What is Medical Billing and Coding?

First things first - don't make the mistake of thinking that medical billing and coding are the same thing. In fact, medical billing is a subspecialty of medical coding. So, a medical biller will prepare reimbursement requests on the behalf of medical care providers and facilities to make sure that insurance companies pay them back for providing services. While this might seem as simple as sending the insurance company a bill, it's not - hence the need for coding specialists.

Mistakes in the medical billing and coding industry can be disastrous - the difference between patients getting the treatment they need and having to pay for whatever treatments they can afford. What's more, medical billers and coders have a huge financial impact on both the

patients and medical facilities they handle. A patient's diagnosis and the treatments received are some of the main factors in determining the amount of money that a hospital gets from an insurance company. However, the specificity with which a patient's diagnosis is documented can cause the reimbursement amount to vary wildly. For example, according to Richard D. Pinson, MD, of HQC Consulting in Houston, documenting a condition as "simple pneumonia" rather than "aspiration pneumonia" can result in the provider receiving $1,500-$3,000 less in payment.

It is important to remember that coding and billing may not be the only tasks that a medical billing and coding specialist handles. This can justify additional courses in administration and medical documentation during your education. The fact of the matter is that coders don't just code. According to a 2008 AAPC survey, 58 percent of the participating medical billers and coders stated that 80-100 percent of their job tasks involved coding. Twenty-three percent of the respondents stated that coding comprises 50-79 percent of their responsibilities, and 19 percent claimed to be coding less than 50 percent of the time. When not coding, these individuals were often responsible for clinical or administrative tasks unrelated to billing and coding.