The Use Of Medical Coding For Insurance Purposes

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Medical Coding is the process used through which the descriptions of medical diagnoses

and procedures are converted into universal bits of numbers, known as "codes". These codes are numeric and alphanumeric designations that depict the descriptions of injuries, diseases and other health care procedures used in the medical field.

Medical coding has emerged as an important field of medical sciences. It allows access to different healthcare records in terms of procedures as well as diagnoses, which can then be used for diverse purposes such as research, education and clinical care. The many uses of this field include:

1. Identification of symptoms to be evaluated, alerting other professionals in the healthcare field to different life threatening situations and allergies,

2. Comparing different facilities and also planning for new services, and
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3. Helping out with administration function, which may include scheduling, staffing, adding services, reporting reimbursement information, and more.

Medical coding can be classified into four major types, which include Diagnostic codes, Procedural codes, Pharmaceutical codes and Topographical codes. Diagnostic codes are used for diseases, symptoms, disorders, medical signs as well as human response patterns. The procedural codes are used to identify the specific interventions by medical professionals. Pharmaceutical codes, on the other hand, are used for identification of medications. Lastly, topographical codes are used to indicate a specific body location.

The main use of medical coding is for insurance purposes, where it is used for financial reimbursement from insurance companies. It helps in identification of codes and thus has the potential of displaying the entire history of the patient and also the services that were performed on him/her. The physician's note is converted into medical codes, which is then used by the insurance companies that make payment to the health care provider accordingly.

Medical Coding is a growing industry and has a huge potential. It has grown as an offshoot of the medical and technological industry as large databases and micro computers are used to manage all the coding work. It has also emerged as a lucrative professional field, which is popularly outsourced because of many different reasons. Medical coders are in high demand and need a specialized qualification in order to be able to work as a medical coder. Several third world countries have specialized outsourcing agencies for medical coding that provide services to companies abroad. That way, insurance companies and other firms requiring coding data benefit from the cost advantage of outsourcing, as they utilize cheaper medical coder services from these countries.

by: Elyse Hartman

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