Medical coders provide an important function in hospitals, doctors’ offices, and clinics, helping to maintain patient record-keeping and ensuring that providers are properly paid by insurance companies. The following attributes are essential to quality medical coding.
Academic Understanding Combined with Good Logic Skills
Medical coding is a highly specialized skill that takes time to master. Those who work in this field must have a basic understanding of anatomy, physiology, and medical terminology. They must also be able to analyze information logically to arrive at the correct diagnosis and procedure codes. The work is especially challenging when patients have symptoms that are equivocal in nature, diagnoses are undetermined, or where a physician orders a range of treatment protocols.
Coding to the Highest Level with Specificity
An experienced medical coder knows the importance of coding to the highest level of specificity within the ICD-9-CM (The International Classification of Diseases, 9th Revision, Clinical Modification). Vague coding often leads to insurance companies rejecting claims. These claims must then be resubmitted while providers wait for payment, impacting their bottom line. Therefore, to ensure claims are paid expeditiously, coders must have more than a general knowledge of relevant codes in a given area, and be able to pinpoint correct subsections of the ICD-9-CM.
Staying Up-to-Date on Changes to Code Procedures
The codes that are currently in use are not static but are continually being modified through new legislation and industry mandates. Quality medical coders are always learning long after they have completed their initial training. The American Health Information Management Association requires members keep up to date with continuing education in order to remain certified. This will become even more important after October 1, 2015, when the current ICD-9-CM system is updated to ICD-10. This new system will encompass more than 68,000 diagnosis codes–more than five times the current number of codes in use.
Ability to Decipher Information Without Direct Access to the Provider
Skilled coders move quickly and efficiently through medical reports. They are able to rely solely on the physician’s or nurse’s record to determine the appropriate codes, without having to speak to the provider. Assuming the notes in the file are accurate and legible, a good coder has enough knowledge to determine the correct codes without having to stall the process to get more information.
New software programs are continually being developed to make the work of medical coders more efficient and more accurate. Those who adapt easily to improved technology are a big asset to providers who rely on their skills for accurate coding.
Advances in medicine and an aging baby boomer population have expanded most medical practices, making it even more important that coding is done accurately and efficiently. Coders with the above qualities are greatly sought after by all medical facilities, large and small.