History of Medical Billing & Coding

Medical billing is the process of submitting bills (also known as claims) for payment to insurance companies and the government. The medical billing process is complicated as the aging population increases and more regulations are put in place. Highly skilled billing specialists are needed to navigate through the billing process to ensure prompt payment to the medical practice.



Medical coding has its roots set in the early 1900s and is an integral part of a medical practice. Standardized codes are associated with diseases, procedures, treatments and diagnoses of patients. Accurate documentation of data (assigned numeric and alphanumeric codes) assures timely payment for services rendered.

HIPAA and Medical Billing

• The Health Insurance Portability and Accountability Act of 1996 addresses the privacy of patient information. The protocol assures, through electronic processing, that patient information stored, sent or retrieved is secured at the highest of standards. Medical billing services complying with HIPAA help to continue the mission of keeping patient information secure by including safety procedures such as using dedicated and secure computer connections to electronically transfer information, following strict confidentiality of patient information, and verifying insurance information.

ICD History

• The International Classification of Diseases (ICD) was created to promote international comparability in the collection, processing, classification, and presentation of mortality statistics, according to the Centers for Disease Control and Prevention.

  From 1900 (ICD-1) through 2010 (ICD-10-CM), there have been 10 ICD revisions. Each revision reflects the changes in the medical field. The medical conditions reported as the cause of death on a death certificate are translated into medical codes. Medical coders use these standardized codes on forms to describe diseases and medical conditions.

From Paper to Computer

• Medical billing and coding was initially processed on paper, which was inefficient and costly. With the introduction of computers and medical billing software there are benefits such as saved time and money, eco-friendly practices by using less paper, more productivity and ease of use. Medical software companies offer ongoing support and automatic updates. File transfer of billing information is fast and secure making editing and updating efficient. Information can be retrieved, electronically filed and printed using a few keystrokes.

Medical Billers and Medical Coders

• The medical billing person and medical coder work hand in hand with the medical practice. First, the medical coder assigns the appropriate codes of the services rendered to each patient the doctor sees. Then the medical billing person begins the process of applying for payment for the services rendered. Both individuals must have a keen eye for detail, be accurate and properly follow all procedures in each perspective field. Training for both is needed to understand the codes and complex billing procedures. These professions are two separate and distinct functions.

Staying Current with CPT

• Current Procedural Terminology is officially maintained by the American Medical Association’s CPT Editorial Panel. CPT is widely accepted and used to report medical procedures and services under public and private health insurance programs. The AMA offers products and services to its members to understand these codes so medical billing and medical coding personnel can stay abreast in the field. Three times per year, the CPT Editorial Panel meet to discuss emerging technologies, issues associated with the CPT and services related to CPT codes.