Continually
changing regulations for reimbursement of health care services have created a
demand for qualified medical coders. This valuable member of the health
information team is responsible for translating diagnostic and procedural
phrases into coded form for reimbursement purposes, analysis of patient
outcomes and research. You learn third-party reimbursement methodologies, along
with a thorough understanding of medical coding guidelines, anatomy and
physiology and disease processes. You’ll also get a thorough understanding of
the medical record content, legal and ethical issues and information systems. Medical
coding is the translation of medical reports into a short code used within the
healthcare industry. This helps summaries otherwise cumbersome medical reports
into efficient, data-friendly codes.
Medical coders are
individuals responsible for translating physicians’ reports into useful medical
codes. These professionals work behind the scenes in a variety of settings,
ensuring all pertinent information is coded appropriately to ensure consistency
and accuracy.
After a medical provider examines or
treats a patient, the insurance company needs to understand what was done in
order to process the bill. Common language is inexact to give the insurance
company the accurate details it needs, so a set of specific codes has been
established to define medical procedures. It is the role of a medical coder to
provide this information in a way that is useful and efficient.
The rise of
the pandemic in 2020-21 let the healthcare industry take the center stage
globally bringing for the challenges both hidden and visible that needed
immediate attention. As healthcare providers have been stretched to deal with
the burgeoning problem at hand, there is a heightened demand for labour across
departments, thus boosting healthcare offshoring across countries.
In World, the healthcare offshoring
industry has witnessed business growth. India is known to be the second-largest
healthcare outsourcing destination. Nearly 80 per cent of healthcare
business from USA is outsourced to India. Thus, the demand for professional
medical coders is increasing and they play a crucial role in the healthcare
delivery system.
The need and demand for medical coding
will only keep rising since the recent advance of computer-assisted coding
(CAC) has only helped ease the job of medical coders the world over.
While
complex and detail-driven, medical coding really comes down to knowing how to
navigate the three main code sets: CPT (Current Procedure Terminology), ICD
(International Classification of Diseases), and HCPCS (Health Care Procedural
Coding System). These code sets help coders to document the condition of a
patient and describe the medical procedure performed on that patient in
response to their condition. There are several
standardized medical coding dictionaries in the market; however five
dictionaries listed below are used for coding:
1.
COSTART - Coding Symbols
for Thesaurus of Adverse Reaction Terms
2.
ICD9CM - International Classification of Diseases 9
Revision Clinical Modification
3.
MedDRA - Medical Dictionary for Regulatory Activities
4.
WHO-ART - World Health Organization
Adverse Reac-tions Terminology
5.
WHO-DDE - World Health Organization
Drug Dictio-nary Enhanced.
It is well known fact that these dictionaries come at a price
and the organizations that perform medical coding activity should posses
appropriate valid licenses. There are separate licenses issued to separate user
groups for each of the dictionaries appropriately.
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