Medical Coding And Billing Tutorials for Beginners | Business of medicine - 12

So hello everyone welcome to great

online training myself Nikita I'm a CPC

certified medical coding trainer in

great online training this is day five

today we're going to discuss about

business of medicine what do you think

what will we going to discuss in this

session what do you think what is

meaning of business of medicine anyone

all right uh business of medicine is

nothing but you can say it is the admin

administrative side of medicine

or healthcare industry. Okay. Here we

going to discuss about future scope or

career opportunities in medical coding.

If you see medical coding as your

professional career then what are

different possibilities. Okay. Uh then

we'll see different kinds of payers,

different kinds of uh providers. Okay.

and other rules and regulation regarding

coding. Okay. Uh different kinds of uh

insurance

provider that we're going to uh discuss

in this session. Okay. So we'll see what

are the different topics we'll going to

cover in this class. Today we'll see

coding as a profession. Then we'll see

hierarchy of providers. Then the

different types of payers. Then we'll uh

understand RB RBS. Then medical

necessity. Then the advanced beneficiary

notice it is also known as ABN. Then the

need for privacy and security. Then

we'll see covered entities of HIPPA.

Remember I told you about HIPPA HIPPA

regulation that we'll going to discuss

in today's session. So then high-tech

and its impact on HIPPA then we'll see

fraud and abuse and their examples and

lastly we'll see some acronyms. Okay. So

first coding as a profession. As of now

I hope you get better understanding of

what is medical coding and what are the

different career opportunities in

medical coding. So can you please uh can

someone tell me what is medical coding?

Anyone anything you learn from uh

previous sessions what is medical

coding? Okay fine I'll explain you

again. Uh medical coding is a process of

taking patients health information which

can be any diagnosis uh symptom illness

anything or abnormal finding from

patient's report or any medical

procedure whether it can be diagnostic

or surgical procedure any any procedure

uh details patient undergone or any

medical necessity medical equipment or

any other medical services the patient

took that we have to uh took from

physician or we can say we have to

extract extract that information from

patients healthcare uh report and then

we have to as a medical coder we have to

convert that information into uh medical

codes which are accepted worldwide okay

and which are numeric or alpha numeric

codes okay so this process is called

this process of conversion of medical or

healthcare information into medical

codes is called medical coding. Right?

Medical coding is technical and rapidly

uh changing field that offers

practitioners a variety of career

opportunities like we discussed in

previous sessions also. Right? If you uh

choose US healthcare prof is your

profession or if you have decided to

work in US healthcare field then you

have many options right you can work as

a medical coder you can work as a

medical biller you can work as a medical

transc scriptor uh or AR caller uh

denial coder or any uh compliance

manager or different different position.

There are many positions available in

this field. But if you choose medical

coding particularly medical coding as

your profession then you have variety of

career opportunities. uh for instance

skilled medical coders may become

consultant, remote medical coder or uh

medical coding trainer or you can say

medical coding educator or medical

coding auditors right also you can

become a TL and manager uh as you gain

more and more experience right coding as

a profession has evolved over the past

several decades and will continue to do

so as the business of medicine embraces

uh new technologies core set new courses

and payment methodologies. Okay. And I

think medical coding is very good

opportunity for those who are just

completing or about to complete their

graduation because this is the only one

uh field where you can directly start

your job as soon as you completed your

graduation. Right? So this is the main

or advantage of this uh profession.

Okay. uh and soon after your completion

of your graduation you get chance to

work with doctors you get chance to work

for doctors and those doctors who is

working in US so I think this is very

good opportunity right now we'll see

coding as a profession okay each time an

individual receives healthcare service a

record is maintained

of a resulting observations, medical or

surgical interventions, diagnostic tests

and studies and treatment outcomes.

Okay. Coding is a process of translating

this written or medical record into

series of numeric and alpha numeric

codes. Right? There are separate code

sets to describe diagnosis, medical and

surgical services or procedures and

supplies. We uh we discussed this uh in

previous sessions also in first step in

medical coding right? Uh what are those

for inpatient

coding which focuses on physician

services and care provided while patient

is being admitted in the hospital. Uh

inatient coders will focus on learning

ICD 10 PCS and ICD 10 CM course. ICD10

PCS codes are used for inpatient

procedure coding while ICD10 CM codes

are used for diagnostic coding. ICD10

codes are common for whether it is in

patient or outpatient any patient. Okay.

ICD10 codes are common for all types of

patient because these are disease. Okay.

Disease symptoms,

illness, abnormal finding. Okay, just

difference is ICD 10 PCS code are used

for procedure coding on impatient. Okay,

so if you want to become a impatient

medical coder, you have to uh take took

training for IPD. Okay, where you you

get trained with ICD10 PCS and ICD10 CM

course. Okay. Otherwise if you uh take

only medical coding training you'll get

uh trained on ICD 10 cm which are used

for diagnostic coding then CPT code and

HCPCS score. Okay. So again inpatient

coders also will assign medical severity

diagnosis related groups MSDRGS also

known as MSDRGS. So again if you want to

choose IPDRG as your coding speciality

and you are going for uh IPDRG training

then there you will get trained with

MSDRG, ICD 10 PCS and ICD10 CM course.

Okay. Then outpatient coding focuses on

medical uh sorry outpatient coding

focuses on physician professional

services and outpatient facility coding.

Okay. Outpatient coders will focus on

learning CPT HCPCS level 2 and ICD 10

PCS uh sorry ICD 10 CM course. Okay.

Generally in medical coding training

you'll get trained on CPT

HCPCs level two course and ICD 10 CM

course okay CPT course are also known as

can anyone tell me CPT course are also

known as try to give answer it's okay if

you are wrong just give me answer anyone

no no uh I'm asking HPCS S are level two

course. CPT course are also known as

these are level one course. Okay. HPCS

HPCS are level two course whether CPT

course are level one course. So they

also known as level one course. Okay

fine. Then regardless of the setting

means any specialtity you choose code

updates and insurance payment policies

may change as often as quarterly. Okay,

that's the reason coders require

continual education to stay a breast of

these changes. Okay. So you have to be

continue learning your learning process

should be continue to get updated in

this film because ICD10 course are get

updated every year in October whereas

CPT HPCS course are updated quarterly.

Okay. Now we'll see the hierarchy of

providers. Now you tell me who is

provider. Earlier we discuss about RCM