Sunday 2 September 2012

What is Medical coding and purpose of it ?

The most common definition of medical coding is transforming the patient charts and disease conditions into alphanumeric codes.

Internationally, coding is done for the purpose of  mortality statistics.  These reports are scaled depending on the location, age, race, gender, etc.  Based on the statistics reports the governments identifies the root cause of these disease conditions and takes necessary steps and eradicate the disease conditions.

In the US Healthcare coding is done for the above reasons as well as it is the first step of billing process.

There are 3 types of coding:
Basically there are 3 books from which coding is done (outpatient physician coding):

1.  ICD-9-CM:  International classification of diseases  9 Revision, Clinical Modification.  Whenever a patient visits a physician or a hospital, all the conditions that the patient has been diagnosed are needed to be documented in the patient's chart.  All these diagnoses are coded from ICD-9-CM.  All these codes are either numeric of alphanumeric.  The code ranges from 3-5 digits.

2.  CPT:  Current Procedural Terminology.  These codes are also known as the HCPCS Level I codes.  These are the codes that represent physician services.  Codes are given based on the effort the physician has put in treating the particular patient's condition.  Each and every CPT code have different charges ($ value).  Based on these CPT codes the insurance company pays the physicians.  All the codes are 5 digit numeric codes.

3.  HCPCS:  Healthcare Common Procedure Coding System (HCPCS, often pronounced by its acronym as "hick picks").  These and HCPCS Level II codes.  These codes basically represent the supplies that a physician or hospital has provided to a patient.  There are also some G-codes which represent physician services and are billed to Medicare.

In conclusion, whenever a patient visits a physician and is treated for the disease conditions. All the physician services are coded from the CPT/HCPCS and the diagnoses are coded from ICD-9-CM.