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What’s the Difference Between Medical Billing and Medical Coding?

Posted Tuesday, Dec 3, 2019 by Altierus

Interested in training for medical billing and coding career opportunities? It’s a growing industry that offers the potential for a satisfying career path. The U.S. Bureau of Labor Statistics (BLS) reports that job openings for health information technicians (which includes medical coders and billers) are projected to grow by 11% over the 2018-2028 period.[i]

You may be wondering: why is the career path called “medical billing and coding”? Don’t both jobs involve working with healthcare records and computers? They do, but medical billing and medical coding put those healthcare records to different uses. In smaller healthcare facilities, medical billing and coding may be combined into a job for one person.

In this article, we explain:

  • The different types of medical codes that medical billers and coders are expected to use on the job;
  • The principal differences between the two roles; and
  • What kind of training and support our Medical Billing and Coding diploma program offers you.

What Medical Coding Is and Why It Matters

The American Association of Professional Coders (AAPC), the nation’s largest training and certification organization dedicated to medical billing and coding careers, defines “medical coding” as the practice of “translating medical reports into a code used within the healthcare industry”.

These codes summarize the conditions patients have and the treatments and supplies used to address those conditions. In the course of their duties, coders will need to communicate with healthcare practitioners to clarify information, ask questions, or address errors.

Medical coding matters because the information generated can be put to use in many different ways. Medical coding data can be analyzed for use in healthcare research or healthcare policy development. Medical coding is also the basis for the medical billing function.

What Medical Billing Is and Why It Matters

The AAPC defines medical billing as “the act or process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider”[ii]. Medical billers use medical records to ensure that providers and facilities are reimbursed appropriately and in a timely fashion.

In addition to entering information about treatments into billing software, medical billers will communicate with patients and providers to follow up on claims and payments.

Medical billing is important to the healthcare industry because it ensures payments flow in a consistent and timely manner from insurers to providers (and to patients who are due reimbursement). Also, healthcare providers and insurers often negotiate agreed billing rates for specific procedures and set contractual terms for payment deadlines. Medical billing helps keep all parties compliant with the terms of these contracts.

What Are Medical “Codes”, Anyway?

Medical billers and coders in the United States need to be familiar with three commonly used medical coding classification systems. These include:

  • International Classification of Diseases, 10th Revision (ICD-10) – Originally developed by the World Health Organization (WHO), ICD codes indicate the conditions patients have.
  • Current Procedural Terminology (CPT)® – Created by the American Medical Association in 1966, CPT is used to report medical procedures to federal and private healthcare insurance for payment.[iii] CPT is revised annually to reflect new advances in medical practice.
  • Healthcare Common Procedure Coding System (HCPCS) Level II – Developed by the U.S. government in the 1970s, HCPCS is a coding standard used to record and file claims for medical devices, supplies, transport, medications and other types of items or services.

By using these three types of codes in combination, medical billers and coders can indicate the conditions patients present with, plus the treatments and supplies used to address those conditions.

Training for Medical Billing and Coding Careers

At Altierus Career College, we offer an eight-month Medical Billing and Coding diploma program that’s designed to provide you with the knowledge and skills you need to pursue a career in this fast-growing field. In this program, you can learn foundational concepts in anatomy, physiology, and healthcare. You’ll also gain practical skills for using CPT®, ICD-10, and HCPCS coding on the latest billing and coding software.

In addition to the opportunity to develop skills and knowledge, Altierus equips medical billing and coding students with tools for professional success, including an iPad that students can keep after graduation plus test preparation and testing fees for the AAPC’s Certified Professional Coder (CPC) examination. To learn more, contact us today!

[i] https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm#tab-2

[ii] https://www.aapc.com/medical-billing/medical-billing-and-coding.aspx

[iii] https://www.aapc.com/resources/medical-coding/cpt.aspx

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