The Role of Medical Coding in Healthcare: Why It's Important and How It Works

16 May 2023
role of medical coding in healthcare

This information is crucial for generating medical bills and tracking the payments for the rendered medical care services. The Affordable Care Act has caused medical coding to become quite significant in the past few years. With the consistent refinement of healthcare, we can be assured of an even more pivotal role of medical coders in the future of healthcare. We shall discuss the importance of medical Coding in this blog.

Why is Medical Coding important?

For an effective and seamless healthcare revenue stream, it is vital to have proper documentation of all the diagnoses, test results, and the decided and performed treatments.

By doing so, the healthcare practice can guarantee excellent medical care; thereby enjoying patient satisfaction and future visits and receiving prompt reimbursement. With the many visits, it is essential to understand the patient's personal health information regarding their consecutive complaints and the treatment details.

It is a challenging task in healthcare, with the many prevalent conditions, diseases, injuries and various causes of death, and multiple descriptions, names, eponyms and acronyms. Also, the number of medical services rendered by providers and the number of drugs and supplies which need to be tracked are significantly high. Easily these get classified, and reporting and tracking are made simple with the aid of medical Coding. The language and presentation of these elements are standardized through Medical Coding so you can understand them quickly, and tracking and modifications are made simple.

Health Information Portability and Accountability Act (HIPAA) have mandated this common language, enabling providers, payers and hospitals to enjoy consistent and efficient communication. Almost all private health information has been digital in recent years, entirely relying on the assigned codes.

Which are the areas where medical Coding is used?

Medical Coding is used in several areas of healthcare. Some of them are Revenue Cycle Management (RCM), Clinical Research, Health Statistics, Education and Scientific Research, Healthcare Management, Clinical Standards, Health Services Planning, Resource Allocation, Epidemiological studies and Financing, Repayment and Auditing.

How medical Coding works?

It is vital to have a professional team of well-trained medical coders to perform medical Coding. Let us see below how medical Coding works.

• Write an Abstract -First and foremost, the medical coder must write an abstract about the case after carefully reviewing the clinical documentation, either presented by paper or electronic health records.

• Ask for missing or incorrect information -At times, certain crucial information may be missing in the clinical documents and records, or they could be unclear. It would affect the quality of Coding. In such situations, the medical coder must ask for that vital information by referring to the meant physician.

• Prepare the Diagnostic Codes -As mentioned in the clinical documentation, the medical coder needs to start coding the diagnosis (Usually ICD codes), and they must ensure that the applicable code for the particular diagnosis is given. This step is quite crucial while submitting the claim to the payer.

• Prepare the Procedure Codes -Next, the medical coder must begin coding the various procedures and examinations, if any, performed for the patient. It must be most precise, as it gets compared to the Diagnosis Code for checking if the procedure was relevant to the particular case.

• Compliance Confirmation -Following this, they must confirm compliance between the diagnosis and procedure codes. This step is essential to ensure that the required medical procedures stated in the case were performed and also provide a suitable justification for the necessity to perform these medical procedures, as it is crucial for submitting the claim to the payer for reimbursements.

• Verify the integrity of the code -Finally, to validate the integrity of your code, carefully re-check and verify the written codes to make sure they are precise and correct.

What are the benefits of medical Coding in healthcare?

There are multiple benefits of medical Coding in healthcare. Some are as follows:

• Helps to set health priorities.

• The common cause of death within the community gets tracked easily.

• Based on international standards, the health statistics get strengthened.

• Can assist in measuring Health performance.

• The rendered medical care's quality and health outcomes get easily assessed.

• The research in the medical movement gets support, and its priorities get defined.

• Aids in forming the medical accounts and health spending scientific and professional basis.

What is the future of medical Coding?

Medical Coding has greater chances of being more vital since the strong emphasis on the quality of care is becoming increasingly crucial. Undoubtedly, the need for professional medical coders specializing in specific diseases or treatments is ever-increasing.

Since the onset of electronic health records, we can be assured that medical Coding will become highly automated. But expert human coders are highly needed to thoroughly check and verify the accuracy and perfection of the same. We can assuredly say that there is an exciting and challenging future for medical Coding.

BIS for expert and seamless medical Coding:

Medical Coding is essential in aiding the healthcare organization to maintain a healthy revenue cycle. Since it is a tedious and complicated procedure, it leaves your medical staff exasperated and hinders them from providing premium care to the patients.

Business Integrity Services has hands-on experience and an adept team of highly knowledgeable professionals to handle this complex process of medical Coding expertly. Trust us and allow us to relieve you and your team as we efficiently handle your medical coding process.