Medical coding is defined as the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. Most practices take support from professional medical billing outsourcing companies to get the codes right on the medical claims. According to a report from Mordor Intelligence, the medical coding market that was valued at USD 15,259.67 million in 2020, is expected to reach USD 28,363.63 million by 2026. The market is expected to grow at a CAGR of 10.93% during the forecast period 2020 – 2026.

Key factors that are expected to boost the market growth include:

  • escalating demand for coding services
  • the rising need for a universal language to reduce frauds and misinterpretations associated with insurance claims
  • high demand to streamline hospital billing procedures
  • the high demand for specialist coders and a favorable healthcare system

Medical codes help create a proper record of patient care, streamline the medical billing process, accelerate payments to physicians, and identify the healthcare areas that require focus.

The market is segmented on the basis of classification system, component, end user, and geography.

By classification system, the market includes International Classification of Diseases (ICD) and Healthcare Common Procedure Code System (HCPCS). Owing to the increasing demand for trained medical coders and a growing prevalence of diseases, the ICD segment is expected to register a significant share, in terms of revenue, over the forecast period. The report highlights that the increasing incidence of cardiovascular diseases is directly proportional to the market growth. According to areport from the World Health Organization (WHO), cardiovascular disease is the number one cause of death globally, taking an anticipated 17.9 million lives each year.

The usage of ICD codes is also expected to rise with its improving versions, as the newer versions provide more information than the previous ones. The latest version ICD-11, released in June 2018 allows member states to prepare for implementation, including translating ICD into their national languages. The ICD-11 version has 55,000 unique codes for injuries, diseases, and causes of death compared to that of 14,400 in ICD-10. This ICD-11 version may be effective from 2022. Because of these factors, the ICD segment is expected to grow in the future due to the rising growth of medical coding across the world.

By component, the market includes both in-house and outsourced segments. To perform medical billing and coding in-house, practices have to invest in additional space to set up the entire infrastructure. They need to consider the services of an expert team with in-depth and up-to-date knowledge of medical billing and medical coding standards, equipment and software, and reference material. Outsourcing coding tasks to experts helps to ensure accuracy and reduce staff’s workload. Using the right codes can also help avoid claim denials.

End users of the market are – hospitals, diagnostic centers and others.

Geographically, the market is divided into North America (United States, Canada, Mexico), Europe (Germany, United Kingdom, France, Italy, Spain, Rest of Europe), Asia-Pacific (China, Japan, India, Australia, South Korea, Rest of Asia-Pacific), Middle-East and Africa (GCC, South Africa, Rest of Middle-East and Africa), South America (Brazil, Argentina, Rest of South America).

North America is the biggest market in 2020 in terms of revenue and is expected to show a similar trend over the forecast period, mainly owing to technological advancements and improved healthcare infrastructure in various countries in this region. In the North American region, the United States holds the largest market share due to factors such as an increasing geriatric population and a growing number of chronic diseases in the country, which is anticipated to motivate the demand of the market in this region. Many companies in the region are either launching new products or entering into strategic initiatives to boost their market share. Asia Pacific is growing at the highest CAGR over 2021- 2026.

The report notes that as the number of professional coders is expected to rise significantly over the forecast period, this will boost the number of medical coding companies providing platforms for those professionals.

All the players in the market are adopting various growth strategies to enhance their market presence.Key players mentioned in the report include 3M Company, Aviacode Inc., Dolbey Systems Inc., Maxim Health Information Services, MRA Health Information Services, Nuance Communications Inc., Optum Inc., Oracle Corporation, Talix, nThrive (Precyse Solutions LLC), and The Coding Network LLC.

While considering outsourcing to a medical billing company, make sure that the firm has the latest technology and infrastructure, as well as stringent security measures to ensure maximum confidentiality and patient data security.