Medical Coding Frequently Asked Questions
What is medical coding?
Each year, in the United States, health care insurers process over 5
billion claims for payment. To ensure that these claims are processed
in an orderly and consistent manner, standardized coding systems are
essential.
The CPT (Current Procedural Terminology) is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. These health care professionals use these codes to identify services and procedures for which they bill public or private health insurance programs.
The ICD-9 is the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the United States.
What do medical coders do?
Those who specialize in coding are called medical coders, or coding
specialists. These technicians assign a code to each diagnosis and
procedure. They consult classification manuals and also rely on their
knowledge of disease processes. Technicians then use computer software
to assign the patient to one of several hundred “diagnosis-related
groups,” or DRGs. (The DRG determines the amount for which the
hospital will be reimbursed if the patient is covered by Medicare
or other insurance programs using the DRG system.) Coders may use
other coding systems and must use their vast knowledge of codes and
how the codes interact to determine the best and most accurate coding
for the procedure or service.
The medical coding specialist must have a thorough understanding of the content of the medical record to be able to locate information to support or provide specificity for coding. The medical coding specialist works as part of a team to achieve the best quality patient care.
What salary do medical coders make?
According to the AHIMA 2006 Salary Study, the average salary for coders
in various employment settings is $43,995.
According to the AHIMA, the average salary for coders by setting is
as follows:
Ambulatory Care, $43,262
Behavioral/Mental Health, $33,777
Consultant/Vendor, $58,488
Educational Institution, $40,522
HIM Specialty Setting, $46,007
Hospital, $44,064
Integrated Healthcare Delivery System, $45,297
Long-term Care, $39,084
Nonprovider Setting, $44,610
Physician Office, $43,995
Where do medical coders work?
Medical coders work in pleasant and comfortable offices in private
practices or hospital medical records departments. According to a
AHIMA 2006 Salary Study, hospitals are the primary work setting for
coders; however, they are also found in physicians' offices, as consultants,
in healthcare delivery systems, and in long term care and ambulatory
care settings.
This is one of the few health occupations in which there is little or no direct contact with patients. Accuracy is essential in this profession with close attention to detail.
According to the Occupational Outlook Handbook (OOH), medical records
and health information technicians usually work a 40-hour week. Some
overtime may be required in hospitals—where health information
departments often are open 24 hours a day, 7 days a week—technicians
may work day, evening, and night shifts.
What about certification and licensing?
Certification in coding results in the following credentials: Certified
Coding Associate (CCA), Certified Coding Specialist (CCS), and Certified
Coding Specialist-Physician-based (CCS-P). Two national organizations
offer certification in coding: American Health Information Management
Association (AHIMA) and American Association of Professional Coders
(AAPC). This medical coding program prepares you to take both these
exams.
According to the AHIMA Candidate Handbook for CCA, to be eligible to sit for the CCA examination, candidates must have earned a high school diploma from a U.S. high school, or have an equivalent background. Although not required, it is strongly recommended that candidates have at least six months experience in a healthcare organization applying ICD-9-CM and CPT coding conventions and guidelines, or have completed either an AHIMA- approved coding certificate program or other formal coding training program.
According to the AHIMA Candidate Handbook for CCS and CCS - P, to be eligible to sit for the more extensive CCS exam, candidates must have earned a high school diploma from a U.S. high school or have an equivalent educational background. Although not required, it is strongly recommended that candidates have experience in hospital inpatient (ICD-9-CM) and ambulatory care (ICD-9-CM and CPT) medical record coding. Results of previous examinations suggest that those with three or more years of related coding experience are more likely to pass.
What are the job opportunities for a medical coder? Because of the growing healthcare field, coders are in high demand. About 2 out of 5 jobs are in hospitals. The rest are mostly in offices of physicians, nursing care facilities, outpatient care centers, and home health care services. Insurance firms that deal in health matters employ a small number of health information technicians to tabulate and analyze health information. Public health departments also hire technicians to supervise data collection from health care institutions and to assist in research.
According to the U.S. Job Occupation Outlook, employment prospects should be very good. Employment of medical records and health information technicians is expected to grow much faster than the average for all occupations through 2014 because of rapid growth in the number of medical tests, treatments, and procedures that will be increasingly scrutinized by health insurance companies, regulators, courts, and consumers.
The majority of new jobs is expected in offices of physicians as a result of increasing demand for detailed records, especially in large group practices. Rapid growth also is expected in home health care services, outpatient care centers, and nursing and residential care facilities.
According to the American Health Information Management Association (AHIMA), health information coding will experience a “faster-than-average-job growth.”
What changes are the coding industry making?
Notable changes are being made in the coding industry. In short, the
new ICD-10 coding system is being developed as a replacement for ICD-9
coding. ICD-10 contains an increased number of codes and categories
that allow for a more specific and accurate representation of current
and future medical diagnoses and procedures. Our advanced coding program
teaches the new updated changes as they are released and keeps you updated
on the remainder as they occur through our news forums and monthly newsletters.
What training is involved?
Certified medical coders are trained in the anatomy and physiology of
the human body and disease processes in order to understand the etiology,
pathology, symptoms, signs, diagnostic studies, treatment modalities,
and prognosis of diseases and procedures to be coded.
In addition to your high school diploma or GED, you need to have completed a certificate program such as this one. You’ll study subjects such as medical terminology, anatomy and physiology, and laboratory and pathology. You’ll learn legal aspects of health information, coding and abstraction of data, statistics, database management, quality improvement methods, and computer training.
Our advanced coding program also trains you in 20 different medical specialties and gives you more coding practice than any other program today. For the best job prospects, we also recommend you have your basic industry certification (CCA credential) by taking the national exam with American Health Information Management Association (AHIMA). But don’t worry – we show you each step of the way what to do and how to do it. With our instructors at the other end of the phone or e-mail, you’re never completely alone.
What if I already know some of the material?
Not a problem. Many of our students have transferred from other schools
or are already in the healthcare field. You may have already had computer
training or medical terminology. Either way, you simply test out of
the areas you already know and continue on with the rest of your studies.
Because the program is self-paced, you can go as slow or as fast as
you like without having to wait on anybody.
How do I get started?
You can get started anytime. Our courses are available to you 24 hours
a day, 7 days a week, so you can go at your own pace and get online
anytime.
References:
AHIMA
American Health Information Management Association
Bureau of Labor Statistics, Occupational Outlook Handbook
http://www.bls.gov/oco/ocos103.htm
O-Net OnLine
http://online.onetcenter.org/link/summary/29-2071.00#menu
American Health Information Management Association
http://www.ahima.org/certification/documents/CCA-2007_000.pdf
http://www.ahima.org/membership/member_profile_data.asp
