How is Medical Coding Different From Medical Billing?

How is Medical Coding Different From Medical Billing?

Although the words medical billing and medical coding sound to be one-in-the-same, there are some integral differences that distinguish the two tasks from each other.

When examining the differences between medical billing and medical coding, it is first important to understand what the two actually are. Medical billing is the process of submitting insurance claims forms from medical providers to insurance companies. In turn, healthcare providers get paid for their services rendered. A medical biller executes this plan. They know the ins and outs of basic insurance coverage and are the people who make sure healthcare providers get paid. This can be a long process for the medical billing company. Many times phone calls to patients or the insurance company is required in order for payment to be made.

Medical coding on the other hand, is the task in which a trained individual selects the correct Current Procedural Terminology and ICD-9 codes for medical reimbursement. A medical coder is highly trained with correct procedural knowledge on how to code certain medical encounters.

Now that we know their definitions, we can talk about the differences between medical billing and medical coding. All medical billing must begin with medical coding. Coders merely choose the correct codes for procedures and diagnoses. Medical billers, on-the other-hand have a different job. Their job is to ensure that the healthcare provider actually gets payment from either the patient, healthcare insurance company, or both. Medical coders have nothing to do with this section of medical billing. Medical coding comes first and medical billing comes second. Billers do not select codes, they just follow up on payment for those codes.

Medical billing and medical coding are similar careers with dissimilar responsibilities. When hiring a medical billing company, it is important to understand the differences to ensure a correct match for your needs.

View all Articles by: Melissa Clark, CCS-P