Archive for the ‘Medical Coding’ Category

Inpatient Medical Coding vs. Outpatient Medical Coding

Monday, May 9th, 2011

In the world of medical coding, there are two fairly distinct groups of medical coders Inpatient Medical Coders and Outpatient 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.  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.

Medical Coding Certification – A Medical Coding Career Requirement

Monday, April 11th, 2011

Due to the amount of regulation and scrutiny given to medical coding activities the need for Medical Coding Certification is greater for individuals embarking on a medical coding career compared with many other career fields. An entry level or advanced medical coding certification is typically considered a prerequisite for entry into the medical coding profession.

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 provide a variety of entry level and advanced medical coding certification options. While an entry level medical coding certification will get you started in a medical coding career, in order for a medical coder to advance in the career field, it is usually necessary to gain advanced medical coding certification status. The medical coding certifications offered by both of these organizations are widely recognized and respected in the medical coding industry.  At this point, 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 it will evolve to become more of a home based career – much like medical transcription is today. As technology continues to evolve and highly secure and remote coding platforms are developed, the outsourcing model will begin to take hold in the industry. However, at this point most medical coding and billing is still performed in hospitals, clinics, and other healthcare facilities.

Introduction to Medical Coding

Monday, March 28th, 2011

Medical coding is the process of assigning standardized numerical codes to patient health care charts. This coded information is used to ensure that insurance companies, government organizations, such as Medicare, and patients alike all receive accurate billing statements for health services performed. Medical coders perform the work of converting diagnostic and procedural information into simplified numerical codes that can be electronically processed for payment by third party payers – Insurance companies and Medicare, for example.

The process of medical coding requires an attention to detail to ensure accuracy of billing records. Because of the large dollar amounts involved, coding is a highly regulated and tightly supervised activity. Coding is also subject to frequent and rigorous audits to ensure accuracy in the billing process as there are literally billions of dollars at stake. In many ways, medical coding is a much more scrutinized activity than, say the transcription of patient records.

Medical Coding work is typically performed in hospitals or clinics, although we are beginning to see some of these coding and billing jobs migrate to work at home positions. Medical coders generally begin with a transcribed patient health record and transform procedures and diagnoses etc. into numerical codes. This takes a great deal of expertise in medical terminology and a fluency with relevant codes. Of course this requires formal training. Billing specialists takes the coded output produced by the coder and submit it for reimbursement to insurance companies, Medicare, or directly to the patient. Many times a single person will perform both the coding and the billing functions. This is particularly true in smaller clinical settings. In large, high volume health care operations, coding and billing are often organized into separate functional areas. Of the two, coding specialists generally enjoy a higher income and require more specialized training.

Medical coders are in high demand and the opportunities in the career field of health records documentation are outstanding. Coders work in hospitals and clinics and for other health care providers across the country. They play a vital role in the health information management cycle.

Increasingly, the health information management industry is taking advantage of the rapid advances in online coding technology. More and more, the work is performed online over the internet. As online coding catches on as a concept, we will likely see many of the positions that have traditionally been offered exclusively in hospitals and other health care settings begin to migrate to home based jobs. The work at home employee model has worked very well for the transcription industry and will also likely begin to gain traction in the coding industry as online coding becomes more prevalent.