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Medical Coding: Who May Be A Certified Medical Coder?

The coding method was previously used in the computer programming and engineering field, but now the era has changed, now medical records are also recorded in alphanumeric code form.

Medical coding was started in the USA, and now it is widely used by many countries, in which alphabetic and numeric techniques are used for storing medical data. The name Medical Coding shows the combination of medical and mathematical fields and also seems like a hard or tricky field! Yes, it seems so, but now it is one of the growing fields in many countries and sectors like hospitals (outpatient, inpatient), government, policy mediclaim companies, nursing homes, and agencies.  

What is medical coding?

Medical coding is converting healthcare methods, medical services, equipment, and diagnosis into universal alphanumeric codes.

Certified Medical Coder (CMC) is a complete program with exams for qualified medical coders to accomplish advanced coding outpatient medical applications. The CMC certification is awarded to a person who has passed the general exam.

Medical coders are directed to have in-depth knowledge of the health records’ content. They work so they can easily find the necessary information to code the records accurately. Many coders obtain certification that symbolizes that they received training in anatomy and physiology and different forms of disease to properly recognize the different signs, indications, pathologies, examinations, and other aspects of diseases and treatments to translate them to a standardized universal code. This oftentimes needs to be informed and up-to-date with illness and the procedures used in their treatment, often through continuing education courses to ensure proper coding.

The  role of the coding specialist and some other settings that coders work in

The coding specialist receives reports from doctors and reviews patient records to identify the diagnosis and the procedures that reflect the patients’ services than medical coders identify the diagnosis and procedure using coding manuals. Coders convert those words into universal alphanumeric terms. 

Medical Coders can work in hundreds of environments. Some of the most common are the hospital setting (inpatient, outpatient), surgery centers, nursing home, home health, emergency departments, rehabilitation centers, insurance companies, and government agencies like veterans administrations.

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Organizations and their certifications

3 major Medical Coding Program organizations offer certification for medical coders, they are;

1. Practice Management Institute (PMI)

PMI is one of the nationally recognized organizations that offers a Medical Coding course and certificate program acknowledged by the Center for Medicare and Medicaid Services and the U.S Department of Labour. 

Certified Medical Coder

PMI offers only one certificate Medical Coder course that depends on 18 hours and includes 1,080 minutes of training and exam. The18 hours class teaches you the whole thing you need to know about ICD-10-CM, CPT, HCPCS, and advanced coding terminology and training to get started in the medical coding field.

2. American Health Information Management Association (AHIMA)

AHIMA is also a professional organization that currently contributes to 3-medical coding certification programs that are NCCA-accredited.

Certified Coding Associate

This program grants qualified coders with the credentials that present code competency across hospitals, medical facilities, and physician practices. People will receive everything they need to know to get began in the medical coding profession, including various sets of code and medical terminology.

Certified Coding Specialist

After receiving this certification program, medical coders have the skills to classify medical data from patient records, which presents that a coder is competent and can review and assign numeric codes to patient records, he/she is a genius in CPT and ICD-10-CM coding systems, and have a strong knowledge of medical terminology.

Certified Coding Specialist Physician-Based

The Certified Coding Specialist, a physician-based certification program, gives medical coders specialized skills for physician-based settings. For Obtaining this certification, a coder should display knowledge of reviewing patient records, assigning numeric codes to diagnoses and procedures of the patient, and understanding CPT, ICD-10-CM, and HCPCS level II coding systems.

3. American Academy of Professional Coders (AAPC)

AAPC is a professional association that allows 4 major medical coding certifications with an additional 18 specialty medical coding certifications for coders to display their level of expertise in a specialty field. To receive any of the AAPC certifications, a person indeed has to pass a 150 multiple-choice examination in 5 hours and 40 minutes. Some of the AAPC programs are listed below:

  • Certified Professional Coder- CPC
  •  Certified Outpatient Coder -COC
  • Certified Inpatient Coder- CIC
  • Certified Risk Adjustment Coder- CRC
  • Ambulatory Surgical Center Coder
  • Anesthesia and Pain Management Coder

Types of coding set

In the United States, as mandated by the health insurance portability and accountability act, HIPAA is also known. There are 3 codes sets that medical coder utilize; they are

  • ICD-10 system: ICD stands for international calcification of disease, established by WHO in 1942, which describes causes of injury, illness, and death. In a day-to-day setting, you’re going to find that most coding specialists  will deal with the ICD-10 system, divided into ICD-10 CM ( for diagnosis codes) and ICD-10 PCS (for the procedures for the hospitals.)
  • CPT: CPT is the current patient terminology established by the American Medical Association (AMA), that converts a patient’s condition into medical terms. 
  • HCPCS: means Healthcare Common Procedure Coding System, convert and submit healthcare claims to Medicare.
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The 3 code levels that relate CPT and HCPCS

Level 1- codes used for numeric Current Patient Terminology (CPT)

Level 2-codes present HCPCS alphanumeric terms, which are utilized for non-physician procedures and products.

Level 3- codes are the Medicaid- Medicare developed codes utilized in specific jurisdictions and programs.

Steps for becoming a certified and specialized medical coder

  1. Gather prerequisite prospective program documents and paperwork, which generally consider basics like biodata, high school diploma, equivalent or,  or somehow 2 years experience in the coding field.  It is also warned that drugs and sex-related convictions may prevent a person from this field.
  2. No formal education is needed to become a Certified Medical Coder like many coders have bachelor’s or master’s program degrees. Administer and enroll in an academic program. 
  3. In completing the program, it would be expected that the person fully understands the literature and procedure of the coding method. The basic things like medical terminology, anatomy (structure of the human body), physiology (a function of the human body), etc., and person may engage in a practicum or internship before graduation.
  4. A considered coder may also get a specialized certificate degree, which is like a graduation degree. A specialized degree adds your expertise and demonstrates the level of competency, and reveals you different from the crowd to prospective employers.  
  5. Last but not least, get started your journey means landing a job, but first, decide what type of environment you prefer, like a hospital setting, a doctor’s office, or work from home?

Skills required become a good medical coder

A Certified Medical Coder should have a solid foundation in the language of medicine, function, and structure of the body so that he/she could understand the physician’s writing and analyze them as healthcare professionals document the medical text. Seldom the record is unclear or incomplete.

  •  Medical coders must have the query capability so that the coder asks the physicians or the provider to explain what’s documented in the record so that the coder can ensure that and assign the most accurate codes to the patient’s encounter.
  • Medical coders should be good in medical terminology, anatomy and physiology, human diseases, and pharmacology.
  • Should have Information about the settlement of medical services and familiar with the health record and different styles in the health record.
  • He/she should have Basic information about software because it is all about computer work.
  • Should be the pro starter- means a person knows how to handle work professionally.
  • Should have the ability to understand writing diagnosis.

Job description

Health care setting is a heavily regulated industry and  so must be familiar with common rules and regulations that Medical coder required to follow;

  • Have Analysing skills clinical statements and assign standard codes by using ICD, HCPCS, etc
  • To keep an eye on patient personal records such as doctor prescription, diagnostic test, etc.
  • Coder knows the Connection links between the mediclaim policy company and the hospital.
  • A coder specialist has to be detail-oriented.
  • Must have good communication skills.
  • Coders must have a researcher quality like independent thinking.
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How long does it take to become a medical coder

It usually takes 4-15 months or 1-2 years to become a certified medical coder. Still, time varies with operating style, variety of settings, part-time or full-time credit hours, projects and assignments submission, etc.

Career scope

A person who is pursuing a certificate in medical coding should be ready to work in the onerous and high paced environment because professionals with computer skills and specialties in areas like health information are likely to be in especially high demand in the future. According to the Bureau of Labor Statistics (BLS) estimated that the employment for medical recorders and health information technicians would increase by up to 13% by 2026. The medical and health service managers who have a medical coding certificate and a bachelor’s degree can make more than $90,000 per year.

Salary of a certified medical coder

According to the pay scale, the average medical coder’s hourly pay is $18.64, whereas the median salary is $ 37,218- 42,300, which will increase by 10% per year. 

Another research site Glassdoor estimates the annual Medical Coder salary is $38,678.

Considerations in Choosing the Right Certificate program in Medical Coding

Most accredited medical coding programs cover comparable foundational classes to prepare learners for certification exams, which offers a slightly different curriculum. Some programs focus on illness models and disease classifications, while others emphasize computer technologies and electronic health records.

  •  Learners should select a program that affiliates with their interests and goals.
  •  The number of required credits also varies by program-by-program and can affect degree completion time.
  •  Students should research each prospective program’s credit requirements, expected completion time, accelerated and part-time options, and transfer policy.
  •  Budget is an important consideration, as tuition varies significantly between schools and program types.

Best online universities for medical coding certificate programs

Due to the COVID-19 pandemic, some universities and colleges are there are who continuingly provide useful student resources and online medical coding certificate programs; they are;  

  1. The University of Alaska in Fairbank
  2. The charter oak state college in New Britain
  3. Northwest technical college in Bemidji
  4. The University of Utah in Salt Lake City.
  5. Wisconsin Indianhead technical college in shell lake

Top 5 medical coding schools

  1. Bowling Green State University
  2. St. Catherine University
  3. Alfred State College- Suny
  4. Keiser University
  5. Ferris State University

Best certifications for today’s medical coders

Although the Medical coding field is growing day by day, but the best certification in Medical coding specialty is; 

  • Certified Professional Coder (CPC) 
  • Certified Coding Specialist (CCS) 
  • Certified Coding Specialist – Physician-based (CCS-P)

Books used by medical coder

  • MEDICAL CODING TRAINING- CPC
  • ICD-10-CM – complete draft code set. 
  •  ICD-10-CM – complete official codebook.
  • Cpt professionals for outpatient procedures.
  • ICD-10-PCS – complete official code set.
  • HCPCS Level II-A resourceful compilation of HCPCS codes.

Takeaway

Medical coding is the field in which patients’ diagnoses, conditions, and all test prescriptions are translated into universal alphanumeric terms to store data. AAPC, AHIMA, and PIA are 3 organizations that launch certified medical coder programs. The medical Coding field is increasing in scope with the increasing population growth. The right training and hard work are required to become a good certified Medical Coder.

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