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Published:
October 29, 2024

Medical Billing & Coding For Dummies

Overview

The essential guide for medical billing professionals, updated for ICD-11 standards

Medical Billing & Coding For Dummies will set you up for success in getting started as a medical biller and coder. To ensure data accuracy and efficient data processing, medical offices need professionally trained coders to handle records. This book provides prospective allied health professionals with everything they need to know to get started in medical billing and coding as a career. In addition to an introduction to the basics of medical coding, you'll get information on how to find a training course, meet certification requirements, and deal with government agencies and insurance companies. Learn about the standard practices in the medical billing industry

and get up to speed on the ethical and legal issues you're likely to face on the job. This accessible guide is a great entry point—and a great refresher—for anyone interested in the medical billing and coding profession.

  • Get a primer on your career options in the field of medical billing
  • Learn coding practices for telehealth, viral outbreaks, and other emerging issues
  • Update your knowledge of the changes between ICD-10 and ICD-11 coding systems
  • Find training programs and explore your options for certification

This Dummies guide is an accessible entry point for prospective professionals looking get a jump on their new career, and current professionals intent on staying up-to-date in this flexible and growing field.

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About The Author

Karen Smiley, CPC, is a certified, multi-specialty coding expert in physician and outpatient reimbursement. With an extensive background as a coder, auditor, accounts receivable manager, and practice administrator, she has also served as an independent consultant to physician practices and as an assistant coding instructor.

Sample Chapters

medical billing & coding for dummies

CHEAT SHEET

Working as a medical biller and coder is a challenging and rewarding job that takes you right into the heart of the medical industry. You are the touchpoint for everyone involved in the healthcare experience, from the patient and front office staff to providers and payers. To succeed, you'll need to know how to file an error-free claim, important acronyms, and what to look for in a payer contract.

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Articles from
the book

The majority of medical billing and coding training programs begin with basic human anatomy and physiology, more commonly referred to as body systems. You need to understand how each organ within a particular body system works, how disease or illness affects the system, and why the treatment was necessary. Most textbooks contain diagrams specific to each body system.
Working as a medical biller and coder is a challenging and rewarding job that takes you right into the heart of the medical industry. You are the touchpoint for everyone involved in the healthcare experience, from the patient and front office staff to providers and payers. To succeed, you'll need to know how to file an error-free claim, important acronyms, and what to look for in a payer contract.
At the top of the government heap is the biggest government payer of them all: good old Medicare. Medicare is funded by payroll taxes deducted from every employed American. (You’ve probably seen the acronym FICA, which stands for Federal Insurance Contributions Act, on your pay stub. This FICA deduction is what helps fund Medicare.
So, what does a medical biller and coder do? To secure timely payment for the provider (that is, your employer or client), you’ll find yourself working and communicating with many different people. As a representative of the office, being friendly and approachable to patients and payers alike is fine. After all, the professional demeanor you exhibit toward patients, fellow office staff, your superiors, and the payers with whom you work goes a long way in helping you establish your role as advocate-in-chief.
Before you start job-hunting as a medical billing and coding specialist, give some thought to what sort of environment you want to work in. The possibilities are almost endless, and if you think about your preferences before you search for a job, you can narrow down your list of possible employers, saving yourself a boatload of time.
Compliance — it’s such a serious word, and for good reason. When people in the healthcare industry speak about compliance by healthcare providers, they mean that an office or individual has set up a program to run the practice according to the laws established by federal or state governments and regulations established by the Department of Health & Human Services (HHS) or other designated agencies.
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