What Is Medical Billing and Coding?

Medical billing involves reviewing medical records and identifying the diagnoses and procedures the patient had. This information is used to submit claims to insurance providers, government programs and/or patients directly in order to receive reimbursement².

Medical coding is a key component of medical practices and healthcare facilities. Certified medical coders must understand anatomy and physiology, the disease process and clinical procedures so they can apply the correct codes to health records and claims².

Medical billing and medical coding are not the same. Medical coding, which is generally the first part of the medical billing and coding process, involves applying the correct codes to health records and claims. Medical billing, which is usually the second part of the process, involves submitting claims to those covering the cost of the service or treatment, such as patients and insurance agencies.

Medical billing and coding is important to healthcare facilities because proper medical billing and coding procedures result in an improved bottom line.

Medical billing and coding is important to patients because proper medical and coding procedures prevent patients from being charged more than they should be. For example, an incorrectly entered code could indicate that a patient received a much more expensive treatment than they actually did.