Ace the ANCC Exam 2025 – Ignite Your Nursing Superpowers!

The selection and submission of billing codes to third-party payors primarily falls under the responsibility of a certified coder. This professional possesses the necessary expertise and training to accurately choose the appropriate codes based on the services provided to patients. They ensure that the codes align with current medical coding standards and regulations, which are crucial for proper reimbursement from insurance companies.

In situations where billing might be affected, factors such as changes in insurance carriers, errors in coding literature, or updates in evaluation and management criteria typically do not directly assign responsibility for selecting and submitting billing codes. Instead, these factors may influence the coding process or the information available to certified coders, but the ultimate accountability for selecting and submitting the correct coding lies with the certified coder. This highlights the importance of professional training and familiarity with evolving coding practices in the healthcare domain.