• The process of converting /transforming healthcare diagnosis, procedures, medical services, equipment’s and management of patient in to universally accepted alpha numeric codes.
• Medical coding is one of the important part of revenue cycle management (RCM)

RCM is the process used by healthcare systems in the United States (US) and all over the world to track the revenue from patients, from their initial appointment or encounter with the health care system to their final payment of balance .it’s a normal part of health care administration.

PROCESS OF RCM : - STEPS

• Pre-Registration - insurance coverage
• Registration - patient information on

ADMISSION

• Utilization review - Examine the necessity of Medical services
• Recording and transcription - Patient information recorded by the physician (called EMR electronic medical record)
• Medical coding - Medical information are converting to alpha numeric codes .
• Medical Billing - The process by which healthcare organizations submit claims to payers and bill patients for their own financial responsibilities. Medical billings begins when a patient register at the office or hospital and schedules an appointment Medical coding and billing are separate processes but both are necessary for provides to receive payment for health care services
• Registration - patient information on
• Registration - patient information on

Claim submission - submitting billable fees to Insurance

Third party follow up - collecting payment (Insurance)

Remittance processing - insurance money transferred to Physician & hospitals

Medical coding is under the authority of AAPC, AHIMA and AMA these all are controlled by WHO (world health care organisation)

• AAPC - American academy of professional codes
• AHIMA – American health information management association.
• AMA - American medical association