Medical Coding

 MEDICAL CODING

You’re interested in capitalizing on the promising growth in the healthcare industry, but you’re not interested in providing direct patient care. It’s no surprise you’re interested in becoming a medical coder.

Medical coders play an important role in the healthcare ecosystem, helping process and organize the massive amounts of medical data produced every day. You’re intrigued by the behind-the-scenes nature of the position and feel like you’d enjoy the daily duties that come with it.

Now you need to gain a better understanding of the road ahead. We’ve compiled a variety of important information to break down the process and provide you a guide on how to become a medical coder.

How to become a medical coder: 5 straightforward steps

Medical coders play an important role in the healthcare system. Whenever you have a doctor’s appointment, the physician or nurse records notes about what procedures took place or what was diagnosed. Using their knowledge of thousands of medical codes, payment policies and government regulations, medical coders take medical records and code them for billing and insurance purposes.

Without them, the medical field wouldn’t know what to charge for each procedure, and insurance companies wouldn’t be able to cover your care properly. Now that you know a little more about what the position, read ahead to learn how you can become one.

Step 1. Meet the basic prerequisites

First thing’s first: To become a medical coder, you will need a high school diploma or equivalent. You also will need to pass a background check. Applicants with a criminal history involving drug offenses or sexual crimes will most likely be turned away.

Step 2: Complete medical coding training

Next, you’ll need to start training. There are no formal education requirements to become a medical coder. Most employers are seeking candidates with a postsecondary certificate, with some requiring an Associate’s degree, according to the Bureau of Labor Statistics (BLS).¹

Earning a Medical Coding Certificate is a smart step for those who want to enter the field with a solid foundation of knowledge. Some programs, like the one at Rasmussen College, can be completed in as few as 9 months.² Here’s a taste of some of the courses students take:

Medical coding courses:

• Coding Foundations
• ICD-CM Coding
• ICD-PCS Coding
• Ambulatory Care Coding
• Revenue Cycle and Billing

Gaining practical training and a solid understanding of the field will allow you to hit the ground running as soon as you land your first medical coding job. You can even complete your medical coding training online so you can fit it into your already busy schedule.

Step 3: Obtain your medical coding certification

Graduating from a Medical Coding Certificate program is an impressive accomplishment. But your work isn’t quite over yet. The next step is getting certified.

This credential shows employers you’re a dedicated medical coder who has demonstrated all of the important skills required to succeed on the job. The choice to specialize is ultimately yours, but the BLS states that it can have a positive impact on your job prospects.¹

There are a few certifications for medical coders to choose from.

Common medical coding certificates:

• Certified Professional Coder (CPC)
• Certified Coding Associate (CCA)
• Certified Coding Specialist (CCS)

Once you gain some experience in the field, you may decide you’d like to specialize your coding career. If so, you might consider pursuing specialty medical coding certification in an area such as ambulatory care, anesthesia, family practice, general surgery or many others.

Step 4: Brush up on in-demand medical coding skills

Before you start applying for medical coding jobs, it’s helpful to know exactly what employers are looking for so you can be prepared and put your best foot forward. Being a medical coder requires a balance of hard and soft skills.

We used real-time job analysis software to examine nearly 30,000 medical coding jobs posted over the past year.³ This data helped us identify the top skills employers are seeking in medical coder candidates. Here’s what we found.

Top technical skills for medical coders³:

• Health information technology (HIT)
• ICD-10
• CPT coding
• Inpatient coding
• Customer billing
• Anatomy
• Outpatient coding
• Physiology
• HCPCS coding
• Medical terminology

This list may seem intimidating at first glance, but rest assured that these are precisely the types of skills taught in a Medical Coding Certificate program. But in addition to this technical training, there are some soft skills that help medical coders succeed.

Top transferable skills for medical coders³:

• Communication
• Computer literacy
• Collaboration
• Research
• Microsoft Office
• Attention to detail
• Organization

If you can identify with some of the traits above, you may be a natural fit for the field. Your medical coding training will help you round out your skills so you’re prepped for success.

Step 5: Find a job

The next step to becoming a medical coder is to land your first job. The BLS projects medical coding jobs to increase 11 percent through 2028.¹ This is more than twice the average for all occupations. This is great news for a job seeker like yourself.

When you’re looking for medical coding jobs, keep in mind the type of environment you’d like to work in. Would you prefer the bustle of a busy hospital or the relative serenity of a physician’s clinic? You have plenty of options for a medical coding career. Once you get your foot in the door and start gaining experience, you can begin considering future advancement opportunities.

Medical coding is a little bit like translation. Coders take medical reports from doctors, which may include a patient’s condition, the doctor’s diagnosis, a prescription, and whatever procedures the doctor or healthcare provider performed on the patient, and turn that into a set of codes, which make up a crucial part of the medical claim. HCC Medical coding

professionals help ensure the codes are applied correctly during the medical billing process, which includes abstracting the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.

THREE TYPES OF CODE YOU’LL HAVE TO KNOW

1. ICD : The first of these is the International Classification of Diseases, or ICD codes. These are diagnostic codes that create a uniform vocabulary for describing the causes of injury, illness and death. This code set was established by the World Health Organization (WHO) in the late 1940s. It’s been updated several times in the 60-plus years since it’s inception. The number following “ICD” represents which revision of the code is in use.
2. CPT: Current Procedure Terminology, or CPT, codes, are used to document the majority of the medical procedures performed in a physician’s office. This code set is published and maintained by the American Medical Association (AMA). These codes are copyrighted by the AMA and are updated annually.
3. HCPCS : HCPCS is also the official code set for outpatient hospital care, chemotherapy drugs, Medicaid, and Medicare, among other services. Since HCPCS codes are involved in Medicaid and Medicare, it’s one of the most important code a medical coder can use.

Billing and coding connects the seller of goods and services (providers and facilities) with the third party who pays for those services. It is the Bill for Goods or Services Rendered. In all commercial activities except healthcare, there is no third-party payer. The consumer is also the payer so there is no need for billing and coding.

Here are some additional facts.

1. Billing and coding is extremely cumbersome, complex and ever changing. Thus, it requires a large number of people whom patients indirectly pay for, people who do nothing to improve patients’ health.
2. Example is the ICD-10 code book which has 68,000 codes used for billing roughly 1400 sickness or injures that occur in humans. Code like: W55.21 (bitten by a cow); W61.33 (pecked by a chicken); V00.01 (pedestrian on foot injured in collision with roller blader); Z63.1 (problem with in-laws); and my personal favorite, Y92.146 (injured at a swimming pool within a prison).
3. Almost all fraud in healthcare occurs through the billing and coding system: up-coding, phantom coding, etc. That’s many billions expended not on patient care first taken by the fraudulent entity, and then spent by the government trying to find the embezzler and then claw back the money.
4. The third largest department in any hospital, whose salaries you pay for, is Billing and Coding.

Now, imagine if the consumer (aka patient) paid the provider directly–no billing and coding. Think how many billions of healthcare dollars could be saved or spent efficiently, i.e., on patient care, rather than wasted on billing and coding.

Medical Coding: It summarizes the all medical information and translates into the alphanumeric codes.

Medical Billing: It involves a healthcare professional submitting and following, claims with healthcare insurance companies to receive payment respond to services rendered.

Specific reasons why both are important.

1. Important to submit medical claims with insurers and bills for insurers and patients.
2. Medical coding ensures that insurers have all the diagnostic codes required for appropriate payment.
3. Keep accurate records of patient’s symptoms, medical histories, medical procedures, treatments and lot more.
4. In this profession, workers are responsible in charge of processing patient data such treatment records and related insurance information.
5. It also involves front office administrative role, back office working criteria and all documentation as well.