Medical Coding and Billing Software Considerations

Medical Coding Software

What are the options for Medical Coding and Billing Software. Learn the major online resources. Is there a viable combined medical billing and coding software solution? If you spend a lot of time looking up codes, a good medical coding software can be a tremendous help and time saver.

What Does Coding Software Do?

Medical coding software – also referred to as medical coding and billing software – is an application that allows you to lookup and search ICD-9 diagnosis, CPT procedure, and HCPCS codes. Most coding software also allows you to search codes by abbreviation, term, acronyms, etc. Other helpful features are the ability to determine appropriate modifiers, medical necessity, and proper unbundling.

Realistically the coding should be determined and assigned before entering codes in the billing or practice management software and it’s probably best they be treated separately as coding by itself demands a lot of concentration. When I’m having to perform coding and billing, I find it easier to go through and assign the proper codes prior to entering the patient visit billing info into the billing software.

Different Configurations
Medical coding and billing software can be in several configurations; online, stand-alone PC application, server, or an additional “Plug In” to the medical practice billing software. The codes can be updated on a regular basis – but this typically requires subscribing to the vendors support or update service.

Just like coding reference books, you really have to have a good understanding of coding and the associated terminology to use it effectively.

I have seen PC based coding software references, but I think the online services are becoming the best source. A PC based coding software is going to require frequent updates (and installations) due to the constant changes and updates to ICD and CPT medical billing codes. In my opinion it’s much easier and less costly to use an online service – and not have to maintain a PC or server application.

If you do a lot of coding these can be a real time saver and help prevent denials. I have used Coding Today a lot and found them to be a real time saver. I also keep a copy of the latest ICD-9 and CPT-4 coding books as I refer to them quite frequently also, even when using online medical coding resources.

Here’s a few of the more reputable medical coding and billing software resources:

Supercoder offers affordable online medical coding and billing software references. They offer great economical CPT & ICD-9 coding tools and references starting at $14.95.

They also have a wide variety of medical coding software products including “SuperScrubber” for reducing denials and optimizing reimbursement. They also offer illustrated guides, specialty libraries, and fee schedule tools.

Coding Today
Cost: $349 per year, $79 each additional user

Free 30 day trial is available to try out.ACS Coding Today also offers the CPT Assistant for and additional $199 a year. This is a nice feature that allows access to 17 years of the CPT Assistant newsletter articles. The codes in ACS Coding Today are linked to the relevant articles.


SpeedECoder is a powerful search tool of all the standard ICD-9 (and soon ICD-10), CPT & HCPCS, coding manuals. A nice feature is SpeedESpeller which is an interactive search term suggestion and spell check tool.

Cost: Different pricing depending for Office, Acedemic, Education, and Enteprise. The office is $199 a year per user or $19.95 per month. Cost is $79.95 for students enrolled in a medical insurance billing and coding program.

AHA Coding Clinic add-on is available for $150 a year. AMA CPT Assistant is also available for $150 a year.

Encoder Pro
Not a lot of descriptive info on their website. They are owned by Ingenix and have a link on the website above for a free 30 trial.

Encoder Pro Expert – Real-time code lookup of ICD-9-CM, CPT and HCPCS Level II codes. Also includes editing tools to assist in increasing accuracy and maintain compliance.Cost: $999/year

Encoder Pro Professional – Real-time code lookup of ICD-9-CM, CPT, and HCPCS Level II codes. Also includes Medicare and commercial payment and coding information.Cost: $549/year

Encoder Pro – An online ICD-9-CM, CPT and HCPCS Level II coding applicationCost: $299/year

Alpha II

Alpha II offers these different standalone or desktop (or PC) software coding solutions related to medical coding and billing software:

Coding System – This is a code search and edit tool intended to power essential revenue improvement efforts. This is a stand-alone application that allows you to look up codes and perform edits all in one program. It includes proprietary tools for E&M generation help avoid under-coding and prevent over-coding.

Cost: Requires quote from Alpha II

ClaimStaker – This is a claim scrubber and claim editor software for verification of both professional and institutional claims using a comprehensive medical necessity database. ClaimStaker accepts claim files created by most practice management systems. It integrates with existing electronic medical billing software and allows the users to maintain their existing billing software and not duplicate data entry.

Alpha II says ClaimStaker gives the user access to basically the same technology payers use. Using it before claims submission allows claims to be validated.

Free Online Coding References
Where to find free if somewhat limited references for CPT medical coding and ICD 9 codes. Here are some online medical coding resources from reputable sites.

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