MEDICAL CODING INTERVIEW QUESTIONS AND ANSWERS
Medical coding is the process of translating a patient’s medical records into universal codes. These codes are used for billing, research, and tracking patient outcomes.
What medical coders do
- Review patient records, including doctor’s notes, lab results, and radiology findings
- Assign a unique code to each diagnosis, treatment, and medical service
- Create a claim for insurance reimbursement
Why medical coding is important
- Helps insurance companies and medical providers work together to bill patients
- Helps ensure high-quality medical services
- Helps track patient outcomes and medical necessity for reimbursements
- Helps maintain detailed patient records
Question: What is medical coding?
Answer: Medical coding is the process of translating medical diagnoses, procedures, treatments, and equipment into standardized alphanumeric codes. These codes are used for accurate documentation, billing, and insurance claims in the healthcare industry.
Question: Explain the importance of medical coding in healthcare.
Answer: Medical coding ensures consistency in healthcare data, facilitates accurate billing and claims processing, supports medical research, and helps in healthcare analytics and decision-making.
Question: What are the main coding systems used in medical coding?
Answer: The main coding systems used in medical coding are ICD-10-CM (International Classification of Diseases, 10th Edition, Clinical Modification) for diagnoses and CPT (Current Procedural Terminology) for procedures.
Question: What is ICD-10-CM?
Answer: ICD-10-CM is a coding system used to classify and code diagnoses in healthcare. It provides a standardized way to document diseases, conditions, and injuries for statistical and billing purposes.
Question: What is CPT coding?
Answer: CPT (Current Procedural Terminology) coding is a system developed by the American Medical Association (AMA) for documenting medical procedures, surgeries, and services. It’s widely used for billing and reporting medical services.
Question: What is HCPCS coding?
Answer: HCPCS (Healthcare Common Procedure Coding System) is a coding system used for describing healthcare procedures and services that are not covered by CPT codes. It includes codes for medical supplies, equipment, and services provided to Medicare beneficiaries.
Question: What qualities are important for a medical coder to have?
Answer: Attention to detail, analytical skills, knowledge of medical terminology, coding guidelines, and the ability to work accurately and efficiently are crucial for a successful medical coder.
Question: What is an E/M code?
Answer: E/M (Evaluation and Management) codes are used to report services provided by healthcare professionals for patient assessment, management, and care coordination. They reflect the complexity of the patient encounter.
Question: How do you ensure accuracy in medical coding?
Answer: Ensuring accuracy involves thorough understanding of coding guidelines, continuous learning, staying updated with changes in coding systems, and double-checking codes against documentation.
Question: Can you explain the concept of upcoding and its impact?
Answer: Upcoding refers to assigning a higher-level code than is supported by the clinical documentation. It can lead to overbilling, claims denials, legal consequences, and damage to the reputation of healthcare providers.
Remember to personalize your answers based on your understanding and experiences, and use these questions as a starting point for your interview preparation.
Key Medical Coding Abbreviations
- ICD – International Classification of Diseases
- CPT – Current Procedural Terminology
- HCPCS – Healthcare Common Procedure Coding System
- DRG – Diagnosis-Related Group
- E/M – Evaluation and Management
- RVS – Relative Value Scale
- RVU – Relative Value Unit
- EOB – Explanation of Benefits
- ABN – Advance Beneficiary Notice
- LCD – Local Coverage Determination
- NCD – National Coverage Determination
- HPI – History of Present Illness
- ROS – Review of Systems
- HCC – Hierarchical Condition Category
- CMS – Centers for Medicare & Medicaid Services
- UB-04 – Uniform Billing Form (Hospital Billing)
- COB – Coordination of Benefits
- HMO – Health Maintenance Organization
- PPO – Preferred Provider Organization
- HIPAA – Health Insurance Portability and Accountability Act
Top Medical Coding Companies in India
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GeBBS Healthcare Solutions – One of the healthcare outsourcing companies in India, offering medical coding, billing, and RCM (Revenue Cycle Management) services.
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Omega Healthcare – A major player in medical coding and RCM with multiple offices in India.
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Vee Technologies – Provides end-to-end healthcare BPO services, including medical coding and billing.
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Access Healthcare – Specializes in medical coding, claims processing, and revenue cycle services.
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CorroHealth (Formerly Visionary RCM – VRCM) – Offers medical coding, auditing, and compliance services.
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AGS Health – A global healthcare solutions provider focusing on medical coding and RCM.
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Episource – A key provider of medical coding and risk adjustment services.
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Miramed Ajuba – A well-known healthcare BPO company offering coding and billing solutions.
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NSI Infinium Global – Specializes in medical coding, billing, and documentation.
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Cognizant – Provides medical coding services as part of its healthcare BPO division.
