ANSWERS: 1
  • A medical coder is a person who reports on the services given by a health provider to a patient using a system of codes. This information is then forwarded to the insurer of the health provider.

    Function

    Medical codes give insurance companies a way to evaluate the services given by a service provider to a patient.

    Need

    The process of medical coding facilitates the submission of a claim against the insurance policy of a recipient. This allows the recipient of the claim to be properly reimbursed by the insurance company.

    Research

    Medical codes are commonly used by governments (both local and national) and private health care companies for research purposes. They help both government and private health care companies evaluate the effectiveness of the treatment being given.

    Systems

    The main coding systems used by medical coders are CPT (Current Procedure Terminology) and HCPCS (Healthcare Common Procedure Coding System). The CPT codes were started by and are maintained by the American Medical Association. HCPCS coding is used by medical coders who work with Medicare and Medicaid.

    Employment

    Medical coders are employed at a wide variety of different businesses. These include home health care agencies, law firms, consulting firms, insurance agencies, medical billing and coding companies, hospitals, clinics, and by private doctors.

    Source:

    Medical Coding Career Guide

    EICD: Medical Coding File Samples

    Ahima.org: About Medical Coding & Medical Records: AHIMA

    Resource:

    BLS: Medical Records and Health Information Technicians

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