Medical Coding Research Paper

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Jaclyn Wallace Byron Corbin Medical Billing August 27, 2011 Medical coding is the act of transcribing or translating regular language into medical documentation reports. Diagnoses and procedures are, for instance, assigned a medical code number (Xu et al., 2007). The medical codes are supposed to be universal but because there is human interpretation involved, it is extremely difficult to assure complete accuracy. There are many constructs in the medical coding environment. One has already been cited, human interpretation of regular or ordinary language. The issue is more involved when we consider the health care provider’s diagnoses. Again is open to errors and inaccuracies in coding. The accuracy of medical…show more content…
A study was conducted in California to determine the data regarding cost-shifting in that state (Iriye, 2002). The examples used in this type of literature are Medicare, which mandates how much the government will pay for any type of health care intervention. Consumers and private insurers in California pay as much as 10 percent more for the same procedures as Medicare patients (Iriye, 2002). This amounted to about $951 per family per year paying more than would be fair to make up for the shortfalls from Medicare payments. Here is one simple example: Medicare would pay $4,913 for kidney and urinary tract infections in adults, including complications but the market cost was $7,289 (Cross, 2006). In other words, private insurance companies would allow up to the $7,289 for the same treatments Medicare would only pay $4,913 for. The shortfall leads to cost…show more content…
The one possible solution is universal health care modeled on one of the successful European models. The health care industry is extremely convoluted; even so an empirical study needs to conduct to determine the actual costs involved with different health care services. Case mix management refers to management refers to managing the case mix, case mix refers to the mix of patients that are being treated in a specific facility or institution (Pam Pohyl Associates, 2008). That could be a hospital or a health care clinic or even an individual physician’s office. It is usually measured by estimating the relative frequency of different types of patients seen or treatments provided. Usually, DRGs (Diagnosis Related Groups) are used when studying case mix (Pam Pohly Associates, 2008). A time study is a study of the actual time it takes to do certain activities. It is conducted of a specific duration of time and at specific times during the work day or work week. In medical coding, a time study could be conduced on the time it actually took the coder to translate the health care provider’s

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