What Is Medical Coding?

Some people enter the healthcare field because they want to work directly with patients. Others have a passion for healthcare but want a less patient-facing role. If you fall into the second category and might enjoy spending your days translating patient data into numbers, a career option to consider is medical coding.

What Is Medical Coding?

Medical coding involves taking a patient’s healthcare information and turning it into alphanumeric codes that insurance companies use to reimburse the medical provider. Information that can be transformed into medical codes includes the patient’s diagnoses, any medical tests conducted, and treatments provided.

Medical coding helps healthcare professionals and organizations communicate with insurance companies without having to use long-hand and spell everything out word for word. It’s similar to going to your favorite restaurant and ordering “the special.” The person taking your order instantly knows what you want without specifying each food item. It speeds up the process and makes it easier for everyone involved.

Standard Medical Coding Systems Used

People who work as medical coders use standard coding systems. This helps ensure that both the healthcare provider and insurance company are “speaking the same language.”

The two main medical coding systems are:¹

• International Classification of Diseases (ICD) – used to record patients’ diagnoses and inpatient procedures
• Common Procedure Coding System (HCPCS) – identifies services and products supplied

HCPCS codes are further divided into two levels. Level I codes are called Current Procedural Terminology (CPT) codes. CPT codes are used when billing for medical procedures and services. Level II codes are used to identify services, products, and supplies not covered by Level I codes.

Additional Medical Coding Systems

While ICD and HCPCS codes are the most used, individuals working in the healthcare field also sometimes use or are exposed to other coding systems. For instance, people in a pharmacy technician role use National Drug Codes (NDCs). These codes identify the drugs prescribed and how they are to be used by patients.

Additionally, workers in behavioral health may use codes as set forth by the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and used to diagnose mental health issues such as depression, anxiety, and schizophrenia, among several others.

An Example of Medical Coding

So, what does a medical coder do in real-life terms? This may be easier to understand by looking at an example. Imagine that a patient goes to the doctor because they have a severe sore throat. The doctor runs a test and finds the patient has strep throat. The patient is given an antibiotic and sent home.

A medical coder must look at the patient’s chart and turn each of these steps into codes. These codes tell the insurance company why the patient was seen, as well as what services and products were provided. This information is used to determine what expenses the insurance needs to reimburse the provider based on the patient’s policy.

Let’s start with the reason the patient sought care: they had a sore throat. The ICD code for throat pain is R07.0.² The doctor suspected strep throat, so they tested a culture. The CPT code for a strep test is 87081.³ Once strep was confirmed, the doctor prescribed antibiotics, which is the HCPCS code G8710.⁴

Based on these three codes – R07.0, 87081, and G8710 – the insurance company can process the claim according to the patient’s coverage. And they can do it without having to go through the patient’s entire file to find the required information.

How to Become a Medical Coder

If this sounds like a good career fit for you, the next step is to learn and develop medical coding skills. These skills include attention to detail, effective communication skills, and computer skills. It’s also important to know medical coding terminology.

This knowledge and skill set can be learned by taking a medical billing and coding training program. While medical coders transform healthcare information into readable codes, medical billers send this information to the insurance company. Many healthcare professionals do both, working as a medical biller and coder.

In a medical coding training program, you learn more about:

• Diagnostic and procedural coding systems
• Coding applications
• Healthcare communication
• Medical records management
• Claims processing
• Introduction to computers

Together, these courses prepare you for a medical coder role, as well as a medical biller and coder role if this is the healthcare position you wish to pursue.

Can You Take Medical Coding Classes Online?

Yes! Online medical coding and billing training is an available option. Doing your coursework online can be more convenient. You’re able to study and do homework when it works best for you. You also have more flexibility in your schedule since you don’t have to commute to campus on specific days and times.

As long as you have a computer or laptop and a good internet connection, you can complete medical coding coursework from the comfort of your home. If you have internet access at work, you may also be able to do some of your studies while on break or during lunch.

UMA Offers Two Medical Billing and Coding Program Options

Ultimate Medical Academy offers both Medical Billing and Coding diploma and associate degree programs. The diploma program can be completed in 11 months, or you can pursue your associate degree in 18 months.⁵ Each covers medical coding basics, and if you enroll in the associate degree program, you also take general education courses and a few additional degree requirements, making you a more well-rounded job applicant.

The benefits of learning medical coding and billing at UMA include classes that start every few weeks, max class size of 25, and a high level of support. This support doesn’t stop at graduation either. When you’re ready to pursue a job, our Career Services team can help, potentially even connecting you with one of our employer partners.

Have questions or want to learn more? Contact us today. We’d love to hear about your healthcare career goals and will do what we can to help you reach them!