Healthcare or Medical field offers a plethora of career opportunities beyond being a doctor or working only in clinics or hospital settings. Let’s start to know what exactly medical coding in health care sector is, Medical Coding is to translate medical information into short codes for documentation of health records and medical billing purpose. American Academy of Professional Coders defines medical coding “The transformation of healthcare diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes.”
Medical coding is a system containing number and letter labels that are unique for each diagnosis, symptoms, and cause of death in human beings. Medical coding aids to summarize complicated medical reports into efficient, data-friendly codes. Coding usually permits uniform documentation between medical and health care facilities.
In Present scenario, Medical coding is a fast-growing industry having great demand and offering good Job opportunities. According to the report stated by U.S. Bureau of Labor Statistics, Job positions for the certified medical coders will increase by 22 percent through the year 2022.
Who are Medical Coders?
A medical coder is a professional whose main responsibility is to translate the services provided during a patient’s visit. A medical coder reviews the report and extracts relevant information from it to assign the proper numeric or alphanumeric codes based on the documentation.
Before we enter the matter of medical coder’s role, it’s necessary to have a thorough understanding of medical coding history. Medical coding and documentation of records tracked back in crude form way back from almost 17th century. From England to all the countries it is now rapidly evolved during the past few decades. According to the New York Times – first medical coding system was introduced by French physician and statistician Jacques Bertillon in the late 1800s known as Bertillon Classification of Causes of Death which was used to classify and track mortality.
Medical coders are aware of human anatomy, physiology, medical procedures, and the payer rules and claim policies. Medical coders take the medical reports from doctors, that may include the patient’s disease condition, diagnosis, a prescription, and medical procedures suggested by the doctor or healthcare provider performed on the patient, and translate into a set of codes making up a crucial part of the medical claim. Medical coding also allows for uniform documentation between various medical facilities.
Medical coding involves codes such as CPT, ICD, HCPCS, DRG and modifiers. These codes are important for communication in describing the medical procedures and medical billing purposes. Medical Coding is also equally important in medical claims.
Why is Coding Necessary?
Why do we code medical reports? Let’s start answering the question. Medical coding is an important component and a powerful tool in the medical facilities and health care industry worldwide.
Medical coding plays a key role in modern healthcare operations for patient safety, accuracy and fast billing process, documentation purpose, maintain patient confidentiality and other required efficient operations. Medical coding collects information about disease diagnosis, treatment methods, medications and necessary equipment and then translates them into relevant alphanumeric codes. Medical coding is an important step required to submit medical claims with insurers and bills for insurers and patients.
Coding is also critical for demographic and statistical analysis of disease prevalence, diagnosis, treatment outcome.
Types of Codes, You Must Know!
There are three sets of code which are used by medical coders on daily basis. Let us briefly look into those codes:
- ICD codes
ICD Codes are the International Classification of Diseases codes. ICD-10 is the tenth version of which is currently in use. ICD codes are usually in use by doctors, and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care. These ICD Codes provide detailed information of diagnostic specificity and morbidity classification.
CPT refers to Current Procedural Terminology Code which is used to report medical, surgical, and procedural code to the entities such as health insurance companies or organizations. They are used in with relevance to ICD-10 during electrical medical process. It is divided into 3 subcategories:
HCPCS is known as Healthcare Common Procedure Coding System and is the official code for certain hospital outpatient care, chemo drugs and other medical services or procedures. HCPCS Codes include reliable medical devices, prosthetics, ambulance rides, and certain medications or drugs.
The HCPCS code set is divided into two levels. Level I is identical to the CPT codes and Level II is a set of alphanumeric codes that is again divided into 17 sections, each based on an area of specificity like medical and clinical laboratory or rehabilitative services.
Just like CPT codes, each HCPCS code should correspond with a diagnostic code that equally justifies the medical procedure. It is the ultimate responsibility of coder to make sure whatever outpatient procedure is detailed in the doctor’s report makes sense with the listed diagnosis, typically described through an ICD code.
Now that you’ve got a better idea of medical coding types of codes, and what does a medical coder do? Let’s start exploring the importance of certified coding professionals.
Who hires medical coders?
Almost all the health care providers like hospitals, clinics, nursing homes, insurance agencies, and other health facility organizations use coded documentation and records by qualified medical coders. Employers usually prefer to hire CPC certified candidates. Hence medical coders need to grab the opportunity in the corporate side of healthcare earning medical coding and billing certification to cope up with the competitive edge in the current job market. Certification assures employers in choosing right candidate having professional skills and qualifications perform his or her duties well. Let’s get a great start with certified professional coding to flourish in medical coding field.
Certified Professional Coder (CPC®)
A certified professional coder, in short CPC is responsible for overseeing the medical coding process. Medical coders make sure that the coding used is in compliance with all medical coding laws and regulations and also ensure that the coding aids reimbursable expenses when required. Medical coders provide health care agencies with regular coding, surgical coding, or hospital coding or others as per the requirement. Coders may also sometimes effectively communicate with patients, doctors and other staff regarding claim procedures or rejections.
Medical coding certification can improve an applicant’s chance at landing a job and can usually enjoy better pay, job security and competency in the field. In order to become certified, medical coding professionals must demonstrate thorough knowledge on medical codes.
Medical coders need to have appropriate knowledge on coding and insurance rules and regulations, documentation skills, communication and interactive skills, computer knowledge and must maintain confidentiality. Above all, medical coders need to be certified for medical coding along with the specified degree. Experience may also be an added advantage in the field to prove you as a proficient coder.
The most common medical coding programs are Certified Professional Coder (CPC), the Certified Coding Specialist (CCS) and the Certified Medical Coder (CMC). Medical students can hurry up to earn your Certified Professional Coder credential, the most recognized and standard medical coding certification in the healthcare industry settings. Medical coding certification is available through different organizations. The right certification for any medical coder ultimately depends on a candidate’s relevant experience and intended specialization. There are institutes and certification programs in Medical Coding to pursue that match their goal of becoming certified professional medical coder.
Certified professional medical coders must demonstrate a strong understanding of following knowledge criteria:
- Appropriate knowledge on Human Anatomy and Human Physiology and disease processes through education.
- Well versed with the Medical Procedures, the rules and regulations that define how to code them in health records and insurance claims.
- Medical Terminology: including evaluation and management, surgery, anesthesia, radiology and pathology.
- Medical Coding guidelines, rules & regulations.
- Payment rules, insurance billing and claim- reimbursement policies.
- Sound knowledge on various types of medical codes: CPT, HCPCS Level II, and ICD-9-CM Volume 1-2 medical codes.
- The ability to translate health care provider notes into accurate code, assignment of accurate medical codes for medical procedures, services and diagnoses.
- Possess problem solving techniques and skills in dealing with queries to ensure medical proper coding.
- Handle complex issues related to medical necessity, claim denials, bundling issues, and charge capture.
- Interactive and good communication skills can be helpful to engage in the difficult task of explanation to patients regarding a specific claim rejection.
How to Earn CPC Certification?
Earning most recognized CPC credential increases job opportunities. This article intends to brief up the procedure to earn CPC certification in simple steps.
CPC Exam – Certified Professional Coder exam is conducted by American the American Academy of Professional Coders (AAPC). One must take CPC exam which covers syllabus of 24 different areas including medical terminology, anatomy, physiology, diseases – diagnostic codes, coding guidelines and specific medical coding. This CPC Exam consists of 150 multiple choice questions with a time limit of five hours and 40 minutes. One must answer at least 70 percent of the questions correctly to pass the CPC exam. Well prepared candidates can get through the exam for being certified.
|Certified Professional Coder Exam|
|Exam Pattern||Duration||Syllabus||Pass Marks||Resources to carry|
|Multiple choice questions (150)||5.40 hrs||24 Areas||70%||Open code book (Approved coding manuals)|
CPC Certification: CPC Certification is awarded by AAPC for those who have passed CPC exam and having membership. The job is not over if certification is done, we need to maintain our certification through AAPC-approved continuing education units called CEUs. Membership must be renewed annually by the members. Also, for the renewal, members need a current membership if applying for the exam or waiting for results.
On-Job Experience: To obtain a CPC credential, one must have spent two years of working experience with CPT, ICD and HCPCS codes – or need to submit a proof of 80 hours of coding education.
Engage in ongoing Education: Updating with the current healthcare technology and regulation changes would fetch better opportunities. You must submit 36 CEUs (36 hours of continuing education) every two years for certificate validation. CE units earning opportunities are available through AAPC.
If you do not initially meet this required qualification, you’ll receive a CPC-A® (apprentice) designation, until the required experience is achieved.
Benefits of Medical Coding Career
Take the first step toward your Medical Coder Career with the below benefits
- High demand career option.
- Work from home
- Job having flexible timings.
- Easy access of job availability.
- Best Compensation.
- Saving life.
Keep reading our latest updates on medical career, to take a closer look at this growing phase for best knowledge source. Browse Pharma Knowledge Centre to get started with finding the medical coder certified program that meets your needs, goal preferences, and career. Here at PKC, you’ll find directive information on medical coding and billing certified professional course, career paths and job options.
At PKC, Training is provided on Medical codes, Legal Amendments, Regulatory changes, Local and National Trends in Coding and Soft Skills Development. Classes are scheduled accordingly, so chances are high to start your course soon. Job placement assistance is also available for the easy landing in the field.
Boost your Medical Coding Career with Best Options
Medical coding certification is a badge of right skills and quality experience as many employers usually prefer to hire candidates with certification. Hence, earning your medical coding certification gives you a competitive edge in the current job market. Once you are set with certification, experience in the field that would be enough to boost your career.
American Academy of Professional Coder (AAPC) was created to provide professional development and standards for the medical coding industry. Through the AAPC, medical coders can receive documented certifications indicating their subject knowledge and understanding analysis of medical coding, billing, medical auditing and medical compliance.
Career paths for successful CPCs
Medical coding or management require more expertise and on job experience with high package salaries. Currently the average certified professional coder salary is rising, and this would be a great time to enter the coding field. Especially for doctors or medicos, who want to move into management other than clinical setting, there are plenty of options available.
Tired of searching the best guide, Industry experienced- certified trainer and job placement assistance for career growth in medical coding field, end your search here at Pharma Knowledge Centre. This would be a good choice to visit before you make any binding decisions about your medical career and best placements. PKC offers trustworthy and customized resources (training, consultancy support, advisory panel, recruitment, workshops) to the aspirants (Doctors, Pharma graduates, life science graduates, medical transcriptionists) towards becoming a medical coder.
- World Health Organization, History of the development of the ICD. https://www.who.int/classifications/icd/en/HistoryOfICD.pdf
- American Association of Professional Coders (AAPC), What is Medical Coding? https://www.aapc.com/medical-coding/medical-coding.aspx\
- Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook. bls.gov/ooh
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