Medical coding is an important part of our overall healthcare system. It ensures that all records are kept in a uniform way across the board. The system itself, the ICD-10, is a vast collection of numbers and letters. Everything, from diagnostics to equipment, has a code and these codes are required for the systematic submission of insurance claims. This submission has long been a problem in the past.
Before the ICD-10 system came into play, insurance claims were submitted late or incorrectly more often than not. What this meant was that they would be returned to the healthcare provider who would have to resubmit them before being reimbursed. This was time consuming and frustrating.
Naturally, even with the new medical coding system, there are significant complexities involved. Some 75,000 different codes exist just for physicians’ practices. This is why they now usually hire a specialized medical coder, who is responsible for the management and maintenance of the system. Some practices do this in house, whereas others outsource it. In fact, medical coding is a popular at home working opportunity as well.
One of the reasons why healthcare practices outsource their medical coding is because it saves them money overall. They do not have to pay for a member of staff and for the training. Instead, they only pay a percentage to the coding company that is reflective of how many medical bills were submitted. It is vital, however, that these practices choose the right company to outsource to, which is one that guarantees the skill of the coders. Anyone who takes on this role should have CPC certification as a minimum. This ensures the coders have sufficient knowledge about physiology, anatomy, and medical terminology, which are all essential elements of the coding system.
Learning to Be a Coder:
The process of becoming a coder is time consuming and quite tedious. It is also vital to the management of the healthcare system. These professionals must be able to understand complex medical terminology and translate that into its universally accepted ICD-10 code. They must also be able to do so in a quick and efficient manner, so that bills can be paid on time.
This field is incredibly specialized, which is why it is now expected for coders to have completed a college degree in order to do the work. Ultimately, coding medical bills properly has a direct impact on the healthcare outcomes of individual patients. Hence, it is a vital role within the industry itself.
Medical Coding as a Career:
Working as a medical coder means working with patients’ computerized medical records. On these records, all services that a healthcare professional has rendered, including medical procedures and diagnostics, are entered. The code has been designed to ensure that insurance companies understand what payments have to be made, and it also gives healthcare professionals insight into the patient’s medical history. This is important if they have been hospitalized or moved between healthcare practices, for instance.
Medical Coding Background:
As stated, a college degree, which is at the associate degree level, is now required for someone to become a medical coder. During this degree, coders enroll in classes focusing on medical terminology, physiology, and anatomy. They also learn about computer database management, healthcare ethics, pharmacology, abuse and fraud, and laws pertaining to insurance compliance. Furthermore, students learn about the ICD-10 coding system, the Healthcare Common Procedure Coding System and the Current Procedure Technology codes. Since the implementation of ICD-10, more and more students now opt to study this at bachelor’s degree level and some even move on to master’s degrees.
Upon completing their education, medical coders have the option of earning additional credentials. The Certified Coding Specialist certification is particularly popular. Those who have worked within different parts of the healthcare system, such as surgical suites, general admissions, and emergency services find this certification particularly beneficial. Medical coders can also obtain Physician-Based Certification, which is suitable for those wishing to work in medical facilities such as physicians’ offices or specialized clinics.
Becoming a Registered Health Information Technician (RHIT)
The next step in the career of a medical coder is to become an RHIT. This usually requires them to hold a bachelor’s degree, as well as professional experience within a hospital. Someone who is an RHIT may eventually move on to management positions. They are responsible for ensuring that the setting’s computer system have fully up to date and accurate medical records. Furthermore, they take responsibility for the coding of medical procedures and disease processes that are to be reimbursed by insurance companies.
The Different Medical Coding Systems:
The CPT codes – Current Procedure Terminology – were developed by the American Medical Association (AMA). These codes are numerical and each has five numbers. They refer to the procedures that are completed in physician’s offices only. The Healthcare Common Procedure Coding Systems (HCPCS) was also developed by the AMA. This system is used for all procedures, services, supplies, and products that are provided outside of general outpatient procedures, for which not CPT code is in place. Both the CPT and the HCPCS are updated regularly.
The most important system, however, is the ICD. This was developed by the World Health Organization (WHO) in the 1970s. For years, medical services around the world followed the ICD-9, but this has now been replaced by the ICD-10. This system is particularly important for public disease and public health, but most clinical settings in the country now use them.
Working as a Medical Coder:
Usually, a medical coder works full time, around 40 hours per week, if they work for a physician’s office, a nursing home, a clinic, or an outpatient medical center. If they work in 24/7 facilities such as hospitals, they may also work shifts, covering mornings, afternoons, or nights. In specialty clinics and some hospitals, it is also common for people to specialize in medical coding relating to a certain field, such as hematology, emergency medicine, or cardiology.
Coders can also work for law firms, insurance companies, home healthcare facilities, and consulting firms. Sometimes, an advanced degree is required for these roles, with classes in business and administration often being required. They may also work from home, often while being employed by any of the aforementioned medical facilities or businesses. Starting salaries are around the $38,000 mark, although this varies greatly depending on someone’s education, geographical location, experience, and specialization.