Am I for In or for Out Patient Medical Coding

A lot of surgeries and procedures that used to require admission to the hospital are now being performed routinely on an outpatient basis – which means you go in and have the surgery and come home the same day without ever being admitted to the hospital.

As you might expect, there is a significant difference in the skill set required to apply medical codes to complex inpatient operative reports vs. the skill set required to apply appropriate medical codes to a report for a laceration or a stubbed toe in a clinic or emergency room setting.

The reality is that most medical coding is outpatient medical coding. The trend is for physicians and hospitals to perform more and more of their procedures on an outpatient basis.

Most entry-level medical coders are going to begin their careers performing outpatient medical coding on outpatient medical records.

Inpatient medical coders are generally trained or mentored on the job and come from the ranks of outpatient medical coders. This creates plenty of opportunities for advancement in both career and income over time.

The Two Groups of Medical Coders

In the world of medical coding, there are two fairly distinct groups of medical coders:

1. Those who perform medical coding for clinics, physicians offices, and hospital emergency rooms. These are typically referred to as “Outpatient Medical Coders”.

2. Those who perform medical coding in major hospitals. These are typically referred to as “Inpatient Medical Coders”.

If you are interested in a medical coding career, it will be important to understand the difference between outpatient medical coding and inpatient medical coding. This might be best understood through example. If you have a procedure performed that requires you to be admitted to the hospital and stay overnight, this medical coding activity will require the skills of an inpatient medical coder. If you have a procedure performed on a same-day basis and are not admitted to the hospital for an overnight stay then it is considered an outpatient event and is typically assigned to an outpatient medical coder.

Types of Medical Coding Certification

Here we list the different medical coding certifications, take a look and if you are not certified yet, choose which certification suits you best.

• AHIMA Medical Coding Certifications:
  Certified Coding Associate (CCA)
  Certified Coding Specialist (CCS)
  Certified Coding Specialist-Physician-based (CCS-P)
  

• AAPC Medical Coding Certifications:
  Certified Professional Coder (CPC)
  Certified Professional Coder-Hospital (CPC-H)
  Certified Professional Coder-Payer (CPC-P)

The right medical coding training program will certainly provide you with the medical transcription skills and training necessary to successfully sit for and pass a medical coding certification exam.

Certified Medical Coders Make More!

It turns out that Certified Medical Coders make more money than their non-certified counterparts – as much as 17% more, according to the American Academy of Professional Coders (AAPC). Additionally, medical coding career advancement opportunities are far more plentiful for certified medical coders than for those without a medical coding certification.

There are two national organizations that certify medical coders:
1. AHIMA – American Health Information Management Association
2. AAPC – American Association of Professional Coders

Both of these organizations are reputable and respected and offer widely recognized medical coding credentials. Both organizations also offer entry level medical coding credentials as well as advanced medical coding credentials. Once a medical coding certification is achieved, credentialing organizations typically require that members maintain their credentials through rigorous ongoing continuing education. Over time, most professional medical coders will continue to improve their status by completing advanced medical coding certification requirements.

The Importance of a Medical Coding Certificate

It is not a requirement that you be certified to be employed as a medical coder – not yet anyway. However, because of the magnitude of money that changes hands every day in the healthcare industry, medical coding has become a very highly regulated and tightly supervised activity. Medical coding is also subject to frequent and rigorous audits to ensure accuracy in the medical billing process as there are literally billions of dollars at stake.

As a result of this intensive regulation, most employers of medical coders have a strong preference that their employees involved in the medical coding process be in possession of a valid medical coding certification. An entry level or advanced medical coding certification while not a prerequisite, is extremely desirable for entry into the medical coding profession.

Health Information Industry and Medical Coding

The medical coding job outlook is rosy indeed. According to the US Department of Labor, the healthcare information industry is expected to grow faster than the average for all occupations over the next decade. This rapidly growing segment of the economy includes medical coding professionals.

As mentioned earlier, medical coding professionals are in extremely high demand. In fact, medical coding is one of the fastest growing segments in the rapidly growing health information industry. And demographic trends in the United States and around the world suggest that this growth in medical coding employment will continue for many years to come. A rapidly aging population, combined with advances in complex treatment options almost guarantees solid job prospects for medical coding professionals well into the future.

The Promising Career of Medical Coding

Medical coding offers an exceptionally promising career path for individuals willing to invest in medical coding training and acquire entry level or advanced medical coding certifications. In fact, the 2007 Medical Coding Salary Survey published by the American Health Information Management Association (AHIMA) indicates that the average salary for medical coding professionals increased to almost $34,400 in 2007 – up from just over $30,000 in 2006. Salaries for managers and administrators increased dramatically as well.

Medical Coding in a Hospital

Hospitals tend to be more rigid and bureaucratic in their approach to medical coding employment than smaller, more nimble medical clinics or physician groups. However, their pay rates can also be higher.


Hospitals tend to require a higher level of inpatient coding skill and certification. On the other hand, large hospitals can offer medical transcription employment benefits which far outweigh those provided by smaller organizations. These benefits may include overtime pay, flex-time, sick leave, paid vacation, and perhaps most importantly - generous health care benefits. Also, if you are interested in pursuing a long-term career as a Medical Records Director or Hospital Administrator, a large hospital system will typically provide more opportunities for upward mobility.


Medical clinics and physicians offices tend to operate under relatively normal business hours. This allows medical coders employed by these organizations to enjoy a traditional and fairly stable medical coding work schedule. However, if medical coding job flexibility is important to you, you should consider a medical coding job in a hospital setting. Most hospitals are open 24 hours per day 7 days per week and often offer significant flexibility to medical coders in terms of flex schedules and shift work.

Find Medical Coding Jobs Here!

Medical coding jobs can be found in a variety of organizations, including:
* Large hospital systems
* Private hospitals – small and large
* Government hospitals
* National medical billing & Coding service providers
* Clinics and Physician Groups
* Nursing Homes & Rehabilitation Centers
* Home Healthcare Agencies
* Insurance Companies
* Law firms and Consulting firms



The path you ultimately take on your medical coding job search will depend on a number of factors. Some of these factors include:
* Level of Experience and Proficiency
* Income Requirements
* Benefit Requirements
* Importance of Freedom and Flexibility
* Personal Motivation
* Risk Tolerance

So how do you find a Medical Coding job?

Of course, you can look in the classified ad section of your local newspaper in search of medical coding job opportunities. However, you are always at the mercy of the timing of postings. It is not our preferred method. You should be aware that there are a lot of medical coding industry publications where medical coding jobs are routinely posted. Advance Magazine, an AHIMA (American Health Information management Association) publication, is an excellent resource. Also, in this day and age, there are many medical coding job boards dedicated to opportunities and information in the medical coding field.


If you are not bashful, one of the best ways we can think of to identify medical coding job opportunities is to call or visit the medical records department of local hospitals or clinics. If you ask to speak directly to the medical records director or medical coding supervisor, you may be fortunate enough to catch them at an opportune moment and make a brief introduction. Finding the best medical coding job requires a little networking and proactivity on your part.

Get a Job As a Medical Coder!

The options for medical coding employment are extremely varied. But most of them lead back to the same place – a medical coding job with a medical clinic or hospital. Fortunately, unless you happen to live in an extremely out of the way locale, opportunities for medical coding jobs should be plentiful. The supply of medical coders has not been sufficient to meet the demand for medical coders for many years now and the supply-demand imbalance in the medical coding industry is only getting worse. This is good news for a newly minted medical coder looking for a medical coding job.