What is the Difference Between Medical Billing and Medical Coding?

Feb 12 2018

Medical billers and medical coders both work with patient records in medical offices. Medical coders review patient records and apply the appropriate codes to the claims to be sent to various insurance companies for payment. Medical billers are responsible for transmitting the properly coded claims to the appropriate insurance companies and will follow the claims processing until payment is received. They also examine claims for completeness and verify that every service and supply is accounted for.

What is Medical Billing?

Medical billers are responsible for taking coded claims and patient information and using it to bill the various insurance companies for services rendered. This role often requires personal interaction, with the patients whereas medical coding does not generally have interaction with patients. Medical billers work with both insurance companies and patients to ensure that all payments are processed properly and quickly. Medical billers are required to have a deeper understanding of the spectrum of medical terminology, medical providers’ insurance policies, and of many insurance companies.

What is Medical Coding?

Medical coders are responsible for converting procedural information into easily identified codes that insurance companies can interpret and pay a claim from. There are multiple coding systems used to determine the proper coding to expedite payment of claims:

  • Current Procedural Terminology (CPT) – This set of codes is used for procedures performed in physicians offices or outpatient services.
  • Healthcare Common Procedure Coding System (HCPCS) – These codes are used to designate procedures covered by Medicaid and Medicare.
  • International Classification of Diseases (ICD-9) – This is a set of codes to identify diseases

Medical coding professionals must be proficient in all coding processes. Medical Billers and Coders work together to facilitate accurate claims which will allow for expedited claim payments.

Why Learn Both?

Medical facilities combine the two roles of billing and coding into one position. Being proficient in both will make you more employable by many types of facilities.

What Training is Required?

Most employers require a high school diploma and certification for both billing and coding. The successful applicants are often those that have a more extensive education in both coding and billing. Pittsburgh Career Institute offers a Medical Billing and Coding program that is designed to give you the advantage you need to pursue these careers.

Learn More!

Are you interested in learning more about medical coding and billing? Our program at PCI helps graduates to be more prepared for the workforce. Contact us to learn more information about a medical coding and billing education at Pittsburgh Career Institute!

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