What is a Licensed Vocational Nurse and Medical Biller and Coder?

Licensed Vocational Nurse (LVN):
A licensed vocational nurse, also known as a licensed practical nurse (LPN), is a healthcare professional who provides basic nursing care under the supervision of registered nurses (RNs) and physicians. LVNs work in a variety of healthcare settings, such as hospitals, nursing homes, and clinics. Their duties may include administering medication, taking vital signs, assisting with patient hygiene, and documenting patient care. LVNs play a crucial role in the healthcare team and provide direct patient care to individuals of all ages.

Medical Biller and Coder:
A medical biller and coder is a healthcare professional who is responsible for translating medical procedures and diagnoses into codes for billing purposes. They work in medical offices, hospitals, and insurance companies to ensure accurate and timely reimbursement for healthcare services. Medical billers and coders review medical records, assign appropriate codes, and submit claims to insurance companies. They also handle insurance denials and appeals, as well as patient billing inquiries. Medical billers and coders play a vital role in the financial aspect of healthcare and help ensure the smooth operation of healthcare facilities.

Difference between a Licensed Vocational Nurse and Medical Biller and Coder

While both licensed vocational nurses and medical billers and coders work in the healthcare field, there are significant differences between the two professions. Here are some key distinctions:

Scope of Practice:

• LVNs are responsible for providing direct patient care, including administering medication, monitoring vital signs, and assisting with activities of daily living. Their focus is on patient care and ensuring the well-being of individuals under their supervision.
• Medical billers and coders, on the other hand, have a more administrative role. They focus on coding and billing procedures, ensuring accurate reimbursement for healthcare services provided. Their work is primarily behind the scenes and does not involve direct patient care.

Education and Training:

• Becoming an LVN typically requires completing a vocational nursing program, which can take anywhere from 12 to 18 months. These programs are offered by community colleges and vocational schools and include both classroom instruction and hands-on clinical experience. After completing the program, graduates must pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN) to become licensed.
• Medical billers and coders can enter the field with a high school diploma or equivalent. However, many employers prefer candidates with formal training in medical billing and coding. These programs are typically shorter in duration, ranging from a few months to a year. They cover topics such as medical terminology, anatomy, coding systems, and billing procedures. Certification is also available through organizations such as the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA).

Job Setting:

• LVNs can work in a variety of healthcare settings, including hospitals, nursing homes, clinics, and home health agencies. They may also have the opportunity to specialize in areas such as pediatrics, geriatrics, or obstetrics. LVNs work closely with patients and other healthcare professionals to provide quality care.
• Medical billers and coders primarily work in medical offices, hospitals, and insurance companies. They may also have the option to work remotely. Their work is typically focused on coding and billing, and they may not have as much direct interaction with patients or other healthcare professionals.

Licensed Vocational Nurse vs Medical Biller and Coder: Job Description

Licensed Vocational Nurse (LVN):

• Administering medication and treatments as prescribed by physicians
• Monitoring vital signs and reporting any changes or abnormalities
• Assisting with activities of daily living, such as bathing and dressing
• Documenting patient care and maintaining accurate medical records
• Collaborating with other healthcare professionals to develop and implement care plans
• Providing emotional support and education to patients and their families

Medical Biller and Coder:

• Reviewing medical records and assigning appropriate codes for procedures and diagnoses
• Submitting claims to insurance companies and ensuring proper reimbursement
• Handling insurance denials and appeals
• Following up on unpaid claims and resolving billing discrepancies
• Answering patient inquiries regarding billing and insurance coverage
• Staying up-to-date on coding guidelines and regulations

Licensed Vocational Nurse vs Medical Biller and Coder: Education and Training

Licensed Vocational Nurse (LVN):

• Completion of a vocational nursing program (12-18 months)
• Passing the National Council Licensure Examination for Practical Nurses (NCLEX-PN)
• Continuing education to maintain licensure

Medical Biller and Coder:

• High school diploma or equivalent
• Completion of a medical billing and coding program (few months to a year)
• Optional certification through organizations such as AAPC or AHIMA
• Continuing education to stay current with coding and billing guidelines