Medical Coding Types And Best Medical Coding Companies
Medical coding is the transformation of healthcare diagnoses, procedures, medical services, and equipment into universal medical alphanumeric codes. Diagnoses and procedure codes are derived from medical record documentation, which includes lab and radiologic results, physician note transcriptions, and more. Medical billing involves abstracting information from documents, assigning the relevant codes, and preparing a claim that must be paid by insurance carriers. Medical coding specialists assist in making sure the codes are applied correctly during this process.
Medical coding happens every time you see a healthcare provider. The medical professional examines your complaint and medical history, determines the cause of your condition and the best course of action, and records your visit. Not only is this paperwork the patient's permanent record, but it also serves as the basis for the healthcare provider's payment.
Types of Medical codes used.
There are three types of codes used in Medical Coding.
1. International Classification of Diseases (ICD)
2. Current Procedure Terminology (CPT)
3. Healthcare Common Procedure Coding System (HCPCS)
1. International Classification of Diseases (ICD):
The International Classification of Diseases (ICD) is a collection of codes that help maintain a standardized vocabulary for defining injuries, illnesses, and causes of death. The World Health Organization (WHO) developed this code in the late 1940s. It has been updated several times since its inception. The number following the ICD indicates the current version of the code.
a) ICD codes classify and code health care diagnoses, symptoms, and procedures.
b) The World Health Organization created and maintained this website (WHO).
c) These codes are essential for medical billing, tracking diseases and health conditions, and analyzing health trends. ICD-10 is the most widely used version in the world and is used to code diagnoses.
d) It comprises alphanumeric codes, enabling a precise and detailed description of diseases and conditions.
e) ICD-10 codes find application across diverse healthcare environments, serving purposes such as medical billing, reimbursement, and statistical analysis.
f) These codes usually consist of three to seven characters and are categorized into chapters according to the nature of the condition, such as infectious diseases, neoplasms, and injuries.
g) ICD-10-PCS serves as a distinct system exclusively employed for the coding of inpatient procedures.
h) It offers a standardized method for representing procedures conducted within a hospital environment.
i) The codes consist of both letters and numbers, with a potential length of up to seven characters.
In the United States, the current coding system is ICD-11-CM, denoting the tenth revision of the ICD code. The "-CM" suffix signifies "clinical modification" and encompasses alterations implemented by the National Center for Health Statistics (NCHS), a division of the Center for Medicare and Medicaid Studies (CMS).
ICD coding is essential for several purposes:
Billing and Reimbursement: Health insurance providers utilize ICD codes to process claims and establish reimbursement for healthcare services.
Public Health Surveillance: ICD codes play a vital role in monitoring and tracking the prevalence of diseases and conditions on a population scale.
Clinical Research: Researchers leverage ICD codes to analyze disease patterns, treatment outcomes, and healthcare trends.
Healthcare Management: ICD codes aid healthcare providers in effectively managing patient care by offering a standardized means of communicating diagnoses and procedures.
Epidemiology: Public health experts employ ICD codes to examine the distribution and determinants of health-related conditions within populations.
2. Current Procedure Terminology (CPT):
Managed and owned by the American Medical Association, this code set comprises over 8,000 five-character alphanumeric codes delineating services delivered to patients by physicians, paraprofessionals, therapists, and other healthcare providers. The CPT® system is predominantly employed for reporting most outpatient services, and physicians also use it to document services performed within inpatient facilities.
CPT codes are 5-digit numeric codes organized into three categories. The first category is divided into six ranges, and it is the most used. These ranges correspond to the following six major medical fields:
- Medicine
- Radiology
- Evaluation and Management
- Anesthesia
- Pathology and Laboratory
- Surgery
Types of CPT Coding:
Category I CPT Codes:
Category I codes constitute the primary set within the CPT codes, encompassing a diverse array of procedures and services. They encompass routinely conducted medical services, such as surgeries, diagnostic tests, and office visits.
Category II CPT Codes:
Category II codes are discretionary and serve the purpose of performance measurement and data collection. They offer supplementary details regarding the quality of care, patient outcomes, and various performance metrics.
Category III CPT Codes:
Category III codes are provisional codes designated for emerging technologies, services, and procedures. They facilitate the monitoring and evaluation of novel and evolving practices within the healthcare domain.
CPT coding is a standardized healthcare system employed to describe and code medical procedures and services. It promotes precise billing, facilitates reimbursement, and enhances communication throughout the healthcare industry. This, in turn, contributes to streamlined healthcare administration and the delivery of quality patient care.
3. Healthcare Common Procedure Coding System (HCPCS):
HCPCS is a standardized coding system created by the Centers for Medicare & Medicaid Services (CMS) to streamline the billing and reporting of healthcare services and supplies. While its primary application is in Medicare and Medicaid claims processing, other healthcare programs and insurers also widely adopt it.
Types of HCPCS Coding:
Level I HCPCS Codes:
CPT (Current Procedural Terminology) codes, recognized as Level I codes, are formulated and managed by the American Medical Association (AMA).
Functioning similarly to CPT codes, they serve to delineate medical procedures and services, with a primary focus on physician services, outpatient hospital services, and various healthcare professional services.
Level II HCPCS Codes:
Alphanumeric Level II codes are employed to designate a diverse array of products, supplies, and services that fall outside the scope of CPT codes.
Encompassing a broader spectrum, these codes include durable medical equipment (DME), ambulance services, drugs, and various non-physician services.
Their significance lies in billing processes, playing a vital role in the reimbursement of healthcare providers.
Like CPT codes, every HCPCS code must be correlated with a diagnostic code that validates the medical procedure. Coders bear the responsibility of ensuring the coherence between the outpatient procedure outlined in the doctor's report and the listed diagnosis, typically conveyed through an ICD code.
India has developed into a center for medical coding businesses, with several of these firms providing excellent services to customers worldwide. It's critical to identify the main companies in the industry as it grows.
These businesses, which range in size from big enterprises to little startups, have established themselves as the greatest in the business by providing excellent customer service and coding services. These businesses should be on your radar if you're seeking for work as a medical coder or as a healthcare practitioner.
Top Medical Coding Companies in India
- Omega Healthcare
- Episource Pvt. Ltd
- CorroHealth
- Optum
- Vee Technologies Pvt. Ltd
- IKS Health
- Cotiviti
- Exela technologies
- Advantum health
- Pacific BPO
- Global Healthcare Billing Partners
- AGS Health LLC
- GeBBS Healthcare Solutions
- Access Healthcare
- Advantmed
- NTT DATA
- Cognizant Technology Solutions
- UnitedHealth Group
- Apexon
- Starmark Software Pvt Ltd