Medical billing and coding are important parts of the American healthcare system, which ensure that healthcare providers are compensated promptly for the medical and clinical services they offer to patients. Billing can be more accurate and efficient with the use of codes. The process and diagnosis are used to evaluate the efficacy of a medical procedure or to monitor the spread of diseases. Medical billing and coding are also much more than just codes and technical language. It is also about working with people and learning how to interact with different types of people and businesses. In this book, the profession, guidelines, and ethics of medical billing and coding are unearthed for both newbies and professionals in the business. Consider this book a friendly guide to all the twists and turns you will face in the medical billing and coding industry, from passing the certification exam to getting a job to dealing with insurance companies and reading physician data. The major objective of this book is to familiarize you with the world of medical billing and coding so that you are prepared to enter this tough, ever-changing, and intriguing profession. This book covers all you need to know about medical billing and coding, from the differences between the two careers to how to prepare for and land a billing and coding job. A snippet of the topics covered The Reality of Billing and Coding Diagnosis Codes Treatment Codes Treatment Code Modifiers Process of a Claim Billing and Coding Terminologies and Abbreviations Acronyms and Abbreviations Job Outlook for Medical Billers and Coders (Career Paths) What do Medical Billers and Coders do? Medical Billing and Coding Job Outlook Why Should You Consider Medical Billing? Medical Coder Job Checklist Working Remotely as a Biller and Coder Compliance and Non-Compliance Recognizing When Unbundling Isn't Appropriate Understanding the Concept of Auditing Distinguishing Between Internal and Payer Audits Penalty of Avoiding an Audit Medical Terminologies Understanding Medical Necessity Proving Medical Necessity for Surgical Procedures Endoscopic Procedures in Perspective Surgical Procedures in Perspective Looking at incidentals and when procedures can be separately reported Understanding billing modifiers Understanding the World of Evaluation and Management Codes Overview of what happens during the run-of-the-mill E&M visit Determining the level of billable service Handling commercial insurance payers Picking third-party administrators Understanding Medicare Putting Medicare supplement policies in perspective Coding and Processing Medicare claims How to become a certified medical biller and coder Going for the AAPC Trademarked Certifications Going for the AHIMA Certifications Digging up Complimentary CEU Resources The Perfect Billing Scenario Entering the Codes into the Billing Software How to Track Claim from Submission to Payment How to prepare an error-free claim Factors Affecting Reimbursement Amounts Understanding Remittance Advice A General Guideline of filing an appeal and when to do so Understanding the art of the appealing Appealing Medicare Processing Understanding the difference between ICD-9 and ICD-10 Working on the 5010 platform ICD-10 How to handle commercial insurance claims Going through and Verifying the Patient’s Plan and Coverage Medicare and Medicaid Working with Medicare Claims Getting Medicare-approved