Procedures And Procedures Of Medical Coding

871 Words Oct 24th, 2015 4 Pages
Medical coding is a very detailed process in which health care professionals use to code an insurance claim, to submit for reimbursement of services. In the following scenario, my task would be to explain the process and steps I took, to code patients cases using ICD-9. When coding it’s very important to code correctly to avoid delays in reimbursement and proper reimbursement. The following will explain the steps I took to perform proper medical coding. When I code with ICD-9 I generally weed out the diagnosis that has been stated and where on the body this diagnosis came from. Some terms you want to avoid performing when coding a claim are, unbundling, upcoding, overcoding, jamming, and downcoding (Green, M, 2014, pg. 12). Those terms are when you code claim improperly which can cause delays and in some cases audits can happen, and insurance companies can revoke your rights to submit claims to them. That could detrimental to a small practice because they wouldn’t be able to accept that insurance and bill claims, so patients would have to find another provider. There is a Code of Ethics that helps differentiate the rights and wrongs with guidelines for ethical coding practices (pg. 13). After I locate the correct term to code, I locate the code in the tabular list, which is arranged numerically (Optum coding, 2015, pg. VI). While analyzing a code it’s important to look for keywords to make sure you pick the appropriate code. Some words to look for are, “excludes, includes,…
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