What Is The Difference Between Medical Coding And Medical Billing?

difA great number of people tend to believe that medical coding and medical billing are one and the same thing. But they are not. The job of a medical biller is different from the work of a medical coder and it’s only in few exceptions that you will find a single employee is covering both, especially in small medical facilities.  In fact, the work done by both is administrative and both groups do not do any medical work with patients so this often makes people think that they are the same occupation.

Therefore, it’s very important that you get to know what the two career professions involve before venturing into either one of them. That’s where we step in to offer our help. Keep reading for a basic overview of The Difference Between Medical Coding and Medical Billing:

Understanding Medical Billing And Medical Coding

Medical billing mainly entails the process of handling and submitting the records of patients to government agencies and insurance companies for the services that have already been offered to the patient. Medical billers make use of alphanumeric and numeric codes that were assigned by medical coders during the procedure of diagnosis to process this medical form and submit them in claim forms to payers.

Patient data concerning their clinical procedure is entered into practice management software which is eventually used on the claims.

A competent medical billing process makes sure that the paperwork process is completed in time to ensure payment is received without delay. The quality and integrity of the data is also the sole responsibility of the medical biller together with running of the medical reports. They need to understand all the insurance procedures in order to facilitate accurate submission of claims. In some cases, medical billers are the ones responsible for explaining these charges and insurance benefits to patients. Medical billers should keep track of the billing process and maintain contact with insurance firms to ensure money is received on time.

Medical coding mainly involves the medical records of the patient. The coding should be accurate in order to eliminate any misguided diagnosis or notes. Alphanumeric and numeric numbers that have been constituted by the healthcare industry is used by medical coders in the translation of patient clinical records into a universal agreed letters and numbers in order to aid in medical billing process. These codes are helpful to marketing staff, resource management and health care statistics due to their shortening of lengthy descriptions for treatments, diseases and illness. These codes cover all the types of clinical procedures from office visits, to routine examinations, to injuries, to illness, to surgical procedures.

Coders are responsible for gathering all the information on the patients record from the other office staff and establish the correct coding for the patient diagnosis. Some of the health care coding systems used by medical coders are:

· CPT-Current Procedural Terminology: These are codes that apply to physician’s office procedure and outpatient procedures.

· HCPCS – Healthcare Common Procedure coding System: These are codes that apply to Medicaid and Medicare procedures.

· ICD-9 – International Classification of Diseases – this is an international coding system for procedural and diagnosis codes.


The training of medical coders is mainly done in diploma and certificate training programs and others pursue their training in Health Information Technology associate degree programs that basically deal with reimbursement and coding. Some of the coding credentials are a certified professional coder that’s offered by American Academy of Professional Coders.

Medical billers also obtain their training form certificate and diploma programs that is channeled towards insurance and medical billing. Certified Reimbursement Specialist is a special credential for billers.

With this information, you will have a better understanding about medical billing and medical coding which can be important in your future decisions. More importantly, you will be able to understand what the difference between medical coding and medical billing is. These two closely related professions have been very vital in the healthcare industry and are required to be accurate and detail oriented to avoid slow processing and delayed payment. Accuracy, proficiency, experience and education are core values in these special departments of the healthcare industry.