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A medical biller and coder will have, generally, the same sort of duties no matter what type of facility they’re employed in. From clinics to hospitals to physicians’ offices, medical billers and coders use medical codes to document patient diagnoses and treatments. Specifically, their duties include:
• Reading and analyzing patient records
• Determining the correct codes for patient records
• Using codes to bill insurance providers
• Interacting with physicians and assistants to ensure accuracy
• Keeping track of patient data over multiple visits
• Managing detailed, specifically-coded information
• Maintaining patient confidentiality and information security
Is Medical Coding the same as Medical Billing?
The main task of a medical coder is to review clinical statements and assign standard codes using CPT®, ICD-10-CM, and HCPCS Level
II classification systems. Medical billers, on the other hand, process and follow up on claims sent to health insurance companies for reimbursement of
services rendered by a healthcare provider. The medical coder and medical biller may be the same person or may work with each other to ensure
invoices are paid properly. To help promote a smooth coding and billing process, the coder checks the patient’s medical record (i.e., the transcription
of the doctor’s notes, ordered laboratory tests, requested imaging studies, and other sources) to verify the work that was done. Both work together to
avoid insurance payment denials.
The medical coder and biller process a variety of physician services and claims on a daily basis. Medical codes must tell the whole story of the patient’s encounter with the physician and must be as specific as possible in regards to capturing reimbursement for rendered services.
Education and training is key to becoming a skilled and successful medical coder. The first step coders must take is to have a thorough knowledge of anatomy and medical terminology. It’s also important to become familiar with the codebook resources CPT®, HCPCS Level II, and ICD-10-CM and their coding systems. It’s also vital to know the coding systems’ corresponding guidelines and what codes are accepted by which insurance plans, which government and payer regulations to follow, and how to be compliant while coding.
Besides assigning CPT®, ICD-10-CM, and HCPCS Level II codes correctly to claims, coders may also audit and re-file appeals of denied claims. They may step into the role of educator to providers and recommend the appropriate codes that follow federal mandates and compliance. When coders are auditors as well, they will require providers to use specific coding and billing standards through chart audits. They may also speak on behalf of the provider and patient on coverage and medical necessity issues. The standard medical coding professional obtains the Certified Professional Coder (CPC®) credential. The good news is coding-related jobs are expanding due to the growing landscape of the business side of healthcare. For example, Certified Professional Medical Auditor (CPMA®), Certified Professional Compliance Officer (CPCO™), and Certified Physician Practice Manager (CPPM®), etc., are areas that coders can branch into.
What Education and Training Is Required to Become a Medical Coder?
Master degree / Degree / Diploma or equivalent examination from any recognized Board or Council in any discipline
Career Growth in Medical Coding
The career growth in the field of Medical Coding depends on individual abilities. The quality of a candidate enables him/her to reach the next level in the industry.
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.
Our Placement Assistance
We offer 100% Placement assistance at various medical coding firms within India and abroad. Various companies situated at Hyderabad, Chennai, Delhi, Bengaluru, Cochin, etc. are the hub for medical coders to flourish.
Salary Range and Outlook
Coders earn an average of Rs. 25,000 – 45,000 per month, 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.
Looking at the prospects of medical coding between 2016 and 2022, the main areas of job opportunity are as follows:
• In a Medical Office Company (starting with patient records in medical offices & liaising with medical insurance companies for claims processing). This can be a lucrative field especially after you gain a few years experience. This is equally true of cities like Ahmedabad, Bengaluru, Hyderabad, Chennai, New Delhi, Mumbai, Pune and Chandigarh which have a high concentration of medical coding specialist jobs.
• In a Hospital Administration Environment where you can take up more duties like billing, quality control and auditing In both cases, you will need to have a certification from either AAPC or AHIMA.
Take Your Career as Medical Coding Professionals
Start your new career as medical coding professionals, because it has been termed to be an important one in the present health care industry when compare to other Indian industries. NWT Academy offers both classroom and online training program for medical coding. We also provide ICD 10 CM, CPT, HCPCS LEVEL11 training and also prepare the candidates with good anatomy, physiology and medical terminology knowledge. Healthy classrooms and experienced faculties are prepared the candidates for AAPC (American Academy of Professional Coders) CPC(Certified Professional Coder)certification.