When you visit your doctor, your medical insurance provider will receive a bill containing medical codes, including CPT, ICD-10 and possibly other codes.
For example, if an X-ray is performed or blood is taken, those services would also be represented by medical codes on your bill. There are thousands of medical codes – one for nearly every type of health care service, procedure and even for medical equipment.
Medical coders spend their days reviewing medical records to assign these codes and ensure that the health care providers they support are properly reimbursed for services. Physicians and hospitals depend on accurate coding to receive proper reimbursement, making the role of the coder a valued one.
Coding accurately is not easy. The coder must carefully read the doctor’s and nurse’s notes to precisely determine the services received by the patient. The coder must also understand private payer policies and government regulations for accurate coding and billing. By some estimates, inaccurate or incomplete coding costs the doctors thousands of dollars each year in lost payments. Without competent coders, providers run the risk of losing revenue.
Medical coders work in every type of health care facility, including doctor’s offices, surgery centers, hospitals and health care systems. Some experienced coders have the ability to work at home through an employer or as a contract worker.
Coding requires extraordinary detail. The coder must carefully review the patient’s chart to learn the diagnosis and itemize every service provided. If a service is overlooked, the provider will not receive payment for it. If the coder chooses the wrong code, the provider may have to return any excess payment or face legal charges for overbilling.
Codes frequently change, so coding professionals must keep up to date on new rules and interpretations. A solid understanding of medical terminology, including anatomy, is also required.
Salary Range and Outlook
Coders earn an average of $45,000 to $65,000 per year, according to a 2015 salary survey conducted by AAPC. Certified coders earn more than non-certified coders. Many employers now require certification for newly hired coders.
Earning a bachelor’s degree or master’s degree can strengthen a medical coder’s career; however, it’s not required to show proficiency. What is necessary is to have a solid foundation of anatomy, physiology and medical terminology education. If you want to pursue a career as a medical coder, you should complete a medical coding course of study.
Training in coding skills is available at many community colleges and through online learning centers. Most training programs can be completed in 18 to 24 months. AAPC, a credentialing body for medical coders, offers several medical coding courses.
Your course of study should prepare you to take a certification exam to become a certified professional coder. Certification lets employers know that you understand coding rules and have demonstrated a high level of accuracy in translating patient charts into correctly coded insurance bills. Coders with less than two years’ experience receive a CPC-A (apprentice) designation until their experience is complete. AAPC offers examinations testing your knowledge of coding for physician offices (CPC), outpatient facilities (CPC-H) or payers (CPC-P).
Because coding is based on the nature of the medical services provided, certification is available for specific medical specialties, including evaluation and management, general surgery and obstetrics and gynecology. Continuing education is required to maintain certified status.
Learn More About a Career as a Medical Coder
- Get details about a medical coding career.
- Learn about the benefits of medical coding certification.