Medical Billing vs Medical Coding

Medical Billing is the practice of submitting reimbursement claims to Insurance companies (e.g. Blue Cross Blue Shield) or the United States government (e.g. Medicare or Medicaid), in order to receive payment for services provided to a patient by a doctor.

Medical Coding is the practice of putting the procedure codes (CPT or HCPCS Code) and diagnosis codes (ICD9 Codes) in a format to be paid by the insurance company.   This information is provided by the office visit notes and then reviewed for entering and transmission.

The terms Medical Coding and Medical Billing are often used synonymously, however, medical coding must be performed by a medical coder before the medical billing reimbursement claim can be submitted.  Medical Billing is a subspecialty of Medical Coding.

Medical Billing in the physician office is typically performed by a clerk through medical billing software. After a physician sees and diagnoses the patient, and performs the necessary procedure, the physician then makes his/her notes of the diagnosis and procedure and gives those notes to the Medical Coder. The physician’s diagnosis and procedure is then properly coded before the medical billing reimbursement claim can be submitted. After the medical coding is completed, the medical billing claim can be completed and submitted for reimbursement.

Although there are programs that offer Medical Billing training by itself, if you are going to consider a course, you should consider a program that combines both billing and coding in one training program, since Medical Coding is the first step in the medical billing process.


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