What to Expect from a Medical Coding and Billing Education
Many people are fascinated with medicine but don’t want to go through all of the years of medical school. Fortunately, there are many careers within the medical field that don’t require medical school. One such career is a medical coder and/or biller. This career ensures that the proper treatments are billed to the correct patients and insurance companies and it requires that you understand what the medical providers did so that you can properly document the bills. A medical coder/biller is an exciting career and one that can be trained for online.
What to Expect from your Medical Coding and Billing Program
Your medical coding and billing school will teach you several common things that are a requirement for the job:
Anatomy is a core part of your program. In order to accurately bill an insurance company for services rendered you must be able to bill for the correct body part as the codes used in billing are body part specific. To ensure you bill for the correct services that were rendered you must understand the layout, form, and function of the human anatomy.
Medical providers and others in the medical field have a language all their own, that they speak, dictate, transcribe and write in as well as use its own abbreviations and shorthand. In order to properly bill the insurance company or make sure you have received the proper reimbursement you must be able to read and comprehend the terminology used by medical providers. Terminology courses teach root words, prefixes, suffixes, how to put them together, commonalities among surgical procedures, commonalities in disease names and anatomy terminology. Medical terminology is a major component of your medical coding and billing program.
Current Procedural Terminology or CPT®
The CPT® is a book published each year by the AMA. It contains descriptions of all the medical procedures that have been approved to be performed. Each body area has a section containing specific codes that describe treatment that a provider could render. This book is the most important resource and topic that you will study. Your classes about CPT® codes generally involve a lecture of basic coding rules, then case studies to read, then determine what code best describes the services that were rendered in the case study.
The International Classification of Diseases- 9- Clinical Modification or ICD-9-CM Book
This ICD-9-CM is another major book that is published each year and is vital to the coding profession. This book defines what the diagnosis of the patient is and once the diagnosis has been defined you will know be able to determine if the CPT® code being used is appropriate.
Other Books and Resources
There are other books that you will use as resources and that may also be incorporated into your coding and billing program. Some books include Healthcare Common Procedure Coding System (HCPCS), National Correct Coding Initiative (NCCI), Diagnosis Related Group (DRG), Outpatient Prospective Payment System (OPPS), American Society of Anesthesiologists (ASA), Relative Values Physicians (RVP), Crosswalk books, pharmacy pricing lists and more. Your coding and billing program will likely go over how to utilize these resources as well as how to function in the various job environments that a medical coder or biller will have as opportunities.
After completion of your coding and billing program, a myriad of job opportunities are going to be available to you. Perhaps the most obvious position would be in a Doctor’s Office, Clinic or Hospital which is the traditional coding and/or billing position. The jobs in these facilities require that you look at services rendered by the providers’ and bill the patients or their respective insurances. You would also be expected to speak to insurance companies and patients about their bills if they have questions.
Another option is to work for an Insurance Company. In working for an insurance company you are doing the same job a doctor’s office employee would, just in reverse. The insurance company coding and/or billing specialist would receive a bill that was already coded and would review medical documentation to determine if it was billed with the appropriate code Then they would determine if it is an eligible expense according to the plan you are working with.
Workers’ Compensation is an emerging position for professional coders and/or billers. The work is similar to work in an insurance company employee. The workers’ compensation employee will review the bill to determine if the code matches what the medical documentation shows and if it matches the documented injury, and then pay the bill according to the state specific rules.
Medical Coding and/or Billing is a very lucrative career and is also a fun career. There is an investigation aspect to it, when you are investigating the billed charges versus the eligible charges. If a career in medicine is something you want but you don’t want medical school Medical Coding and/or Billing is the program for you.
There are many schools that offer medical billing, coding, transcription courses to choose from. To see these and others, visit the Medical Billing and Coding Schools directory today.