Medical coding vs Medical billing: What’s the difference?

  • Medical Billing and Coding
  • March 12, 2024
  • 5 min read
Medical coding

Medical billing and medical coding are both medical professions, but they differ in the type of work that they do.

Medical coders perform medical coder duties by using their knowledge of medical terminology to assign codes to medical records; these codes then identify what kind of care was given for a patient.

The code also helps determine how much the insurance company will reimburse the provider for services rendered. Medical billers, on the other hand, keep track of all payments made by patients or insurance companies and make sure that providers get paid appropriately.

This article discusses some pros and cons related to each profession so prospective medical professionals can decide which one is best suited to them!

What is medical billing?

Medical billing is the process of submitting and following up on medical claims with insurance companies in order to get patients’ medical bills paid.

Medical billers need a great deal of knowledge about medical terminology in order to assign codes to medical records; these codes then identify what kind of care was given for a patient. The code also helps determine how much the insurance company will pay out for medical care.

Medical billers are also responsible for making sure that medical records are complete and up-to-date so that the insurance companies know exactly what was done to treat a particular illness or condition in an insured patient.

Billing is usually performed by certified medical billing specialists who have gone through rigorous training programs to ensure they have the medical knowledge and coding skills required to perform their job.

In medical billing, there is a very strict code of confidentiality that must be observed between medical providers and those who process insurance claims. Because medical records contain highly sensitive medical information about an individual’s health care history, it is important for medical billers to maintain confidentiality at all times.

What is medical coding?

Medical coding is the process of assigning diagnostic and procedure codes to medical records. The main goal of medical coding is to ensure that all information contained in a medical record is accurately and completely coded so that it can be used for reimbursement, research, and statistical purposes.

The codes that are used to determine medical billing procedures for medical claims are determined by the World Health Organization’s (WHO) International Classification of Diseases, Tenth Revision Clinical Modification (ICD-CM). The ICD is updated annually and contains more than 14,000 medical codes.

Coding medical claims involves the use of medical billing diagnosis, procedures and supply codes to accurately describe medical services rendered by a medical provider.

It is also used for statistical analysis and validation so that health care providers can be compensated fairly for their work as well as charge patients appropriately based on medical coverage rules set by insurance companies.

The medical coding process begins with the medical biller assigning a code to each diagnosis listed on the patient’s medical claim.

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Then, the coder reviews all medical procedures and supplies that were billed to the medical claim and assigns a code to each medical procedure.

The medical biller must then determine how much of the medical insurance company’s benefits were used in order for them to be able to accurately charge patients co-payments, deductibles, or full price for medical services rendered during an office visit.

Lastly, when filing medical claims with medical insurance companies, medical billers must also include a superbill which is a document that itemizes the medical services rendered to the patient and the corresponding codes assigned to each service.

What is the difference between medical billing and medical coding?

Medical billing is the process of submitting and following up on insurance claims in order to receive payment for services provided by a healthcare provider.

Medical coding, on the other hand, is the process of translating medical services into specific codes that can be understood by computers. This code is then used to

Medical billing and medical coding are two important aspects of healthcare administration that work together to ensure patients receive appropriate care and providers are paid for their services.

While medical billing is more focused on the patient, medical coding is concerned with how medical services are billed to insurance companies.

Which one is better suited to me?

Medical billing is best suited for medical assistants who like working with people and want to make a difference in medical billing.

Medical coding is best suited for more technically minded people; who enjoy detailed work that requires precision, accuracy, organization skills, attention to detail, and patience.

Become a vital part of The Healthcare Cycle

Taken together, medical coding and billing form a link between patients, healthcare providers, and insurance companies. As a medical biller or coder, you’ll need to be accurate, detail-oriented, and well organized as you’ll be a vital part of any healthcare provider’s staff.

As one of the premier Medical Billing and Coding Schools in Las Vegas, Northwest Career College employs established, seasoned instructors to teach you every aspect of medical billing and coding. 

Our student-focused approach puts you first, and we offer online and on-campus workshops to accommodate your work and family schedule.

We continue to support our students after they graduate as our experienced Career Services team works with you to help you find medical billing and coding jobs in Las Vegas. Call us today on (702) 403-1592 to learn more about the exciting opportunities that our Medical Billing and Coding School can offer you!

Nancy Ferrante
Medical Billing & Coding Senior Program Chair

Nancy began her career as a Medical Assistant in 1979. From there, Nancy mastered many other areas of the medical field. She spent 35 years in Ohio, building a successful medical practice with the same Physician until his retirement in…Read Full Bio

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