There are thousands of sets and subsets of corresponding code that any dental coder must familiarize themselves with. Two of the most common are from the International Classification of Diseases (ICD) that are linked to a patient’s injury or sickness, and Current Procedure Terminology (CPT) on the other hand, relate to what functions and services the healthcare provider performed on or for the patient. These codes act as the renowned verbal exchange between doctors, hospitals, insurance companies, government bodies, and other health-specific organizations that depend on these codes to properly disseminate information amongst themselves.
The coder first begin to read the healthcare provider’s report of the patient’s visit and then translates every bit of information into a code. It is a meticulous task as there’s a specific code for what kind of visit this is, what symptoms the patient has, what tests the doctor does, and what the doctor diagnoses the patient with.
There are also rules to follow for every code and guidelines to abide by. Certain codes need to be placed in a very particular order, as with the case of a pre-existing condition. Coding accurately and within the specific guidelines for each code will significantly affect the status of a claim.
The coding process ends when the medical coder enters the appropriate codes into a form or software program that compartmentalizes it. Once the report is coded, it’s passed on to the biller.
In a nutshell, you can think of the biller, like the coder, as a sort of translator where the coder translates medical procedures into readable code, the biller translates codes into a financial report. The biller has a number of other responsibilities, but essentially the biller is in charge of ensuring the healthcare provider is properly reimbursed for services rendered.
There are many number of ways that this streamlined process can find difficulties, as any single mistake will cascade throughout the procedure. This is why having professionals handling your patients’ vital information is important as it not only proves your reliability but also your dedication to quality service to your patients.