Medical Billing and Coding Examples

By DeVry University

March 6, 2026
6 min read

Behind every healthcare visit is a system of medical billing and coding. Each diagnosis, procedure, and treatment relies on accurate coding to ensure providers are reimbursed properly and patients understand their portion of financial responsibilities.

If you’re considering this career field, the following medical billing and coding examples can give you a clear picture of how complex medical information is translated into standardized codes used across the healthcare system — and highlight the important role medical billers and coders play in the process.

What is medical coding?

Medical coding is the process of translating a patient’s diagnoses, procedures, and treatments from patient records into standardized medical codes used across the healthcare industry. These codes — including Current Procedural Terminology (CPT®), International Classification of Diseases (ICD), and Healthcare Common Procedure Coding System (HCPCS) — help ensure that medical information is recorded accurately, submitted correctly for billing, and easily understood by other healthcare and insurance professionals.

Medical coders need a strong grasp of medical terminology, anatomy, and healthcare regulations to assign the right codes for each procedure and diagnosis. This helps healthcare providers get reimbursed for their services and maintain accurate patient records.

Medical coding example 1

In this medical coding example, the coder receives a patient record for an abscess drainage procedure and translates the information into standardized CPT codes using the following steps:

Identify the procedure: The coder reviews the record and confirms the procedure is a CT-guided retroperitoneal peripancreatic fluid collection drainage.
Review indications: After examining the CT images, the coder notes that they show a mass that potentially represents an abscess.
Check sedation and medications: The record also shows moderate sedation was used during the procedure.
Document lab actions: The surgeon aspirated purulent fluid, which was sent to the lab for evaluation.
Assign codes: Using knowledge of human physiology, medical terminology, and the CPT coding process, the coder translates each step into the appropriate codes. In this case, CPT 49405-59 is assigned to represent the various steps and supplies used.

By following this step-by-step process, the medical coder ensures that patient records are accurately represented and claims can be submitted efficiently.

Medical coding example 2

In this example, a medical coder receives a patient record for a cholecystostomy exam. Translating the details of this procedure into billing codes requires coding knowledge about ultrasound and fluoroscopic guidance in intervention radiology:

Identify the procedure: The coder confirms the procedure is an ultrasound-guided cholecystostomy drainage.
Review the indication: The patient has been diagnosed with cholecystitis, which guides the coding process.
Check for sedation and monitoring: The coder notes that moderate sedation was applied and monitored by ICU nurses.
Document additional procedures: Details of the procedure are noted to show that a complete ultrasound was obtained for diagnostic paracentesis.
Assign codes: The medical coder then translates the complex procedure into billing codes using knowledge in human physiology, medical terminology, CPT coding, and the ICD coding practices. Two CPT codes (47490 and 49083), two ICD codes (575.8 and 789.59), and two ICD-10 codes (K82.8 and R18.8) were assigned to represent this procedure.

What is medical billing?

Medical billing is the process of reviewing medical records, submitting claims to insurance companies and government agencies, and billing patients for their portion. Medical billers ensure that healthcare providers are reimbursed accurately and on time, and that patients are billed for their portion of financial responsibility.

Medical billers also act as liaisons between insurance companies and patients. They track claims, resolve denials, and reprocess claims when needed, while making sure patient information is secure.

Medical billing example 1

In this example, a medical biller receives a coded patient record for a cholecystostomy exam. Translating the details of this procedure for billing and submission requires coding knowledge about ultrasound and fluoroscopic guidance in intervention radiology. The medical biller uses the following steps:

Review the coded record: The biller identifies the procedure as ultrasound-guided cholecystostomy drainage.
Verify diagnoses and procedures: The indication reveals the patient’s diagnosis of cholecystitis, the use of moderate sedation and monitoring by ICU nurses, and that an ultrasound-guided percutaneous cholecystostomy was successfully completed.
Confirm the assigned codes: The record indicates two CPT codes (47490 and 49083), two ICD codes (575.8 and 789.59), and two ICD-10 codes (K82.8 and R18.8) to represent the procedures.
Prepare the insurance claim: The biller ensures all required information is accurate and formatted correctly for submission.
Submit and track the claim: After submission, the medical biller monitors the claim status and follows up on any issues.

Medical billing example 2

Once a procedure is completed and a medical coder turns the patient records into medical codes, the revenue cycle shifts to the back-end medical billing process. This involves creating, issuing, and managing claims until the healthcare provider is reimbursed.

Here is how a medical biller handles this part of the revenue cycle:

Transfer coded information: The biller receives the finalized codes and enters them into the correct format required for billing, claims submissions, and collection.
Apply pricing and charges: Each diagnosis, procedure, and supply is matched with correct pricing based on payer contracts.
Submit claim to payers: The biller sends claims electronically to insurance companies or government agencies for reimbursement.
Monitor claim status: After submission, the biller tracks the claim to identify delays, rejections, or denials.
Resolve denials and discrepancies: If a claim is denied, underpaid, or rejected, the medical biller reviews the issues, corrects errors, and resubmits as needed.
Reconciled payments and patient balances: Once payment is received, the biller ensures insurance payments and patient invoices have been correctly and fully paid, so the provider is reimbursed.

This behind-the-scenes work requires medical billers to be knowledgeable in health services and information systems, health information processes, and legal and regulatory issues in health information, as well as health insurance and reimbursement processes.

How do I get into medical billing and coding?

Getting started in medical billing and coding typically begins with education and training. Many professionals start by completing an undergraduate certificate in medical billing and coding, which covers essential topics like medical terminology, coding systems (CPT, ICD), and healthcare regulations.

After completing your education, you can pursue a professional certification such as Certified Coding Specialist (CCS®) from the American Health Information Management Association (AHIMA). The American Academy of Professional Coders (AAPC) also offers 5 certifications, including Certified Professional Coder (CPC®) and Specialty Medical Coding Certification. These certifications demonstrate your competency to accurately apply medical codes, understand healthcare terminology and procedures, and follow coding guidelines.

Start preparing for your medical billing and coding career

Medical billing and coding plays a vital role in healthcare, and the right training can help you build the skills you need to support providers and patients. At DeVry, we offer 2 online medical billing and coding certificate programs, giving you the flexibility to choose a path that fits your career goals:

Undergraduate Certificate in Medical Billing and Coding program: This credential can help you learn skills that align with the Certified Professional Coder (CPC) certification, which is ideal if you’re just starting out or plan to work in smaller healthcare settings, like a doctor’s office.
Medical Billing and Coding – Health Information Coding Certificate program: Learn the knowledge you need to help you prepare for the Certified Coding Specialist (CCS) certification and to pursue coding roles in larger organizations, such as hospitals and insurance companies.

Learn the code for your future success

Whether you’re preparing for entry-level roles in clinics and medical offices or developing advanced coding skills to move forward in your career, gain the knowledge and skills needed for a medical billing and coding career.

Let's get started

FAQs for medical billing and coding

What does a medical coder do on a daily basis?

How hard is medical billing and coding?

What are some medical billing and coding jobs?

The information presented here is true and accurate as of the date of publication. DeVry’s programmatic offerings and their accreditations are subject to change. Please refer to the current academic catalog for details.