insurance provider, a business, or even directly to the patient.

In the claim, the patient’s healthcare provider must use specific codes to describe the services and supplies that the patient received.

So, what is coding in comparison to medical billing? Are they basically the same thing?

Although medical coding and billing go hand-in-hand, they’re different. Medical coding is one part of the medical billing process.

Patient care can be very detailed and complicated. Coding makes creating the patient’s billing claim much simpler.  

Special medical codes are used to describe any procedures and treatment given.

Codes are also used to describe any supplies used by the patient, used while caring for the patient, or given to the patient. For example, a total knee replacement surgery has a specific code, and so do the surgery supplies used in the operating room to perform this surgery.  After surgery, and until the patient is released to go home, all supplies and care the patient received during the hospital stay also have specific medical codes assigned to them.

Besides the billing process, what is coding used for?

Medical coding is very useful in identifying trends. A medical coder has the ability to recognize patterns in the healthcare setting. For example, the coder may be asked to help find out which supplies and services are most often used for patients with a specific medical diagnosis.

A skilled medical coder can help a healthcare organization in many areas; including helping to control costs, educating healthcare team members, and serving as an advocate for both patients and healthcare providers when determining the need for medical services and supplies.