As the healthcare industry grows, the need for specialized employees is increasing. Becoming a medical coder is a smart move. It's a rewarding, in-demand position that doesn't take years of higher education to obtain.
Medical coders play an important role in the healthcare system. These coders are responsible for reviewing medical records and entering correct codes for services rendered so that health insurance companies reimburse healthcare providers.
Are you interested in becoming a medical coder? It's a great time to pursue a medical coding career. To learn more about the process, check out this handy guide.
What is Medical Coding?
Medical coding is the translation of different medical services into special alphanumeric codes. Each service is represented by a universal code. These services can include:
- Examinations and diagnosis
- Use of medical equipment
- Medical procedures
- Radiologic and laboratory testing
The specific code associated with each service ensures that no billing mistakes are made. Medical coders ensure that the right codes are applied during the billing process so the right amount of reimbursement comes back to providers.
Medical statements reviewed by coders are assigned codes that use different classification systems. These include:
- CPT® (Current Procedural Terminology)
- ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification)
- HCPCH Level II (used mainly for supplies, products, and services that aren't included in other codes)
Coders have a thorough understanding of all the information contained in medical records. In addition to services rendered, this information includes test results and physician's notes. All of this documentation is used by the coder to assign the proper codes for claims that are to be paid by insurance providers.
Importance of Competent Coding
Hospitals, clinics, and physicians are dependent on medical coders to receive the correct reimbursement for their services. This makes medical coding an invaluable skill.
Coding can be complicated and requires special knowledge and attention to detail. Coders must review physicians' and nurses' notes in order to correctly determine what services a patient received. In addition to understanding medical services, they also must know government regulations and private pay policies in order to accurately code for billing.
Coding that is not complete or accurate can financially hurt healthcare providers. Physicians and other providers stand to lose thousands in lost payments annually due to coding mistakes. In addition to revenue loss, coding errors could potentially impact patient care directly. Medical coders with proper training ensure these costly mistakes don't happen.
How to Become a Medical Coder
Now that you know what medical coding is, it's time to find out how you can become a coder. While you may be able to get a position as a medical coder without a certification, you probably won't have the same opportunities as someone who has received proper training.
Becoming a skilled coder requires a solid education and intensive training. Coders must know medical terminology and have a thorough understanding of anatomy. It's essential for them to know every aspect of the codes they'll be using so their claims are accurate. They also must know:
- Which codes to use for specific insurance plans
- Government regulations
- Private pay regulations
Without understanding all of this, it would be difficult for a coder to be compliant with regulations and accurately code for provider reimbursement. This is why education and certification are so valuable.
Coders may also find themselves advising healthcare providers on which codes to use in order to comply with federal mandates. They may need to be a voice for the patients or the provider on medical necessity and coverage issues that may arise with insurance carriers.
The First Steps
All medical coders must have a high school diploma or an equivalent. Next, obtaining the Certified Professional Coder (CPC®) credential is the standard for professional medical coders. As a coder gains experience, there are other areas they can move into, including:
- Certified Professional Compliance Officer
- Certified Professional Medical Auditor
- Certified Physician Practice Manager
The jobs are increasing as healthcare becomes more complex and needs better business management. The opportunity to branch into other coding-related jobs is another motivation to get certified and become a part of the medical coding profession.
Many people opt for a certification program. This type of education is focused so that students can enter the workforce quickly. Certification programs teach:
- Medical coding and billing
- Electronic medical records practices
- Ethics, laws, and confidentiality
- Managed care
- Clinical, anatomical, and physiological terminology
- How to submit claims to insurance companies
- How to process bills
- Billing software navigation
- Insurance plan navigation
Some opt for an associate degree program which covers all of the above in addition to general education courses. While having a degree isn't required to become a medical coder, it certainly helps you stand out among other applicants. Having an associate degree benefits you by:
- Providing a solid knowledge base
- Giving you strong job skills
- Giving you better earning potential
Associate degree programs for medical coding offer a supportive environment. Instructors offer guidance to keep you on track. Additionally, these programs often have career services guides that help prepare you for interview success.
Classes taken while earning an associate degree prepare students for certification exam success. This is important, as passing this exam will give you the Certified Professional Coder credential.
Exam preparation is essential, so an education that covers all subjects involved is a huge plus. You can view here for more information on an associate degree for medical coder professionals.
Passing your exam and earning your Certified Professional Coder credential from AACP (American Academy of Professional Coders) is a huge step forward in your pursuit of a coding career. This is the standard for coders and is nationally recognized by healthcare providers, government organizations, and physician societies.
A Great Job in a Growing Industry
The healthcare industry is expanding and will continue to do so. As billing and recordkeeping become more complex to meet the needs of increasing numbers of patients, the need for accurate coding will remain in high demand. This means there has never been a better time to learn more about becoming a medical coder.