The medical profession is very dependent on its billing department. Doctors need to make sure that there are reliable, accurate, and consistent medical coders to maintain the financial aspects of their practices. A professional medical billing department is what holds a medical practice together -- and proper coding procedures are essential.
A medical coder will:
- Have knowledge of the human body and its inner workings
- Know medical law and ethics, diseases, and terminology of medicine
- Review charts and reports from a person's medical record
- Add the corresponding codes for the services provided
- Provide accurate and reliable coding records
A medical biller, on the other hand, is the second person to receive the medical claims after the medical coder has coded them. The biller files the claim with the insurance company. Medical billers must also research all filed claims to see that they are resolved efficiently. Oftentimes, medical billers contact patients regarding outstanding claims, and set up a payment plan if necessary.
If you've decided that you want to venture into the field of medical coding, the first thing to do is research available medical coding programs offered by local colleges or trade schools -- online accredited medical coding schools are often an ideal choice for flexible and convenient learning. You can also talk to people who are currently employed in the field and get advice and tips on starting a new medical coding career. Medical coding offers a rewarding and exciting career opportunity -- with a little work and preparation, you too can become a medical coder.
What is Medical Coding and Medical Billing?
Medical coding includes the process of using specific codes to identify medical procedures and services for private billing and health insurance companies. A medical coder reads medical documentation, such as a medical chart, and assigns the right code based on their coding knowledge. The codes are entered into a form on their computer system.
Once the procedure and service codes are determined, the medical biller transmits the claim to the insurance company for payment.
Medical billing includes the process of submitting and following up on claims to insurance companies in order to receive payment for services rendered by a health care provider. A medical biller ensures that the patient and health insurance company are properly billed for all procedures. Approved claims are reimbursed, while rejected claims are researched and amended.
Medical billers and medical coders ensure that the billing cycle is smooth - from patients being billed the correct amount to doctors getting paid. They are both essential to the financial well-being of an organization and the health care industry as a whole.
In fact, the need for experienced medical coders can be even stronger when times are tough, since health care providers will be looking for a way to make the most of every health care dollar. The right medical codes can mean the difference between a denied claim and one that is paid in full and on time -- it is easy to see the value an experienced and capable medical coding professional brings to the table.
The constant need for new medical coders has meant that many educators are offering medical coding courses to help workers get started in this in-demand field. Many of these medical coding schools provide online medical coding education -- helping those who already have jobs train for a great new career without giving up their current jobs or their incomes. Among the features to look for in an online medical coding training program are:
Convenient Online Courses -- The ability to study when you want, where you want, and at your own pace is essential in today's world. One of the chief benefits of online education is the ability to tailor the needs of your education to the needs of your career and family.
Strong Student Support -- Ongoing support for students and former students is vital in the online education field, and it is important to choose a medical coding school with a strong commitment to helping their students succeed. A strong support system can be the main success factor in your medical coding course -- getting the help you need with your medical coding training is vital.
Up-to-date Material -- An online medical coding education is worthless if the education received is inaccurate or out of date. The world of medical coding is a rapidly changing one, and it is important to choose a school whose faculty and staff keep up with all these changes. Choose a medical coding school that provides the most up to date information and you will find many career opportunities available to you.
Of course not all medical coding schools are the same, and it is important for would-be medical coding professionals to choose their school very carefully. Choosing the wrong medical coding school could rob them of their time and hard-earned money. If you plan to start a medical coding career, you should do your homework first. A high-demand career awaits you -- make sure your first step is the right one and choose the best medical coding school.
What is ICD-9-CM? ICD-9-CM (International Classification of Diseases, 9th edition, Clinical Modifications) is a set of codes used by physicians, hospitals, and health care professionals to indicate the diagnosis for all patient visits. ICD-9-CM contains approximately 13,000 codes; these codes are mandatory for all health insurance claims in the U.S.
What is ICD-10-CM? ICD-10-CM is the long awaited diagnosis code revision to ICD-9-CM. This coding system contains approximately 68,000 codes. ICD-10 has been in use throughout the world for both morbidity and mortality statistics since 1994. It has been required for reporting mortality statistics in the United States since 1999.
Why is the new ICD-10-CM coding system needed?
• Limited Space – It is running out of numbers to assign for codes and in some cases, new code proposals have not been adopted because of limited space
• Not Specific Enough – Its diagnosis codes do not describe the severity or complexity of the various disease conditions. This has resulted in increasing requests for additional documentation in order to support claims.
• No Exchange of Information – It hinders the exchange of meaningful health care data with health care organizations and professionals around the world.
What are the benefits of adopting ICD-10-CM?
• Expanded injury codes
• Combination of diagnosis/symptom codes
• Addition of sixth and seventh characters
• Laterality (left and right specific where applicable)
• V and E codes incorporated into the main classification
• Addition of ambulatory and managed care encounter information
• Expanded postoperative complication information
How does this affect my medical coding career? Because October 1, 2013 is the drop-dead date for compliance, you will need to be familiar with the new system in advance. This means that you will need to enroll in an ICD-10-CM medical coding course to learn about the new medical coding system – including a comprehensive overview of the changes and impacts on your medical coding career. While there’s still a lot of time to prepare, you need to look ahead toward the upcoming changes.
Certified Professional Coder® (CPC®)
The CPC® exam addresses billing and coding for physician services. If you code in the following places or situations, this is the exam for you:
-Physician office or group
-Hospital-associated physician office or group
-Health system-associated physician office or group
-Home health agency
-Physician group at a university and or in educational setting
-Compliance auditor or forensic auditor of physician claims
-Physician billing service
-Ambulatory surgery center (ASC)
-Outpatient hospital services not reimbursed by Ambulatory Patient Category (APCs) groups
-If you are a consultant, educator, legal counsel, physician or other caregiver seeking credential to demonstrate your command of physician-based medical coding
Certified Professional Coder – Hospital® (CPC-H®)
The CPC-H® exam concentrates on outpatient facility services. If you fulfill the following roles in connection with medical coding, this is the exam for you:
-Billing Ambulatory Patient Category (APCs) groups for facility outpatient services.
- Working in hospital outpatient billing and coding department
-Auditing facility outpatient service billing and coding
-Ambulatory Surgical Center
-Performing utilization review for outpatient services
-If you are a consultant, educator, legal counsel, physician or other care-giver seeking credential to demonstrate your command of medical coding
Certified Professional Coder – Payer® (CPC-P®)
The CPC-P® exam concentrates on coding and billing after it's been submitted to the payer. Take this exam if you are in the following situations:
-Claims manager for a payer (private insurance, Medicare, Medicade, etc.)
-Auditor for a payer
-Post-billing auditor for a physician group or facility
-If you are a consultant, educator, legal counsel, physician or other care-giver seeking credential to demonstrate your command of medical coding
CIRCC™ (Certified Interventional Radiology Cardiovascular Coder™)
The CIRCC ™ exam was created for individuals who will be working in the complex and specialized areas of interventional radiology and cardiovascular coding and charging. It covers:
-Diagnostic angiography, non-vascular interventions, and percutaneous vascular interventions
-Diagnostic cardiac catheterization and basic coronary arterial interventions
-Sections on ICD-9-CM, basic coding (E&M, modifiers, etc.), anatomy and terminology
AAPC has developed specialty credentials to enable working coders to demonstrate superior levels of expertise in selected specialty disciplines. Whether a coder wishes to show expertise in a specialty they currently work in or wish to move to another specialty, these credentials are designed to prove superior knowledge and skills.
The medical coding certification exams are designed to test your knowledge of medical coding principles and proficiency. Whatever exam you choose, it is the perfect way to take your medical coding career to the next level. Take the next step today - complete your medical coding classes and sign up for a medical coding certification exam today. The right credentials can set you apart!
In today's economy, it is becoming more common to start a second career. After being exposed to terms like "outsourced," "downsized," and "laid off," it is becoming a necessity to chart a new career path. You want a recession-proof career and medical coding seems a good choice. Before you get started, consider:
1. You can imagine having a long-term and fulfilling career in the medical coding field
2. You already have some of the skills that are necessary to succeed in this field. If not, you are willing to get the training that will prepare you for your new medical coding career.
3. You have done your homework and thoroughly researched the medical coding field. You are up to date and know about the career outlook, wage data and necessary qualifications.
4. You have studied relevant organizations or health care facilities within your area and know your medical coding career options. You know what's out there and what opportunities exist for a newcomer.
5. You have networked and made contacts with people in the field. You like what they've told you, and have a foot in the door when it comes to getting a new medical coding job.
Done all of that? Now you can move forward with your career plans knowing that have made the right choice and can imagine a solid future as a medical coder. It's always a little bit scary when you try something new, but being fully informed can make the transition that much easier. You will know what to expect from your medical coding career and exactly how to make it happen.
The Academy of Professional Coders (AAPC) played a large part in getting the ICD-10 switchover postponed. Full compliance is now due in 2013 instead of 2011, which is great news for medical coders and the U.S. health care system. This extra time will allow the entire health care industry to effectively upgrade practice and billing procedures -- and get in compliance before the deadline. As expected, the revised timeline is welcomed by doctors, medical coders and other professionals. It will give adequate time for the needed software upgrades and facilitate a smooth transition.
The Need for an Expanded Medical Coding System
The bottom line is that the change is needed. The current ICD-9 medical coding system is nearly 30 years old, including approximately 17,000 procedure and diagnosis codes. The medical coding process is limited by the system -- the scope and capability is not large enough to encompass all of the procedures and diagnosis in use today. The new ICD-10 system has approximately 155,000 codes, with 68,000 diagnosis codes alone. It will enable medical coders to be more accurate -- more data and detail will improve the medica billing and coding process as a whole.
Attn Medical Coders: Additional Medical Coding Training Not Needed Yet
The AAPC's stand is that it would be too soon to get additional medical coding training. With over four years until the compliance deadline, it would be difficult for medical coders to retain all of the new knowledge. As the due date nears, they should enroll in a medical coding program to learn the new medical codes and gain new coding knowledge. Medical coding schools will need to update their courses to be inline with the new changes, but there is no need to make any changes yet -- there's over four years still.
Medical coders read medical reports about a patient's diagnosis and the medical procedures used to treat that patient. They then assign specific codes to that information for the purpose of accurate billing and record keeping.
It's the perfect way to transition into the health care field. It's a behind-the-scenes career that is an integral part of a smooth-running medical office or health care facility. You'll use your knowledge of anatomy and physiology and insurance and billing procedures to apply the right codes and facilitate insurance payments.
Medical coding requires less education than other health care careers. You don't have to go to schools for years and acquire advanced degrees. In a short period of time -- less than two years -- you can find yourself in a respected, health care position. An online medical coding program will make it even easier -- learn when and where you want!
Health care is the largest industry in the U.S. -- with a forecast of 3 million new wage and salary jobs on the horizon between 2006 and 2016. (Source: BLS) An aging and growing population is expected to create a greater need for medical coders to perform accurate record-keeping and billing procedures in hospitals, physician offices, nursing and residential care facilities, and outpatient care centers nationwide.
You don't need to be a doctor or nurse to start a health care career. Medical coding provides an ideal way to step into this ever-growing industry. And it's easier than you think. With the right medical coding training, you can make the transition into a stable, rewarding career that will be needed for years to come.
It's no secret that the medical field is one of the fastest growing industries in the U.S.
According to the American Associate of Professional Coders (AAPC), careers in medical coding have ample room for professional growth, salary advancement, and specialty fields to explore. The AAPC published its annual survey on September 25, 2008 and some of the results even surprised Reed Pew, CEO and President of AAPC.
This year's survey was completed by over 12,000 medical coders; more coders than ever and conducted via the internet during July and August. A striking 89% of survey respondents have a CPC, CPC-H, CPC-P, or CPC-A credential. While CPC's made up 82 percent of the survey's respondents, members also exhibited other certifications. Those with specialty certification include three percent of those surveyed. Other certifications held by respondents include CCS, RHIT, CTR, among others.
- Average salaries have increased more than 11% compared to the 2007 survey!
- The average salary for a credentialed coder is 18% higher compared to a non-credentialed coder!
- 60% of coders work less than 40 hours a week!
- The average range for medical coders in general is $39,000 to $46,500!
According to this year's survey.
The survey indicated that compensation differences result from multiple influences such as employer, training, work sites, complexity of the coding being dones, experience, and geographical location.
Let's take a closer look at some of those factors that can includence the average Medical Coder's salary:
|No experience - $30,600||Physican Practice - $39,400|
|2 years experience - $34,800||Hospital - $44,700|
|4 years experience - $37,700||Government Facility - $46,500|
|8 years experience - $42,400||Payers - $52,500|
|Family Practice - $40,850||Atlantic - $52,599||New England/NY - $46,375|
|General Surgery - $43,500||Pacific - $49,688||Mountain/Plain - $40,876|
|Plastic Surgery - $47,200||South - $41,998||Mid-Atlantic - $39,970|
|Neuropsychiatry - $62,500||Payers - $52,500||South West - $39,794|
This powerful information gathered from the AAPC annual survey supports the opportunity for a successful and rewarding career in the Medical Coding Field. There are generous opportunities for advancement and numerous speciality fields to enter. It's eveident that NOW is the time to start preparing yourself for a stable career in medical coding.
Knowing that you can enter a secure profession now in a field that promises sustained and dramatic growth means peace of mind for the studnet, their family, and their future!
Medical terminology is the root of all medical professions. You need to have a thorough understanding of complex medical terms if you are going to succeed as a medical coder. How can you choose the right code for a diagnosis or procedure if you don't recognize medical terms? Knowledge of prefixes, suffixes, root words, and abbreviations will give you a leg up in your medical coding career.
With knowledge of these common and not-so-common terms, you will be able to perform your medical coding job in a fast, precise, and educated manner. And you will ensure that doctors get reimbursed for the right amounts -- a necessary part of your job as a medical coder!
Medical terminology provides a solid foundation for your medical coding career. You will be able to perform effective coding procedures with a thorough knowledge of medical terminology. A medical terminology course will cover: basic word structure, organization of the body, medical specialist and case reports, body systems, major classes or drugs, diagnostic tests and procedures, and more. You will get an overview of the terms associated with these topics.
Lay the groundwork for your medical coding career and enroll in a medical coding course today. Choose a course that enables you to learn using different learning methods and techniques, such as CDs, books and videos, to enhance your educational experience. Benefit from a school that offers medical terminology and medical coding in one convenient package.
You will be prepared to take the next step and get the medical coding training you need. Incorporate your medical terminology training into a lasting medical coding career! You will have the know-how to be an effective medical coder.