What is medical billing and coding?
What is Medical Billing and Coding? Medical Billing and Insurance Coding is the process of converting patient health information into a numeric code that makes it possible for healthcare providers to seek reimbursem*nt for services rendered to patients by insurance companies or directly from patients.
The certification exam for medical coding and billing can be challenging, but certainly not impossible—over 70% of examinees passed in 2022. However, preparation and practice are vital for passing the exam, which is why MedCerts offers the Medical Coder & Biller Certification Course to help you succeed.
Medical coding involves extracting billable information from the medical record and clinical documentation, while medical billing uses those codes to create insurance claims and bills for patients. Creating claims is where medical billing and coding intersect to form the backbone of the healthcare revenue cycle.
Medical coding and billing is technical, requires great attention to detail and demands sharp communication and problem-solving skills. This may prove challenging for some, while others might find it fits right into their natural working style.
Certified Billing and Coding Specialist (CBCS) Exam
The exam takes about 3 hours to complete, is 100 scored questions, and is timed. In order to take the exam, you'll need to register on the NHA website. You'll then have the option to take the test at a testing center near you or remotely.
The answer is yes and no. Medical coding is primarily about organizing medical information into codes, so while mathematical skills are helpful, they aren't always necessary. However, being able to understand and work with numbers is still important in this field.
It goes without saying that being a successful medical coder or biller requires both training and knowledge. As previously stated, coders and billers don't have to memorize all the CPT codes currently in use. Doing so would be nearly impossible anyway.
There are accelerated online courses that allow you to earn a certificate in medical billing and medical coding in as little as four weeks.
- Not all areas of the CPC curriculum require equal study time. ...
- Know your modifiers. ...
- Know your medical terminology. ...
- Know the letter ranges for ICD-10 and number ranges for CPT® codes. ...
- Acclimate yourself to the language in the code books.
Not only does medical coding and billing certification give you a practical advantage in getting a job, but it may also help you get a better salary. A 2021 report by the Bureau of Labor Statistics showed the median salary for all medical records specialists (coders and billers) was $46,660.
What is the hardest part about medical coding?
The hardest phase is the beginning when you're still familiarizing yourself with the codes and terminology while also having to think critically so that you can organize them accordingly. It's enjoyable working to solve the puzzle.
Compensation: One of the most common reasons for experienced coders to leave their jobs is compensation. If they feel that they are not being paid fairly or that their skills and experience are not being recognized, they may be tempted to look for opportunities elsewhere.
One of the main challenges of working in medical billing and coding is the need to keep up with constantly changing regulations and codes. Additionally, the work can be repetitive and requires a high level of accuracy to ensure that claims are processed correctly.
Math skills for medical coding and billing
On the math side of the fence, you need to have a fairly solid proficiency in math because some positions require higher-level math skills. For example, you may have to compute reimbursem*nts by using relative value units (RVUs) and then applying a conversion factor.
Yes, you can technically take the CPC exam without going to school. However, it is not recommended. The exam covers highly specific material, medical coding procedures, and codes.
Individuals who earn a score of 70 percent or better (105 correct questions) will pass the CPC exam. If you fail your first test, you are allowed one free retake.
Learning the Codes : Medical coders must also have a fundamental understanding of health-related topics such as anatomy, physiology, and medical terminology. Knowing thousands of codes from many code sets that are frequently updated is one of the most difficult aspects of medical coding.
The best Medical Coder jobs can pay up to $122,000 per year.
Having a degree is not required, but many employers prefer candidates who have an associate degree in medical coding or the Certified Professional Coder (CPC) credential.
Medical billing and coding jobs are on the rise and expected to grow at 8% through 2029. This is double the national average job growth according to the BLS.
The golden rule of healthcare billing and coding departments is, “Do not code it or bill for it if it's not documented in the medical record.” Providers use clinical documentation to justify reimbursem*nts to payers when a conflict with a claim arises.
Do medical coders have to talk to patients?
Billers work with patients.
Luckily there are many jobs in healthcare, including medical coding, where you can really help patients without having to work with them directly. Medical coders work behind the scenes in collaboration with physicians, billers and other staff. Medical billers must communicate with patients.
Dress codes for medical billing and coding specialists can vary based on the employer and setting. You may be asked to wear the same type of scrubs as clinical staff, or you may be asked to wear traditional office attire.
| Length | You Earn | Certifications |
|---|---|---|
| 4-6 months | certificate | CBCS |
| 10-12 months | diploma | CCA |
| 24 months | associate degree | CCS |
| 4 years | bachelor's | / |
Can you learn medical billing and coding on your own? Yes, it is possible to study medical billing and coding on your own through resources like free courses, books and videos.
Medical Coder Demographics
There's almost 135,000 medical biller coders in the United States. 90% of medical biller coders are women, 10% are men, with an average age of 45 years.
References
- https://chronicleapp.com/
- https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare
- https://www.urologytimes.com/view/what-are-category-iii-codes-and-how-are-they-best-used-billing
- https://www.meremhealth.com/consequence-of-medical-coding-errors/
- https://www.nerdwallet.com/best/small-business/free-invoice-software
- https://www.northwestcareercollege.edu/blog/is-medical-billing-the-same-as-coding/
- https://www.unfcu.org/financial-wellness/50-30-20-rule/
- https://southbend.iu.edu/professional-development/why-earn-a-medical-billing-and-coding-certification.html
- https://www.allalliedhealthschools.com/medical-billing-coding/medical-billing-and-coding-salary/
- https://medsitnexus.com/what-is-the-easiest-medical-specialty-to-code
- https://www.creditcardprocessing.com/glossary/show/bill-service-provider-bsp/
- https://www.sierra-view.com/hospital-services/emergency/
- https://www.sjvc.edu/guides/guide-to-medical-billing-and-coding/
- https://www.fool.com/the-ascent/small-business/accounting/articles/automated-billing/
- https://www.ama-assn.org/about/cpt-editorial-panel/cpt-code-process
- https://campus.edu/blog/medical-billng-and-coding/is-medical-billing-coding-certification-important
- https://www.cdc.gov/nchs/icd/icd10.htm
- https://www.ultimatemedical.edu/blog/how-to-start-career-in-medical-billing-and-coding/
- https://www.herzing.edu/difference/medical-billing-vs-coding
- https://streamlinehealth.net/is-medical-billing-and-coding-hard/
- https://www.aafp.org/pubs/fpm/issues/2007/0100/p21.html
- https://www.cloudblue.com/glossary/billing-management/
- https://www.gethealthie.com/glossary/clinical-coding
- https://www.practicesol.com/single-post/accounting-vs-billing-pitfalls-to-avoid
- https://www.sydle.com/blog/billing-system-61b0f8b85448461cf99138a6
- https://apps.apple.com/us/app/bills-manager/id834370671
- https://www.piedmont.org/living-real-change/what-to-expect-in-the-emergency-department
- https://en.wikipedia.org/wiki/Buffalo_Bills
- https://www.cambridgehealth.edu/medical-billing-and-coding/
- https://www.aafp.org/pubs/fpm/issues/2018/0700/p5.html
- https://www.forbes.com/advisor/business/software/best-invoicing-software/
- https://www.asha.org/advocacy/health-care-billing-codes/
- https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system/coding-questions
- https://www.aapc.com/resources/understanding-the-differences-between-medical-coding-and-medical-billing
- https://irq.sirweb.org/clinical-practice/Category-III-CPT/
- https://www.definitivehc.com/resources/healthcare-insights/top-25-physician-procedures
- https://www.medicalbillingandcoding.org/billing-process/
- https://www.va.gov/WHOLEHEALTH/docs/cpt-category3-codes-long-descriptors.pdf
- https://www.meremhealth.com/level-of-office-visit-code/
- https://www.aapc.com/blog/41276-new-vs-established-patients-whos-new-to-you/
- https://hiteks.com/4-challenges-of-medical-coding-and-why-its-worth-the-effort-clinical-documentation-improvement-software/
- https://www.aafp.org/pubs/fpm/issues/2021/0100/p27.html
- https://www.pennfoster.edu/blog/which-medical-coding-billing-certification-exam-should-you-take
- https://www.aapc.com/certifications/cpc
- https://www.aao.org/practice-management/news-detail/e-m-level-3-4
- https://www.cnbc.com/select/what-is-a-billing-cycle/
- https://www.avidxchange.com/glossary/what-is-billing-system-software/
- https://www.linkedin.com/pulse/top-challenges-medical-billing-how-overcome-them-alex-anderson
- https://www.aapc.com/resources/what-is-hcpcs
- https://www.ziprecruiter.com/g/Highest-Paying-Medical-Coder-Jobs
- https://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/HCPCS/index.html
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865623/
- https://vyaparapp.in/invoice-formats
- https://www.nata.org/practice-patient-care/revenue-reimbursement/general-revenue-reimbursement/commonly-used-cpt-codes
- https://www.medicalbillingandcoding.org/what-is-the-cpc-exam/
- https://painwaz.com/wp-content/uploads/2022/07/55b39ec4737fc065240a9df2db0ecad3.pdf
- https://nurse.org/healthcare/medical-billing-coding-salary/
- https://www.public-health.uiowa.edu/wp-content/uploads/2016/05/Types-of-Service-Codes.pdf
- https://www.dummies.com/article/body-mind-spirit/medical/billing-coding/prerequisites-for-medical-coding-and-billing-training-173352/
- https://www.linkedin.com/pulse/you-worrying-how-difficult-medical-coding-shweta-datye
- https://www.careerstep.com/blog/news/certified-professional-coder-cpc-exam-frequently-asked-questions/
- https://www.goodwin.edu/enews/is-medical-billing-and-coding-hard/
- https://therathink.com/cpt-code-99214/
- https://www.besthealthdegrees.com/accelerated-medical-billing-coding-programs/
- https://www.sofi.com/learn/content/how-to-organize-bills/
- https://www.timecamp.com/glossary/monthly-billing/
- https://www.aafp.org/pubs/fpm/issues/1999/0700/p32.html
- https://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00136700
- https://www.amtrauma.org/page/traumalevels
- https://www.cms.gov/medicare/coding/medhcpcsgeninfo/downloads/2018-11-30-hcpcs-level2-coding-procedure.pdf
- https://medcerts.com/blog/medical-billing-coding-certification-guide-2023
- https://www.genio.ac/glossary/service-bill/
- https://www.aapc.com/tools/medical-coding-salary-survey/
- https://www.healthsystemtracker.org/brief/outpatient-visits-are-increasingly-billed-at-higher-levels-implications-for-health-costs/
- https://revcycleintelligence.com/news/providers-are-increasingly-billing-outpatient-visits-at-higher-levels
- https://link.springer.com/chapter/10.1007/978-3-031-39626-7_6
- https://www.guvi.in/blog/easiest-programming-languages-to-hardest-ranked/
- https://www.indeed.com/career-advice/finding-a-job/medical-coding-vs-medical-billing
- https://www.moneylion.com/learn/how-to-organize-your-bills/
- https://reading.activatelearning.ac.uk/courses/detail/coding-practices-level-3-cert-online/
- https://quickbooks.intuit.com/payments/invoicing/generator/
- https://therathink.com/cpt-code-99213/
- https://www.findacode.com/articles/cpt-code-basics-need-know-37287.html
- https://www.quora.com/What-is-a-Tally-on-an-invoice
- https://www.medicalbillingandcoding.org/intro-to-cpt/
- https://www.facs.org/media/3pqhpnxk/2017_08_unlisted.pdf
- https://www.cco.us/medical-coding-vs-medical-billing-need-learn-both/
- https://www.codingclinicadvisor.com/about-hcpcs-coding
- https://www.indeed.com/career-advice/career-development/billing-and-coding-certification
- https://www.beckerspayer.com/policy-updates/the-2-midnight-rule-and-medicare-advantage-6-things-to-know.html
- https://www.freshbooks.com/hub/invoicing/billing-system
- https://staxbill.com/requirements-of-a-comprehensive-subscription-billing-platform/
- https://help.salesforce.com/s/articleView?id=sf.blng_billing_rules.htm&language=en_US&type=5
- https://www.forbes.com/advisor/education/healthcare/is-medical-billing-and-coding-hard/
- https://revcycleintelligence.com/features/exploring-the-fundamentals-of-medical-billing-and-coding
- https://www.medicalbillersandcoders.com/blog/clear-confusion-about-new-patient-cpt-code-range/
- https://www.bestcolleges.com/computer-science/coding-language-types/
- https://gocardless.com/en-us/guides/posts/what-is-a-billing-cycle/
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=ubcompop.pdf
- https://www.ziprecruiter.com/Salaries/Computer-Programmer-Work-From-Home-Salary
- https://www.medkart.in/blog/medical-coding
- https://www.linkedin.com/posts/links2success_billing-tip-wednesday-what-is-the-golden-activity-6998631249623838720-qQgC
- https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/website-pos-database.pdf
- https://www.aapc.com/resources/study-tips-to-pass-cpc-exam
- https://www.coursera.org/articles/popular-programming-languages
- https://medsitnexus.com/what-is-the-hardest-part-of-medical-coding
- https://www.ama-assn.org/practice-management/cpt/cpt-code-99203-new-patient-office-visit-30-44-minutes
- https://www.investopedia.com/terms/d/double-cycle-billing.asp
- https://resources.workable.com/billing-specialist-job-description
- https://www.forbes.com/advisor/education/healthcare/free-medical-billing-and-coding-course-options/
- https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices
- https://help.sap.com/docs/BI_CONTENT_757/d26cb97cca534166b0cd52f94e935524/c3b08653e3ef6359e10000000a174cb4.html
- https://www.medicalbillersandcoders.com/coding-update/how-can-coders-increase-their-earning-potential.html
- https://www.carecloud.com/continuum/procedure-coding-25-modifier/
- https://www.clevergirlfinance.com/keep-track-of-bills-and-payments/
- https://www.medicalbillersandcoders.com/blog/why-providers-not-hiring-an-in-house-medical-billing-team/
- https://www.accreditedschoolsonline.org/healthcare/medical-billing-coding/careers/
- https://www.ama-assn.org/practice-management/cpt/cpt-overview-and-code-approval
- https://quickbooks.intuit.com/accounting/invoicing/billing/
- https://www.northwestcareercollege.edu/blog/is-there-math-in-medical-coding/
- https://www.liveflow.io/learn/bill-com-vs-quickbooks
- https://www.pcgsoftware.com/medical-coding-in-the-real-world
- https://streamlinehealth.net/hcpcs-vs-cpt/
- https://www.highradius.com/resources/Blog/automated-billing-system-how-to-set-it-up/
- https://www.edsmart.org/4-week-online-course-for-medical-coding-and-billing/
- https://www.thesuperbill.com/blog/what-is-a-ub-04-form-used-for-cms-1500-vs-ub-04-forms-explained
- https://www.pcgsoftware.com/cpt-code-99213-knowledge-usage-and-studies
- https://www.forbes.com/advisor/business/software/best-medical-billing-software/
- https://corporatefinanceinstitute.com/resources/commercial-lending/billing-cycle/
- https://www.enter.health/post/medical-billing-vs-medical-coding-main-differences
