Medical Billing and Coding Myths Busted Ross Medical Education Center

Myths About Medical Billing & Coding: BUSTED

Medical Billing and Coding Myths Busted Ross Medical Education CenterBecause of the diverse need of them, medical billers and coders can be found across a variety of positions and in many different facilities. Some places you may work with medical billing and coding training are doctor’s offices, nursing homes, clinics, hospitals, and more. Although they don’t do as much work directly with patients, their positions are extremely important and they are responsible for a wide array of tasks in any healthcare facility.

In a typical day, they may be interacting with patients, insurance companies, physicians, nurses, medical assistants, and other members of the healthcare team while also keeping and updating medical records. They work hard to make sure that all patient information is recorded, coded, and billed properly and kept highly confidential. However, there are a few things that are commonly believed about them that just aren’t true! We came up with a few of them and busted those medical billing and coding myths!

Medical billing and medical coding are the same.

Although medical billing and medical coding could be done by the same healthcare professional, that is not always the case. This is because they are in fact different aspects of the process and therefore require slightly different skill sets. Both medical billers and medical coders need a good understanding of the diagnostic and procedure codes found in the ICD-10 in order to do their jobs. They also need medical terminology training and a few other shared skills.

However, even though they have a lot of the same knowledge and skills, their duties are actually different. More of this is outlined in a previous post we wrote entitled Are Medical Billing and Coding the Same?, but diagnoses, procedures, and prescriptions all have codes that correspond to them. It is the medical coder’s responsibility to accurately and fully translate all of the these into the correct codes. Then, they hand off the codes to the medical biller that uses them to appropriately bill patients and insurance companies for services offered.

So, in one location, there may be a medical biller and another person that is responsible for medical coding. Or, if it is a smaller office, there may be a healthcare professional that performs both medical billing and coding. In either situation, they are two different sets of responsibilities that just happen to work together – not the same thing.

Medical billing and coding is easy.

Some people believe that, just because the person doing medical billing and/or coding is sitting behind a desk instead of taking their blood pressure or performing phlebotomy, medical billing and coding is simple. It’s important to consider the fact that in order for someone to translate a diagnosis or procedure into a code or process that code for the appropriate billing, they must have a strong understanding of the human body and its systems and the possible issues that a patient could have.

Plus, the 10th and most current version of the International Statistical Classification of Diseases and Related Health Problems (ICD) has around 68,000 different codes in it! So, although a medical coder or medical biller may not have them all memorized (although we wrote a funny blog post about some of the most unique ICD-10 codes!), they will likely have a good idea of where to find them and a certain level of comfort with those that are more often used. Also, since codes are kind of like a foreign language, they take some time and effort to get comfortable with!

Just ask a medical biller or coder that you know and they will tell you that it’s not easy! Not to mention the fact that you have to be very thorough, organized, and detail-oriented. You have to have a good understanding of medical billing, medical coding, medical terminology, anatomy and physiology, insurance policies and the larger companies, billing and coding guidelines, how to use the coding manual, HIPAA regulations, and much more!

Medical billing and coding is just data entry.

As we said before, medical billing and medical coding aren’t the same thing, so we will deal with them separately.

First off, medical coding is like data entry only in the fact that you are taking information and entering information. However, medical coding actually requires knowledge of the subject matter because the coder must read and interpret and then translate the information provided in such a way as to make it useful to the medical biller to understand.

Additionally, the coder must be able to determine which pieces of information in the patient’s medical chart are significant and which aren’t. Then they must have a profound understanding of the medical codes and their uses according to a variety of guidelines that determine when certain codes can be used, the order in which they should be used, and more.

As for medical billers, in addition to being familiar with the medical codes and their usage guidelines, they must also be familiar with a variety of different insurance companies. Each insurance company comes with its own requirements and stipulations.

Both medical billers and coders also communicate with a variety of different people and must be able to understand what is being communicated with them as well as speak clearly and effectively about what needs to be done. We already wrote an article about the characteristics of a medical biller and coder that goes more in depth on this.

Are you interested in pursuing medical billing and coding training?

Finally – this is not a myth! At Ross Medical Education Center, we offer intensive, hands-on training to help you achieve your medical billing and medical coding career goals! Whether you’re ready to start your first career or change to a new career, we would love to help you to become all that you can be! Find out more about our Medical Insurance Billing and Office Administration program today!

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