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Medical coding professionals provide a key step in the medical
billing process. Every time a patient receives professional health
care in a physician's office, hospital outpatient facility or
ambulatory surgical center (ASC), the provider must document the
services provided. The medical coder will abstract the information
from the documentation, assign the appropriate codes, and create a
claim to be paid, whether by a commercial payer, the patient, or
CMS. While the medical coder and medical biller may be the same
person or may work closely together to make sure all invoices are
paid properly, the medical coder is primarily responsible for
abstracting and assigning the appropriate coding on the claims. In
order to accomplish this, the coder checks a variety of sources
within the patient's medical record, (i.e. the transcription of the
doctor's notes, ordered laboratory tests, requested imaging studies
and other sources) to verify the work that was done. Then the coder
must assign CPT codes, ICD-9 codes and HCPCS codes to both report
the procedures that were performed and to provide the medical
biller with the information necessary to process a claim for
reimbursement by the appropriate insurance agency. This text is
intended to dispel any ambiguity prior to taking your national
certification. This text contains over 400 preparatory examination
questions, covering ICD-9, ICD-10, Revenue cycle, Medical report
extrapolation assignments, HCPCS, UB04, and CPT.
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