Medical Coding Where?

Most medical coding work is still performed by medical coders working in hospitals or clinics. Medical coders work in a professional environment and perform a vital behind the scenes billing support activity.

There is a trend toward outsourcing of medical coding work to third party vendors. As this trend catches on, more medical coding work will be done in homes and medical coding will evolve to become more of a home based career – much like medical transcription is today. It is believed that as technology continues to evolve and remote medical coding platforms are developed, the outsourcing model will begin to take hold in the industry. However, at this point it is important to point out that most medical coding is still performed in hospitals and clinics.

What do Medical Coders Do?

Medical coders review patient medical records to identify reimbursable or billable events and activities. Once a reimbursable event has been identified the proper numerical code is input into a healthcare reimbursement system. Proper coding will ultimately determine the amount the healthcare provider will be reimbursed by Insurance companies or by Medicare or Medicaid. It is of paramount importance that the medical coder accurately codes each patient chart. Errors and omissions can be costly and burdensome to the healthcare system.

Define: Medical Coding

Medical coding is essentially the process of assigning formal, standardized medical codes to patient medical records. When a patient goes into a clinic or hospital a medical record is created. This medical record will include patient identifying and demographic information. It will also include a description of the chief complaint, any procedures that were performed, medications prescribed, a diagnosis, and follow-up instructions.

The diagnostic and procedural information contained in the patient medical record must be converted into simplified numerical codes by trained medical coders. These numerical codes allow complex medical procedures and diagnoses to be recognized quickly and easily by health care computer systems where they can be electronically processed for payment by third party payers – Insurance companies and Medicare, for example.

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.