Whenever people visit a medical provider, the provider is supposed to write up a formal report describing the visit in detail.
In addition to explaining all procedures and exams, the provider should also include his or her diagnosis and treatment plan.
Another person, called a medical coder, has to examine the report and translate it into a series of numbers and symbols. Each provider may describe his or her work on a patient differently.
The coding practice standardizes and simplifies the report so that other providers as well as insurance companies and others can easily understand the patient’s medical history.
For example, the medical community relies on a book of standard medical codes that any provider or facility is expected to understand.
The Social Security Administration will pay careful attention to medical codes
Coding is important both for efficient billing and for maintaining quality healthcare. However, it is also important for disability determinations.
For example, since it is medical codes, and not written reports, which get submitted for payment, the Administration may find the coding the most reliable information about a patient’s true condition.
The Administration might try to match the codes to one of its listed impairments which qualify a person for disability. Without a match, it could be harder to convince the Administration to award disability benefits.
To some extent, a medical code is what it is. However, sometimes important coding mistakes happen, and the Administration should not base its decisions on mistakes. In other cases, the coding of a particular diagnosis or procedure could be up to meaningful debate.
This is why it is important for a resident of San Diego or the greater Southern California area who needs disability benefits to enlist the help of a qualified professional who understands coding and billing.