The Advantages of Medical Coding

Medical coding is an important health care process that transforms patient diagnosis and procedure descriptions into numeric and alphanumeric codes. The task is performed by a specially trained professional called a coder. Because medical codes are used for both administrative and clinical purposes, every department within a health care organization benefits from the advantages of the medical coding process.

Standardization

• Because medical professionals may use different terms for the same illness or procedure, it is important to have a standardized way to report them. Medical coding allows for standardization of terms by assigning codes instead of using subjective terms. For example, heart attack and myocardial infarction are two words for the same thing and are reported with one medical code.

Uniformity

• Medical codes create uniformity for procedures, services, supplies and other resources utilized for reimbursement and reporting. Surgical gauze used at one facility has the same medical code as surgical gauze used at another facility. This allows insurance payers to reimburse accurately.

Reimbursement

• Insurance billing claims use medical coding for reimbursement. Medical codes are grouped together and assigned an amount based on factors like insurance payer, type of provider and location. The codes are then submitted for reimbursement of patient services to the provider.

Evaluation of Care

• Medical codes are used to help health care organizations determine scheduling for care. In outpatient surgery centers, medical codes for the most frequent procedures performed are reviewed to plan specialized staff and resources.

Statistics

• Statistical reporting, both within and outside of health care organizations, is done using medical codes. For example, reports for number of injuries caused by motorcycle accidents come from medical coding statistics reported to health care agencies.

Clinical Research

• Clinical research is an important part of medical care because it helps us understand how to treat patients. Medical coding provides important information used in clinical research. Information, like cancer codes, is reported to each state to help researchers understand patterns and where to concentrate efforts.

Reporting

• Medical coding helps to meet state and federal reporting requirements. For example, hospitals are required to report mortality information, or how many deaths occurred during a certain time period. Medical codes are used to gather and submit this information. Additionally, medical codes are used to perform regular internal reporting on topics such as hospital-acquired infections, reimbursement and resource usage.

Marketing

• Medical codes may also be used for marketing of health care services. In some cases, health care organizations may run reports on the highest incidence of diseases reported by medical codes. The health care organization uses diseases occurring most often to create a marketing campaign to educate patients and the community on those diseases.