Understanding Severity of Illness (SOI) in Medical Coding What is SOI? Severity of Illness (SOI) is a classification system used in healthcare coding and reporting that measures the extent of a patient’s illness. It reflects how sick the patient is and how much...
What Is MCC in Medical Coding and How Is It Used? Understanding MCC In medical coding, MCC stands for Major Complication or Comorbidity. It is a classification used in the ICD-10-CM and MS-DRG (Medicare Severity Diagnosis-Related Group) systems. MCCs represent...
How to Approach a Long Medical Coding Exam Scenario Read the Case Carefully Skim the entire scenario once to understand the big picture (inpatient, outpatient, ED, surgical, etc.). Underline or highlight key clinical details: Primary diagnosis Secondary...
What Is Pro Fee Coding? Pro fee coding, short for professional fee coding, refers to the process of assigning medical codes to professional services provided by physicians and other qualified healthcare professionals. It focuses on capturing and billing for the...
What Is CMS in Medical Coding? The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the U.S. Department of Health and Human Services (HHS) that plays a critical role in healthcare administration and policy. In the context of medical...
What Is a Manifestation Code in Medical Coding? In medical coding, accuracy is crucial for proper diagnosis reporting, insurance reimbursement, and compliance. One specific type of diagnosis code that often confuses new coders is the manifestation code. Understanding...
Trauma Registry Coder Guidelines & Tips A trauma registry is a specialized database that collects, stores, and analyzes information on patients who sustain traumatic injuries. Accurate and complete trauma registry coding is critical for quality improvement,...
Pneumonia Coding & Billing – Guidelines & Tips Pneumonia is a common and potentially serious respiratory infection that medical coders frequently encounter. Accurate coding and billing are essential to reflect the severity of illness, ensure compliance with...
What Is Medical Necessity in Medical Coding & Billing? Medical necessity is a cornerstone of accurate medical coding and billing. It determines whether a service, procedure, or supply is reasonable, necessary, and appropriate based on a patient’s medical...
What Is an Encoder in Medical Coding? An encoder is a specialized software tool used by medical coders to streamline the coding process by helping identify the correct diagnosis (ICD-10-CM), procedure (CPT/HCPCS), and modifier codes. Encoders often integrate official...