Medical coder

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In medical billing, a medical coder is a mapping code that allows insurance companies to map the service provider's services to their equivalent. This is necessary in order to be able to submit a claim to an insurance for any of the services or items sold to a patient.

Insurance companies publish codes that service providers must use during the process of claim creation. Without this code, service providers will almost certainly not be reimbursed for their services by the insurance companies, leaving the service providers with either of three options:

  • Resubmit the claim with the right codes.
  • Discard the claim, charge the patient for the loss, and leave the patient with the task of recovering the charges.
  • Ignore the claim and take the loss, keeping the customer happy, and hoping that the customer will repeat business in the future.


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