A medical coding job or medical coding career is not the traditional choice of many young adults, but there are many benefits to pursuing this path. A medical coder or classifier is someone who transforms medical diagnoses or procedures into numbers.
These numbers are universal medical codes that allow for insurers, governments and other institutions to determine the health of the nation, and figure out how to bill and pay for illnesses. These diagnoses generally come from lots of health care records, from doctor’s diagnoses and notes to lab results and hospital charts.
Medical diagnoses, converted to codes can be used for:
- Analysis of diseases and therapies – in this case, it can serve a government well to know if there is an excess of a particular health issue, such as diabetes or HIV/Aids. With the codes that indicate these diseases and the therapies being used to treat them, the government can determine whether they have an epidemic on their hands or whether certain problems and medical issues are actually improving.
- Insurers reimburse for medical expenses – in some cases, an insurer is bound by a contractual obligation to reimburse a patient for any expenses when relating to certain diseases. For example, if a patient has medical insurance that covers diabetes, the insurer is obliged to pay for any expenses that relate to that disease. Having the medical codes that relate to a disease helps those insurers do that.
- Support systems – support systems help government and private organizations make decisions. A medical coding job is an important one in this case, because it ensures these stakeholders have access to the information they need.
- Surveillance of breakouts – can you imagine if life were like a Hollywood movie in which the main characters have to fight an outbreak? Well, governments, health providers and other organizations use medical codes provided by those in the medical coding career to ensure that this never happens. Using these codes, they can analyze the severity of certain outbreaks and keep them in check, so that if a dread disease comes to town, it can be quickly nipped in the bud.
The Importance of a Medical Coding Job
If you happen to check a medical claim form, you will notice that words are no longer used to describe what ails you and how it will be treated. Instead, a series of codes is used. Medical coding is a job path that works in conjunction with medical billing and both are important. There is so much that happens in a hospital or a doctor’s practice that the public doesn’t see. A medical coder and medical biller ensure that these processes run smoothly, so that doctors can focus on their patients and their needs.
Pursuing a Medical Coding Career
In the field of medical coding, certain specific criteria need to be fulfilled. Whether you choose a medical coding job or a career in medical billing, you should take the CMRS or RHIA exams. Though the law does not prescribe these as precursors to working in medical coding or billing, they can assist with career advancement. In fact, many institutions prefer to hire candidates with these qualifications.
The important thing to note here is that you cannot become a medical code or get a medical billing job without specialized training. To do this job, you would need to understand the importance of medical codes and how to use them. You would need to be very skilled in changing diagnoses and treatments into code and analyzing information. This is not a job that just anyone can pursue.
To succeed in this field, someone in a medical coding job must have specialized training that teaches them about biology, about pharmacology and how the CPT coding system works. This is the system that is used globally, and thus an understanding of it ensures that a medical coder can do their job. Because this system translates diagnoses into billing, it is also a program that can take up to two years to complete. A good medical coder will know this system, should have a basic understanding of math and science and be good with computers.
Prospect of a Medical Coding Career
Now that you know something about what pursuing a medical coding career entails, you should know what the prospects are of finding a job. You will be pleased to know that the prospects for this type of career are very good, but sadly this is because of the high number of injuries and ailments throughout the world. Because people suffer more from diseases, are involved in more accidents and have higher levels of stress than ever before, there is a lot of need for medical coders and billers. Because the job requires those who are highly trained and skilled, a good medical coder or biller can earn about $50 000 per annum. Of course, this is determined by the candidate’s level of experience, their level of education and the company for which they work.
Medical Coding versus Medical Billing
If you plan on pursuing a medical coding career or a job as a medical billing expert, it is vital that you understand the differences between the two. Basically medical billing is a process that ensures that patients’ insurers settle their bills. For this to happen, the medical coder has to convert the medical codes into specific phrases as required by the insurer. The coder also assigns codes for the medical biller to translate, so that they can bill the insurance companies.
Unlike a biller, someone in the medical coding career has a lot of complicated work that they need to do. This includes:
- Using the software provided to enter codes
- Reviewing doctor’s charts and ensuring that all of the entries they have made are accurate. If not, they have to ask the doctors or specialists to clarify their diagnoses or treatments
- Using medical codes as assigned to any diagnoses, treatments or services
- Making sure that every medical record they see has been signed
This involves a lot of administrative work, which means that a medical coder needs to be organized and good with deadlines.
Learning Outcome of a Medical Coding Career
If you are sure of your future in medical coding, you will need a qualification and you will need to cover certain skills. You will find that there are a lot of online courses that offer training for a medical coding job, but be sure to check them out thoroughly. If they are good, they will include the following courses:
- The procedures for rejections and appeals
- Managed care terminology
- Dealing with collections for medical billing
- Fraud and billing issues
- An introduction to medical codes
So how do you know that you have picked the right institution and the right course? Well the easiest way is knowing whether the institution is formally accredited. You can find this out by simply checking their website or asking for course materials.
Working in the medical coding career is not an easy path to take, but it is really worth your while. If you are the type of person who does well with accuracy and attention to detail, who enjoys math and science and who has a vested interest in the medical field, then pursuing a medical coding job may be right up your alley.
This is not a job for those who struggle to retain information though, since there are thousands upon thousands of medical codes in the CPT system, and though you won’t have to remember every single one, you will need a good understanding of how the codes work and a good memory for some of the most common codes.
You will also need to be intuitive, since some doctors use different terms to describe treatments and ailments. Can you imagine what might happen if you incorrectly use the code for diabetes type 1 instead of diabetes type 2? Someone could lose their life, or the medical insurer involved might not pay. This is the kind of job that comes with a lot of responsibility, so you need to be able to function well under pressure. And of course, thanks to the prevalence of generic medications on the market, you may find that there are a lot of new codes coming in on a daily basis.
It is true that pursuing a medical coding career is not for the faint-hearted, but if you do it well, you have the potential to make a lot of money and to advance far in this field. The responsibilities associated with being a medical coder or medical biller are rather large, but those who take on those responsibilities with aplomb are often rewarded in their fields. If this is something that appeals to you, and the thought of being involved in the complex yet interesting world of medical coding, then you should look for an institution near you that offers this training. You may find that your medical coding job is the perfect fit for your personality.