Question

Explain why it is important to know the differences between the code sets when submitting electronic claims?

Answer 1

Answer: It is important that the medical coder puts in the correct code when submitting claims. It is important because the codes show what the patient is seen for and what the doctor does during the procedure or office visit. If the coder puts in the wrong code set, the patient could be misdiagnosed to their insurer or charged unfairly. Each visit, procedure, lab test, etc has their own code set to abide by. The coder should have software that enables them to check over their codes before the final submission.

During the process of submitting electronic claims, HIPPA law must followed and the patients privacy should always be kept as the number one priority.