Medical coding software translates patient information, medical services, procedures, and diagnoses into specific alphanumeric codes, which are used for billing purposes and tracking patient care and outcomes. These codes follow standards such as the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT). Coding staff can access a comprehensive database of medical codes, as well as advanced tools for searching, selecting, and entering codes into patient records. Newer solutions also utilize artificial intelligence to auto-complete or auto-suggest codes, reducing human error that can impact claims reimbursement. Medical coding software verifies code accuracy, identifies coding errors, and generates detailed reports, ultimately helping healthcare organizations streamline their billing, improve revenue cycle management, and ensure regulatory compliance.
Medical coding software functionality may exist within medical billing software or healthcare claims management software, but point solutions will integrate with these tools. Integration with EHR systems is also crucial to simplify data transfer.
To qualify for inclusion in the Medical Coding category, a product must:
Automate code lookup using keywords or phrases related to diseases, conditions, treatments, etc.
Update the codebase in accordance with updates from health organizations and insurance bodies
Flag duplicates, omissions, and mistakes that can impact reimbursement
Support code automation, auditing, and reporting workflows
