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Medical Coding

Medical Coding

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Medical coding for healthcare is an increasingly complex discipline requiring ongoing attention to regulatory changes, patient care, and clinical documentation. AIMA’s in-house team combines coding skills and technology with industry intelligence. We transform the commercial operations of healthcare businesses by eliminating coding errors, prioritizing clean claims, and staying one step ahead of coding and compliance regulations.

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About AIMA Medical Coding Services

Medical coding expertise from AIMA. Our dedicated and certified medical coding department has multi-specialty experience. We cover pathology, internal medicine, dermatology, and general surgery to complicated billing scenarios such as anaesthesiology and dental billing. You can be confident of our professionalism through our AHIMA and AAPC certifications. Our team is available 24/7, 365 days a year, to code all specialties of medical encounters directly from medical records. Our coders utilize quality-assured processes to maintain a 24-hour turnaround time and elite accuracy percentages. We let you focus on your operations while we code from the initial encounter and seamlessly transition to our specialist medical billing cycle teams.

Customer-centric family-owned AIMA’s clients include laboratories, physician practices, surgical centers, healthcare groups, treatment centers, and large-scale health systems. Our results are consistent and exceed industry benchmarks. On average AIMA clients witness:

  • 25% Revenue Increase

  • 90% Reduction in Claim Processing Time

  • 25 AR Days

  • 99% First Pass Acceptance Rate

  • 97.5% Net Collection Rate

  • 2% Denial Rate

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What is Medical Coding?

Medical coding transforms healthcare diagnoses, procedures, services, and equipment into universal medical alphanumeric codes. The diagnoses and procedure codes are taken from medical record documentation, such as transcription of physician’s notes and laboratory and radiologic results. Medical coding professionals correctly apply the applicable codes during the medical billing process, which includes abstracting the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.

Medical coding happens every time a patient interacts with a healthcare provider and how you get paid. Medical coders translate all related documentation into standardized codes that tell payers the following:

  • Patient’s diagnosis
  • Medical necessity for treatments, services, or supplies the patient received
  • Treatments, services, and supplies provided to the patient
  • Any unusual circumstances or medical conditions that affected the treatments and services

Our Healthcare RCM Services

Need Help?

Contact AIMA Business and Medical Support today. Our friendly team is on hand to answer your questions.

sales@aimabms.com

US (321)236-8300

Our Medical Coding Specialities

Pathology Coding

 

AIMA has a proven track record and reputation for success within pathology coding services. Our dedicated, AAPC and AHIMA-certified coding team has experience in coding a variety of lab tests starting from simple blood tests to complicated coding scenarios, including Next Generation Sequencing (NGS) panels, microbiology procedures, venipuncture and travel codes, and ever-evolving testing scenarios with PCR based infectious disease testing including Covid and Monkeypox.

  • Cancer genetics
  • Pharmacogenomics
  • Multiplex PCR panels
  • Allergy testing
  • Hormone testing
  • Liquid biopsy and cancer biomarkers

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Coding for Ambulatory Surgery Centers

 

AIMA’s certified surgical coders are trained in surgical coding by industry experts. Our coding team proudly serves the nation’s premier Ambulatory surgery centers. We are adept at using the appropriate modifiers for anatomical specificity, technical and professional components, and other special scenarios.

ASCs currently use ICD-10 and CPT codes for reporting procedures, diagnoses, drugs, and devices. Ambulatory surgery centers, like other specialities, will need to adapt to ICD-11 when that comes into effect.

Capturing appropriate codes and services are colossal tasks for ASCs requiring exceptional attention to detail. Many surgery centers find themselves unable and under-resourced to complete these tasks in-house and instead choose to partner with a specialist medical coder such as AIMA.

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Coding for Primary Care and Speciality Clinics

 

Assigning the correct E/M code can be daunting, especially when considering the latest MDM criteria set forth by AMA. Our certified coders use the MDM tables to assign the right level of code for new and established patients. Ancillary service codes are assigned appropriately based on the services provided at the clinics.

We’re incredibly proud of our growing customer base that comprises every healthcare specialty, including:

  • Solo and group physician practices
  • Surgical centers
  • Laboratories
  • Healthcare groups
  • Urgent and in-patient treatment centers
  • Large-scale health systems

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Compliance and Industry Knowledge

 

Coding compliance and accurate billing are central to the long-term success of any healthcare business. Don’t leave proper documentation and reimbursement to guesswork when you see patients, perform exams, and test samples. All too often, paperwork and billing become an overwhelmingly complex regulatory process, and a single misstep can mean lost revenue, fines, or worse. At AIMA, we adopt a holistic approach to compliance, evident throughout all we do. Not just a bolt-on, an after-thought, or an up-sell service. Compliance for all, always.

Over the years, the AIMA coding team has mastered the guidelines of various federal and commercial carriers, which helps our clients to optimize their billing. Our coders specialize in analyzing the NCD and LCD guidelines, along with the usage of CCI Edits and Medically Unlikely Edits. We regularly help pathology laboratories to obtain Z codes from the MolDX program. Furthermore, we have worked with multiple labs, helping them generate PLA codes to commercialize newer tests.

LEARN MORE ABOUT AIMA COMPLIANCE SERVICES

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Have questions about medical coding and how AIMA’s revenue cycle management can benefit your healthcare business?

 

Contact our team today, and we can schedule a free, no-obligation RCM Financial Audit and start your AIMA optimization journey.

Contact AIMA Business and Medical Support

Call Us Now (321)236-8300 sales@aimabms.com

What is Medical Coding and Why is it Important?

Medical coding is the process of translating healthcare diagnoses, treatments, procedures, and services into standardized alphanumeric codes. These codes come from internationally recognized systems like ICD-10, CPT, and HCPCS. Medical coding is essential in all healthcare environments, from hospitals and outpatient clinics to specialized areas like pathology labs and pain management centers. Key reasons medical coding is important: Accurate billing and reimbursement from insurance companies, Medicare, and Medicaid Standardization of communication between providers, payers, and agencies Compliance with healthcare regulations, preventing fraud and billing errors Analytical tracking for public health trends and operational planning Continuity of care through properly coded medical documentation Whether youre coding for a general practice, diagnostic laboratory, or pain clinic, accurate coding is essential for compliance and cash flow.

How Does Medical Coding Affect the Healthcare Revenue Cycle?

Medical coding plays a foundational role in the healthcare revenue cycle — the financial process from patient scheduling to final payment. Here’s how medical coding impacts revenue generation: Claims Submission: Coders review provider documentation and assign appropriate codes for services like lab testing, diagnostic imaging, or pain procedures. These codes are then used by billers to submit claims to insurance companies. Reimbursement Accuracy: Insurance companies base payments on submitted codes. Correct coding ensures providers receive accurate and timely reimbursement. Audit Protection: Clean, compliant coding reduces the risk of audits, claim denials, and fines due to coding errors or fraud. Strategic Insights: Medical coding data helps administrators track which services — such as laboratory testing or outpatient procedures — are most profitable. Transparent Patient Billing: Patients are billed fairly and accurately based on the actual services performed and documented.

What Are ICD-10, CPT, and HCPCS Codes and How Are They Used in Medical Coding?

Medical coding relies on three primary code sets: ICD-10 (International Classification of Diseases, 10th Revision) Used to describe diagnoses and medical conditions Maintained by the World Health Organization (WHO) Examples: E11.9 – Type 2 diabetes without complications J02.0 – Strep throat CPT (Current Procedural Terminology) Used to code medical procedures and services Maintained by the American Medical Association (AMA) Examples: 93000 – Electrocardiogram with interpretation 20610 – Joint injection HCPCS (Healthcare Common Procedure Coding System) Covers services and supplies not listed in CPT Maintained by the Centers for Medicare & Medicaid Services (CMS) Examples: A0429 – Ambulance service, basic life support J1815 – Injection, insulin, per 5 units How these code sets work together: ICD-10 codes explain the patient’s diagnosis (the “why”) CPT codes describe the services provided (the “what”) HCPCS codes detail additional items or drugs used (the “how” or “with what”) For example, a lab performing a glucose test for a diabetic patient would use an ICD-10 code for diabetes, a CPT code for the test, and a HCPCS code if any special supplies were used.

How Does Medical Coding Ensure Compliance with Insurance and Regulatory Standards?

Medical coding is a critical tool for compliance in healthcare, ensuring that services are billed properly, documentation is accurate, and providers follow all applicable laws and payer guidelines. Ways medical coding supports compliance: Creates standardized records for consistent billing and claims processing Prevents overbilling or underbilling by matching services to documentation Supports legal and regulatory audits by agencies like CMS and OIG Reduces the risk of HIPAA violations and False Claims Act penalties Ensures proper use of modifiers, frequency edits, and preauthorization when required by insurance contracts In areas like laboratory billing or pain management, where services are frequent and highly regulated, compliant coding is particularly important for maintaining payer relationships and avoiding payment issues.

What is the Difference Between Medical Coding and Medical Billing?

While they work closely together, medical coding and medical billing are distinct functions in the revenue cycle. How coding and billing work together: A patient is treated — possibly in a specialty like pain management, pathology, or a diagnostic lab The medical coder reviews the documentation and assigns appropriate codes The medical biller uses those codes to create and submit an insurance claim The payer responds — either paying, denying, or requesting more info — and the biller manages the rest

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