Connection Between Anatomy and Physiology and Billing and Coding

Human anatomy is the study of the various structures in the human body. Human
physiology, on the other hand, is the study of how different body structures function (Shiland,
2016). The fields of medical study have close relationship with medical billing and coding.
Understanding of human anatomy and physiology helps medical coding and billing to be
more accurate. This is because medical coders have to correctly interpret the dictations of
physicians in order to select the right code (Shiland, 2016). Knowledge of anatomy and
physiology helps the coders to understand the medical terminologies, details of procedures,
organ names, and surgical procedures that physicians usually include in their writings to
them.

An example of the role knowledge of human anatomy and physiology helps in
medical billing and coding is when a surgeon writes that he used a pediatric endoscope to
pass through the oropharynx, gastroesophageal junction, stomach proper, and then
duodenum. The surgeon also writes that before retraction, he took biopsy. A medical coder
who is not familiar with anatomy and physiology will look up each individual term used by
the surgeon and enter three different codes for biopsy. These are biopsy of oropharynx,
stomach, and duodenotomy. However, these codes will be inaccurate. A medical coder with
knowledge of human anatomy will know that what the surgeon is describing is one long
passageway and what the surgeon did is esophagogastroduodenoscopy (Ahlawat & Ross,
2019). Instead of three, esophagogastroduodenoscopy has one code.

As the example has shown, the accuracy of the code that is entered is largely
dependent on the coder’s knowledge of human anatomy. Even though it is not directly
applied, knowledge of human physiology helps in understanding human anatomy, especially

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gross anatomy. As for medical billing, its accuracy depends on the accuracy of the codes
entered. The more accurate the medical codes are the more accurate the medical billing is
likely to be.

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References

Ahlawat, R., & Ross, A. B. (2019). Esophagogastroduodenoscopy. StatPearls Publishing.

Shiland, B. J. (2016). Medical Terminology & Anatomy for Coding-E-Book. Elsevier Health
Sciences.