Medical Coding Market: By Classification System (Healthcare Common Procedure Code System (HCPCS), International Classification of Diseases (ICD), Current Procedural Terminology (CPT)), By Component (Outsourced, In-House), By End User (Hospitals, Diagnostic Centers) and by Region (North America, Europe, Asia-Pacific, and Rest of the World)—Forecast to 2027

Medical Coding Market Forecast

The global medical coding market is expected to cross ~USD 29,738.19 million by 2027 at a CAGR of ~11.12% during the forecast period of 2021-2027.  

Market Overview:

Medical coding is the translation of significant medical information such as procedures, healthcare diagnostics, and medical services into universal medical alphanumeric codes. Medical coding is used to extract billable data from medical records to settle insurance claims and patient bills. The advancement and digitization in healthcare infrastructure have propelled the demand for medical coding. Additionally, the digitization of information records and billing systems has augmented the demand for medical coding across the globe. The rising mandate for automated medical billing is also likely to drive the medical coding market in the forecast timeline.

Increasing investment in the transformation of healthcare infrastructure, growing number of hospitals, modernization of lab facilities, and supportive government regulatory guidelines are driving the medical coding market. Additionally, the industry experts are aiming at business strategies such as product launches, partnerships, and association with local and regional players to enhance the product expertise in the various geographical locations. The medical coding market is estimated to grow over time owing to the increasing deployment of cloud infrastructure and the integration of electronic records for patient data management. The government authorities in the countries such as the US, India, China, and Japan are focusing on modernization and technological advancement of hospitals, research facilities, and medical institutions. These factors are fueling the medical coding market and are accounted to grow at a rapid pace in the projected timeline.  

COVID-19 Analysis

The outrageous spread of COVID-19 across the globe affected small enterprises, medium companies, and large organizations across the globe. However, the usage of internet-based solutions and services was leveraged during the pandemic. The medical coding demand surged during the viral outbreak leveraging workflows intended to rationalize vaccine designing, manufacturing, and commercialization. The pandemic has created opportunities for the market players. Medical coding systems are utilized in clinical trials and clinical data management during drug and therapy development. The pharmaceutical and biotechnology companies were involved in the development of vaccines generating a huge amount of data and laboratory records. These data are translated into medical records using medical coding. The urgency of data conversion into medical records generated opportunities for the market players.

Medical coding systems are used in managing bed information, healthcare providers records, vaccine information, and patient dosage details among others. In addition, the billing information for the admitted patients was fueled during the COVID-19 outbreak. The hospital management and clinics used medical coding systems to advance the billing and other payment procedures. The integration of digital platforms with diagnostic devices has leveraged the utilization of medical coding for the conversion of data from the equipment for medical analysis. The rise in COVID-19 cases have augmented the demand for technical support to advance medical services across the globe. Such practices have fueled the demand for medical coding during the coronavirus spread.

Market Dynamics

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  Increasing demand for advanced healthcare billing systems
  
  
  
  • Increasing geriatric population and rising prevalence of chronic diseases visit hospitals and diagnostic centers for regular checkups and treatment. The rising demand for instant, accurate and effective medical billing has strengthened the development of advanced medical coding systems. In addition, the emerging demand for compatible billing systems to deal with claim procedures and denial claims is expected to augment the market demand. Moreover, medical coding is gaining popularity due to the increasing acceptance of electronic bill systems for easy claim processing and tracking. Furthermore, the growing integration of cloud-based medical billing solutions has provided remote access and precise handling of data to the users. Such prospects have grown over the years and is accounted to accelerate the market demand in the upcoming years.
  
  
  • Companies are collaborating to advance the billing systems and provide retail experiences to the users. For instance, in October 2021 Blue Shield of California (US) collaborated with Google Cloud to evolve medical billing by integrating technologies such as AI to offer real-time reimbursement information and reduce the administrative burden for providers and patients. Additionally, the Delhi government (India) is expected to launch a cloud-based health management system by 2022. The launch is expected to leverage the medical services for the local individuals.
  
  
  
  


• Increasing adoption of telehealth services for outpatient care


• Growing adoption of medical practice management systems

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  Concerns pertaining to bad documentation or missing documentation
  
  
  
  • Bad documentation about the required solution by the healthcare service providers leads to misplacement of the related documents. Missing documentation leads to the formation of different solutions that might affect the reputation of the company. In addition, the coder might miss or select wrong codes based on the documentation provided resulting in technical errors. Poor documentation may also hamper the performance of the coder further hampering the quality of the software. These factors are accounted to limit the market demand over the forecast timeline.
  
  
  
  

• Healthcare Common Procedure Code System (HCPCS): It is a type of coding system with a collection of codes that signify procedures, products and services, and supplies for assisting healthcare professionals and individuals registered in private health insurance programs


• International Classification of Diseases (ICD): It is a type of diagnostic tool that is used for clinical applications, health management, and epidemiology. This type of medical coding classifies and monitors causes of injury and categorize mortality data from death certificates


• Current Procedural Terminology (CPT): It is a set of codes that defines the guidelines and descriptions intended to define services and procedures carried out by physicians and other medical experts

• Outsourced: Outsourcing medical coding is contracting with other organizations or third parties to do the company's medical coding instead of the employed workforce


• In-House: The in-house method aims to train internal employees to code for health services within an organization

• Hospitals: Hospitals use medical coding for streamlining their processes from diagnostic procedures to billing systems


• Diagnostic Centers: The diagnostic centers apply medical coding to enhance their diagnosis procedures and analytical abilities


• Others: Other segment consist of ambulatory centers, laboratory units, and research facilities. In ambulatory centers, the medical coding is utilized to generate and manage clinical bills, whereas in labs the coding system is used to manage the inventory and the records of the clinical trials and patents.

• Increasing integration of electronic health record and electronic medical record software across the region is driving the North American medical coding market


• North America held the largest medical coding market share in 2020, owing to the rising capitalization in the transformation of healthcare infrastructure, growing establishments of healthcare digitization organizations, increasing government interests in developing new technologies for diagnosis, treatment, billing, and record management. Other factors strengthening the medical coding market demand include growing communication with physicians, nurses, and other healthcare professionals to categorize the services for patient. Integration of HCPS, CPT, and ICD-10 CM standardized codes for accurate reflection of services is gaining attention among the healthcare sector. In addition, the growing demand for advanced and smart healthcare systems is accelerating the demand for medical coding across the region.

• Advancements in healthcare infrastructure are fueling the Asia-Pacific medical coding market


• The Asia-Pacific medical coding market is driven by the modernization and privatization of healthcare technology, digitization supportive government policies, augmenting investment in healthcare IT infrastructure, growing adoption of preventive health programs, and accelerating adoption of medical management systems. These dynamics are anticipated to strengthen the medical coding market demand in the considered timeline. Moreover, increasing capitalization in drug and vaccine development is accounted to accelerate the medical coding market throughout the region.

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  Increasing demand for medical coding system for biomolecule purification
  
  
  
  • The medical coding system is consistently evolving with growing medical diagnostics and treatments across the globe. Increasing investment in enhancement of hospital infrastructure and growing demand for quick and precise clinical billings is driving the medical coding market. Moreover, medical coding providers are embracing various business approaches to propel their market growth. The companies are capitalizing on developing efficient technologies such as artificial intelligence integrated medical codes to advance the functioning of hospitals, ambulatory centers, and diagnostic units. Moreover, the industry players are focusing on various business strategies such as acquisitions and mergers, upgrading services, fundings, and partnering with other regional or local players to expand their global footprint.
  
  
  
  

• Startek Health (US)


• Oracle Corporation (US)


• Verisk Analytics (US)


• Aviacode, Inc. (US)


• Parexel International Corporation (US)


• Maxim Health Information Services (US)


• Precyse Solutions, LLC (US)


• AGS Health (India)


• GeBBS Healthcare (India)


• Medical Record Associates LLC (US)


• 3M (US)


• Dolbey Systems Inc. (US)


• Semantic Health (Canada)


• MRA Health Information Services (US)


• Nuance Communications Inc. (US)


• Optum Inc. (US)


• Talix (US)


• nThrive (Precyse Solutions LLC) (US)


• The Coding Network LLC (US)

• In September, 2021 AGS Health (US) acquired EZDI, Inc. (US), a modern computer-assisted coding organization headquartered in the US. The acquisition aims to enhance company's AI-based clinical documentation and medical coding


• In August 2021, GeBBS Healthcare (US) acquired a US-based organization, Aviacode Medical Coding & Coding Audit Services. This acquisition will strengthen the company's medical coding product portfolio providing the competitive edge in Health Information Management (HIM) space


• In March 2021, Athenahealth, Inc. (US) launched a medical coding solution, athenaOne Medical Coding to provide high-quality coding support to the medical staff and other medical service providers


• In November 2020, Diagnoss Inc. (US) launched an AI-based coding assistant to minimize the coding errors. The launch aims to improve clinician’s accuracy and provides real-time feedback to medical practices during the administrative process


• In September 2020, Semantic Health (Canada) launched medical coding and auditing platform for improved care delivery, review of clinical documentation, reducing revenue cycle inefficiencies, and enabling actionable use of unstructured data

• The study covers the existing short-term and long-term market effects and helps decision-makers draft short-term and long-term plans for businesses by region. The report covers major regions in North America, Europe, Asia-Pacific, and the Rest of the World. The report analyzes market drivers, restraints, opportunities, challenges, Porter's Five Forces, value chain, and impact of COVID-19 on the market.

• Healthcare Common Procedure Code System (HCPCS)


• International Classification of Diseases (ICD)


• Current Procedural Terminology (CPT)

• Outsourced


• In-House

• Hospitals


• Diagnostic Centers


• Others