August 27,2018
By Dr Guruvayurappan PV
In the gamut of healthcare and revenue cycle management, medical coding is a niche specialization in which coders study medical records and charts of patients, and assign universal alphanumeric codes. Coders refer to various medical documents such as transcription of physician's notes, laboratory and radiologic results, etc. and assign standard codes from Current Procedures Terminology (CPT), International Classification of Diseases (ICD), and Healthcare Common Procedure Coding System (HCPCS) Level II classification systems.
When coded accurately, medical codes can tell the whole story of a patient's encounter with the physician capturing reimbursement for the services rendered too. This procedure of converting patient data into codes is crucial for creating and processing insurance claims accurately.
The healthcare industry is rapidly evolving with rising income levels, greater health awareness, increased precedence of lifestyle diseases and improved access to insurance being key contributors to growth. This would also mean a rise in number of medical procedures and tests to be processed for claim reimbursement and a tangential increase in medical coding.
Rising demand for world-class healthcare services, need for a universal language to reduce frauds and misinterpretations associated with insurance claims are said to be the two key factors propelling the market growth.
Countries such as the US, UK and Australia have been early adopters of medical coding following the ICD standards for almost 30 years now. The Middle Eastern countries have recently mandated following the ICD–10 guidelines for medical coding. Similarly, many other countries across the globe have started adopting the ICD standards owing to digitization of healthcare sector making it a global playing field.
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