List Three Reasons Why Proper Coding Is Important to Medical Facilities

Page 1

LIST Three Reasons Why Proper Coding

Is Important to

Medical Facilities


Medical coding service includes assigning numeric or alphanumeric codes to medical diagnosis, treatment procedures and surgery, signs and symptoms of disease and ill-defined conditions, complications of surgery and medical care. In the United States, the medical coding systems widely used are ICD-9-CM and HCPCS (Level I CPT codes and Level II National Codes).

Medical coding systems have a vital role to play in the collection of general medical statistical data, medical reimbursement, hospital payments, quality review and benchmarking measurement. Health investigators make use of raw data offered by the coding systems for planning and research, to analyze outcomes and costs; to easily track and monitor occurrence of diseases and injuries and develop best practices.

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Hospital/inpatient Coding

Medical Coding Services Include:

Emergency Room e-Code Evaluation Medical Coding Audits Payer Specific Coding DRG/ICD-9-CM Coding Validations and Review Facility/non-facility RVUs ICD-9 Coding Based on AMA and CMS Guidelines CPT Coding

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Reasons Why Proper Coding Is Important The accuracy and adequacy of coding and documentation has a significant role to play in the medical billing process. Healthcare providers are paid for their services

on

the

basis

of

numeric/alphanumeric codes assigned to a patient’s diagnoses and procedures. Codes are clubbed together to alert the insurance

payer

of

the

treatment

provided, so reimbursement can be made. Only accurately coded medical

Accurate coding is important because it helps to prove the medical necessity of treatment provided. Documentation explains what services were provided, so suitable codes can be assigned to explain why treatment was needed. Moreover, correct coding helps to assign charges to resources used in patient care. Facilitating insurance reviews and helping in appeal denials are the other two reasons that make accurate medical coding so important in the healthcare industry.

claims can speed up the reimbursement process. Errors in medical coding lead to erratic medical billing, which will ultimately result in denial of medical claims. So, to ensure accurate medical coding, medical

Insurance companies often perform random reviews to ensure that the charges claimed are valid. Coding documentation helps insurance companies understand why specific charges were submitted.

coding outsourcing is the ideal option. There are many professional medical coding

companies that can provide

accurate coding service for you. They will offer you accurate coding and on that basis medical billers generate accurate claims.

Medical facilities also have the opportunity to send appeal letters for compensation denials by submitting supportive coding documentation that explains why particular codes were allotted.

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