Medical Coder

Overview

Medical coders are vital members of the health care team, even though medical coders don't work directly with patients. Medical coders assign specific codes to medical services and procedures, enabling doctors, hospitals, and other health care providers to be paid. After a patient visits a doctor or hospital, the medical coder reads the patient's charts and assigns the proper codes to the procedures and services the health care provider performed. Whether a patient received a flu shot, had an x-ray, or underwent surgery, it's the medical coder's duty to determine the correct codes that correspond to each element of a patient's care.

There are several health care coding systems: CPT codes are Current Procedural Terminology codes developed by the American Medical Association; HCPCS codes are Healthcare Common Procedure Coding System codes, used by Medicare; and ICD codes are International Classification of Diseases codes, maintained by the World Health Organization. While medical coders do use coding manuals or encoder software to assist them in determining codes, the coder must also have knowledge of diseases and their treatment in order to consistently apply the correct codes.

The codes that medical coders assign help determine how much the healthcare provider will be reimbursed by Medicare, Medicaid, and insurance companies. The information compiled by medical coders is also used to prepare reports that clinic and hospital administrators require for management purposes. Local, state, and federal governments also use medical code information to identify critical health care concerns, such as outbreaks of E. coli.

Medical coders can work in a variety of settings, from hospitals, clinics, surgery centers, long-term care facilities, dental offices, and home health care agencies to insurance companies, consulting firms, coding and billing services companies, and government agencies. A coder may manage the entire business for a single physician in a rural location, or work from home for a coding and billing company, or work in a large hospital in a city and concentrate on coding in one area, such as radiology. While most coders use electronic medical records and computer software to assist with coding, in some small health care practices, the coder may work from traditional paper forms. Coders typically work under the supervision of a health information manager or chief financial officer.

Outlook

According to the Bureau of Labor Statistics, employment of medical records and health information technicians, including medical coders, is expected to grow 20% or more through 2018, which is much faster than the average for all occupations. As the population continues to age, the occurrence of health-related problems will increase. Employment growth will result from the increase in the number of medical tests, treatments, and procedures that will be performed. In addition, with the increasing use of electronic health records, more technicians will be needed to complete the new responsibilities associated with electronic data management.

Salary Table

In 2010, the average salary of medical coders was $45,404 for those who are certified and $37,746 for coders who aren't certified.

Employment estimate and mean wage estimates for this occupation are as follows:

  Certified Medical Coder Non-Certified Medical Coder
Average Annual Salary $45,404 $37,746

Research, Explore, and Become a Medical Coder

In order to get a job as a medical coder, aspiring employees must have solid knowledge of medical terminology, anatomy and physiology, and database management. In order to obtain that knowledge, prospective medical coders can earn a medical coding certificate or an associate, bachelor's, or master's degree in health information.

Medical coding education programs are available online and in the classroom and should include such subjects as medical terminology, anatomy and physiology, coding, and health care laws and ethics. Some programs also offer training in medical billing, so that graduates are able to perform both coding and billing, increasing their employment options. Graduates of medical coding education programs receive a certificate of completion and should be prepared to take an exam to earn a professional medical coding certificate.

The National Healthcareer Association (NHA) administers professional medical coding certificate exams, including the CBCS: Certified Billing and Coding Specialist exam. The CBCS certification demonstrates that the holder has the ability to assign codes to each diagnosis and procedure and can code patient medical records correctly to optimize reimbursement for medical services.

The American Health Information Management Association (AHIMA) also administers professional medical coding certificate exams, including the Certified Coding Specialist (CCS) exam for medical coders who work in hospitals and the Certified Coding Specialist—Physician-based (CCS-P) exam for medical coders who work in a doctor's office. AHIMA states that the CCS and CCS-P exams demonstrate mastery of coding proficiency and recommends that those who sit for the exam have at least three years of coding experience.

Additional Resources

Certification

The American Health Information Management Association (AHIMA) is an association of health information management (HIM) professionals. AHIMA offers certification exams, including the Certified Coding Specialist (CCS) exam. Learn more about AHIMA certification at: www.ahima.org/certification/.

The National Healthcareer Association (NHA) offers certification exams, including the Certified Billing and Coding Specialist (CBCS) exam. Learn more about the exam here: www.nhanow.com/billing-coding.aspx.

Job Boards

The American Academy of Professional Coders' job board allows you to search for medical coder positions in your area. Check employment options at: www.aapc.com/medical-coding-jobs/index.aspx.

HIPjobs specializes in health care industry jobs. Search their listings at: www.hipjobs.net.

Want to work from home? Maxim Health Information Services specializes in remote medical coder positions. View their opportunities at: www.maximhealthinformationservices.com/remote-medical-coding-jobs.aspx.

Professional Associations

The American Health Information Management Association (AHIMA) is an association of health information management (HIM) professionals. Learn more about AHIMA at: www.ahima.org.

The American Academy of Professional Coders (AAPC) is a professional association for medical coders. To join, visit: www.aapc.com.

The Professional Association of Healthcare Coding Specialists (PAHCS) is a network dedicated to enhancing the compliance, documentation, and reimbursement capabilities of health care coders. Visit their site at: www.pahcs.org.

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