Health care detectives: Medical coding professionals meet growing need

October 15th, 2008

A physician or other health care professional meets with a patient in a hospital, doctor’s office or clinic. The professional writes down or dictates what was done. Those files are not just used as medical records. They also are used for insurance, government or other reimbursement.

To request reimbursement, someone must assign numeric codes for each treatment component. That someone is a professional coder, who interprets physicians’ notes, assigning universally accepted codes that explain what was done and why.

The medical billing or professional coding task is essential to proper reimbursement for health care providers and individuals. Although coders weren’t in the treatment room, they must play detective, interpreting charts to accurately reflect what was done. A mistake could mean a loss of thousands of dollars or a stigma of a wrong diagnosis on a patient’s medical record.

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