Medical Coding Fundamentals

Introduction to the fundamental concepts of medical coding. You’ll learn about the three main coding systems: ICD-10-CM, CPT, and HCPCS Level II. We’ll explore how to translate medical diagnoses, procedures, and services into these codes. By the end of this guide, you’ll have a grasp of the coding process and be prepared to start coding real medical cases.

Medical billing and coding translate a patient encounter into the languages healthcare facilities use for claims submission and reimbursement.

Medical coding involves extracting billable information from the medical record and clinical documentation, while medical billing uses those codes to create insurance claims and bills for patients. Creating claims is where medical billing and coding intersect to form the backbone of the healthcare revenue cycle.

The process starts with patient registration and ends when the provider receives full payment for all services delivered to patients.

The medical billing and coding cycle can take anywhere from a few days to several months, depending on the complexity of services rendered, claim denial management, and how organizations collect a patient’s financial responsibility.

Ensuring healthcare organizations understand the fundamentals of medical billing and coding can help providers and other staff operate a smooth revenue cycle and recoup all the allowable reimbursement for quality care delivery.