Medical Coder - How to Become a Medical Coder

Medical Coder

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Medical Coder Job Description

 

Medical coders are responsible for reviewing medical records and assigning these codes as indicated. This ensures that the health care providers they work for are properly paid for these services rendered. Coding all of this information correctly is not easy. It requires the coder to carefully read the doctor’s and nurse’s notes to determine precisely which services the patient received. The coder is required to understand private payer insurance policies as well as government regulations for accurate billing and coding.

Whenever you visit your doctor, his or her office personnel will bill your medical insurance provider with a statement that contains CPT codes. CPT stands for Current Procedural Terminology, and is used to describe your office visit and provide a diagnosis code of the condition that was treated. Whether you get blood tests taken or an X-ray performed, all of these services will be represented by CPT codes on your bill.

There is a CPT code for every type of health care service provided by health care facilities and practitioners, amounting to almost 10,000 different variations. There are another 14,000 codes for medical diagnoses. These are international classification of diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. In addition, there are Healthcare Common Procedure Coding System (HCPCS) Level II codes specific to medical supplies and services.

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Responsibilities

 

Codes are constantly changing, requiring coders to keep up-to-date on the latest rules and interpretations. Coders are required to have more than a casual understanding of medical terminology and anatomical terms. Many employers require all their coders to hold certification as a requisite of employment.

Responsibilities common to medical coders include:

  • Translating medical procedures into the proper codes.

  • Verifying patient insurance coverage.

  • Managing collections and unpaid accounts through making payment arrangements and following up with patients.

  • Creating and managing the organization or facility's Account Receivable reports.

  • Working directly with insurance companies, patients, and providers to process claims.

  • Contacting collections agencies and determining legal options in the event of non-payment.

  • Coordinating with insurance companies in the event of payment discrepancies.

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Skills

 

A medical coder must be extraordinarily detail-oriented. The coder is required to review the patient’s chart closely to determine the diagnosis and to carefully itemize every service that was provided. Any overlooked services will not be paid to the provider, resulting in lost revenue. Should the coder input an inaccurate code, his or her employer may have to refund any over payments or face legal charges for inaccuracies in billing practices.

It is estimated that incomplete or inaccurate coding costs the average health care provider several thousand dollars a year in missed payments. Providers run the risk of losing large amounts of revenue without competent coders.

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Working Conditions

 

Just about every type of health care facility will have medical coders working for them. This includes doctor’s offices, hospitals, health care systems and surgery centers. Experienced coders may have the opportunity to work at home as a contract worker or through an employer that approves of telecommuting for certain employees.

 


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How to Become a Medical Coder:

 

The position of the coder is becoming more valued because physicians and hospitals depend on the accuracy of coding to receive proper reimbursement. Previously, coders learned their trade while working on the job. Now there is a certification procedure for a certified professional coder (CPC). This designation lets potential employers know that you have a certain level of coding skill and competency

 

1. Earn an Associate's Degree in Medical Coding (2 Years)

 

Aspiring medical coders should first search for a program accredited by either the American Health Information Management Association (AHIMA) or the American Academy of Medical Coders (AAPC). Programs are typically by local community colleges, technical schools, and universities, and can be completed in multiple formats, including in-person, online, or a combination curriculum.

Both certificate and degree-seeking programs are offered, but those who complete at least an associate's degree will enjoy more career opportunities than those holding only a certificate.

 

The preparation timeline below provides an example medical coding associate's curriculum:

 

Year Example Courses

Year I

 

  • Healthcare Delivery Systems
  • Medical Terminology
  • Basic Diagnosis Coding Systems
  • Basic Procedure Coding Systems
  • Introduction to Health Information Management
  • Introduction to Pathophysiology
  • English I
  • College Algebra
  • Life Science
  • Electives

Year II

  • Anatomy and Physiology
  • Medical Assisting
  • Reimbursement Methodologies
  • Healthcare Software Applications
  • Introduction to Pathophysiology
  • Introduction to Pharmacotherapy
  • Public Speaking
  • Electives

 

2. Become a Certified Professional Coder (CPC)

 

The American Academy of Professional Coders (AAPC) administers the exam for the Certified Professional Coder (CPC) credential.  CPCs are recognized for their expertise in reviewing and designating precise medical codes for services, diagnoses, and procedures carried out by physicians. The credential tells employers that the coder has mastered their craft and possesses the skills and knowledge necessary for more advanced levels of employment.

The CPC exam costs $325 and consists of 150 multiple-choice questions throughout a 5 hour and 40 minute window covering the following topics:

  • 10,000 Series CPT - 60,000 Series CPT

  • Evaluation and Management

  • Anesthesia

  • Radiology

  • Laboratory / Pathology

  • Medicine

  • Medical Terminology

  • Anatomy

  • ICD-9-CM Volumes 1 & 2

  • HCPCS Level II

  • Coding Guidelines

  • Compliance and Regulatory

 

Learn More about the CPC Exam

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Salary Outlook

Title Company Location Posted
12.05.2016
VCU Health System's Business Office - Coding/ Billing is seeking a full time Medical Coder II This person translates authenticated provider documentation and/or reports and makes the determination as to the appropriate CPT, ICD-9/10 codes for...
12.05.2016
Cape Cod Healthcare is the leading provider of healthcare services for residents and visitors of Cape Cod. With more than 450 physicians, 4,700 employees, and 1,100 volunteers, Cape Cod Healthcare operates two-acute care hospitals, the Cape's...
12.05.2016
Abstract, code procedure and diagnosis codes utilizing ICD-10-CM and CPT standards form each dismissed patient's medical record. Responsibilities: Abstracts in detail and completes case abstract form the patient's medical records. Codes...
12.05.2016
GENERAL DESCRIPTION OF POSITION Briefly state the chief objective of this position and age group(s) to be served (if applicable) Translates authenticated provider documentation and/or operative reports and makes the determination as to the...
12.05.2016
Briefly state the chief objective of this position and age group(s) to be served (if applicable) Translates authenticated provider documentation and/or operative reports and makes the determination as to the appropriate CPT, ICD-9/10 codes for...
12.05.2016
Compiles, verifies, and files medical records for facility patient activity. Performs clerical duties required by the medical record keeping function. Retrieves record information in accordance with hospital/departmental procedures. Compiles...
12.05.2016
Boston Medical Center (BMC) is more than a hospital. Its a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New...
12.05.2016
Boston Medical Center (BMC) is more than a hospital. Its a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New...
12.06.2016
Care Site Description Description The Medical Coder is responsible for interpreting clinical documentation and translating that information into a coding classification, in accordance with official coding and reimbursement guidelines....
  1. Medical Coder II Richmond, VA VCU Health System
    VCU Health System's Business Office - Coding/ Billing is seeking a full time Medical Coder II This person translates authenticated provider documentation and/or reports and makes the determination as to the appropriate CPT, ICD-9/10 codes for...
  2. Medical Coder-MACC Hyannis, MA Cape Cod Healthcare
    Cape Cod Healthcare is the leading provider of healthcare services for residents and visitors of Cape Cod. With more than 450 physicians, 4,700 employees, and 1,100 volunteers, Cape Cod Healthcare operates two-acute care hospitals, the Cape's...
  3. Medical Coder Northfield, MN Northfield Hospital & Clinics
    Abstract, code procedure and diagnosis codes utilizing ICD-10-CM and CPT standards form each dismissed patient's medical record. Responsibilities: Abstracts in detail and completes case abstract form the patient's medical records. Codes...
  4. Medical Coder III Richmond, VA VCU Health System
    GENERAL DESCRIPTION OF POSITION Briefly state the chief objective of this position and age group(s) to be served (if applicable) Translates authenticated provider documentation and/or operative reports and makes the determination as to the...
  5. Medical Coder III Richmond, VA VCU Health System
    Briefly state the chief objective of this position and age group(s) to be served (if applicable) Translates authenticated provider documentation and/or operative reports and makes the determination as to the appropriate CPT, ICD-9/10 codes for...
  6. Medical Coder (FT) Valir Rehab Hosp Oklahoma City, OK Valir Health
    Compiles, verifies, and files medical records for facility patient activity. Performs clerical duties required by the medical record keeping function. Retrieves record information in accordance with hospital/departmental procedures. Compiles...
  7. Medical Coder II 40 hrs, Days SEIU (Remote) Boston, MA Boston Medical Center
    Boston Medical Center (BMC) is more than a hospital. Its a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New...
  8. Inpatient Medical Coder II 40 hrs, SEIU (Remote) Boston, MA Boston Medical Center
    Boston Medical Center (BMC) is more than a hospital. Its a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New...
  9. Coder - Inpatient Billings, MT St Vincent - SCL Health
    Care Site Description Description The Medical Coder is responsible for interpreting clinical documentation and translating that information into a coding classification, in accordance with official coding and reimbursement guidelines....