Non-clinical healthcare professions, such as medical billing, coding and transcription, have been gaining popularity over the last decade. Every profession has insider details that aren’t always easy to research on your own, so we’ve asked Jeff from ICE Training Institute to give us some information about one of the most popular programs: medical coding.
Medical Coding is designed to prepare individuals for entry-level employment for positions such as claims examiner, medical coder and related occupations in the medical industry. Graduates of this program will be employable by private health care practices, clinics, government agencies, insurance companies and other health care facilities.
A Certified Medical Coding Specialist’s main responsibility is to translate a medical treatment, surgical procedure, or diagnostic service done by a medical practitioner into specific codes for submitting a claim for reimbursement. As a Certified Medical Coding Specialist you may perform some or all of the following tasks:
- Assign codes for procedures and diagnoses.
- Submit aforementioned codes as insurance claims for reimbursement purposes.
- Locate and identify a patient’s documentation to support coding and billing processes.
- Consult with private health care practices, clinics, government agencies, insurance companies and other health care facilities regarding their medical coding processes.
A Certified Medical Coding Specialist can work in a variety of different office or home-office environments.
Entry-Level / Beginner: As a CMCS, you may start the day reviewing patient notes to be coded from a previous day. The particular type of records in review depends on the clinical setting the CMCS is working in. In an orderly method, the CMCS begins to review the patient documentation to understand the diagnosis assigned and procedures performed, and then assigns the codes according to AMA guidelines.
Experienced/Intermediate: Exploring freelancing opportunities. Once you have 1+ year experience as a CMCS, and have developed a thorough understand of the field, you can begin to freelance. Independent CMCSs have the option to choose from freelance projects, opening up the ability to work from home.
Professional/Advanced: Start your own medical coding business. As a small business owner, you have the ability to work from home or open an office where you can focus on coding and your tasks at hand. There is a low overhead, and very little starting capital for opening a business as a full time CMCS. The professional CMCS would need a computer with reliable medical coding software, as well as the tools listed below. Professional consulting for private health care practices, clinics, government agencies, insurance companies and other health care facilities is always an option for the seasoned CMCS.
Certified Medical Coding Specialists typically use two types of codebooks on a daily or weekly basis: The ICD-9-CM and CPT; both of which are an imperative tool in medical coding. Coders translate the physician’s notes into medical codes using these resources in order to properly submit medical claim documentation.
The ICD-9-CM code set consists of an International Classification of Diseases to include but not be limited to:
- A numeric listing of diseases, classified by etiology and anatomical system, as well as a classification of other reasons for encounters and causes of injury.
- An alphabetic index used to locate the codes.
- A procedural classification with a tabular section and an index.
CPT codes, or Current Procedural Terminology, is a collection of numbered codes created and copyrighted by the AMA (American Medical Association) that are assigned to every procedure a physician provides to a patient. Medicare patients are under a different codebook; however, similar procedures are undertaken. The CPT codes cover any medical, surgical, and diagnostic services done by a medical practitioner. Insurance providers are then able to determine the cost and reimbursement figures for the stated procedure.
Although medical coders do not earn a college degree through their training, there are several different certifications and licensures that you can earn to get in edge in the industry. Once you complete your training, professional organizations, such as the AAPC, will help you find job opportunities, stay current with changes to codes, and offer continuing medical education opportunities.
About the author:
Jeff Godin is the Founder and Managing Director of ICE Training Institute, which is headquartered in Daytona Beach, FL. Jeff works with numerous Department of Health officials on a regular basis, assisting in revisions to safety regulations for overlooked industries. Recently, Jeff has been the driving force behind new ICE offices opening in Maine, Pennsylvania, California, and Hawaii.
Jeff has almost 15 years of experience in the emergency management field. He has served as a Firefighter, EMS Chief Officer, and 911 Dispatcher. He earned a dual bachelors degree in criminal justice and psychology from Elmira College.