Medical Billing versus Medical Coding

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medical billing versus medical coding

Medical Billing versus Medical Coding.

Alicia: Q: Billing versus Coding. “What’s the difference between Billing versus Coding?”

A: Well, if I can answer that question. Let’s see here. OK there we go. Do you like that little graphic I found of the gears of the brain? Isn’t that great?

Medical Billing is really all about reimbursement, first of all. Think of the Billing as reimbursement. It’s much more than that but when you think of billing, that’s the first thing that’s probably going to come to your mind.

It’s about obtaining the reimbursement for the work that was done to the patient by the provider and that usually is the E/M — the Evaluation and the Management of the patient. Whether they did any procedures on the patient or not, he is evaluating and he is managing the care of the patient, maybe it’s the disease process of the patient.

Now, Medical Coding is really just the language in which the transaction is carried out. Coding is literally a code that the actions are translated into. Let’s explain that a little bit differently. Your physician sees a patient. Let’s say our patient’s name is Judy. So, Judy comes in and the doctor does an Evaluation and Management of Judy. By what he does to her with the Evaluation and Management, CPT codes and ICD codes are assigned by the coder.

Let’s say that he did a yearly physical for her and checked her diabetes, and noticed that it appears that she has hypertension. In all that stuff that he did, every procedure that he did gets a CPT Code and the Evaluation and Management is all CPT. Then, the diagnoses that he gives her, which will say that he diagnosed her with diabetes and hypertension, those are ICD codes, diagnosis codes.