Medical coding is a key component of revenue cycle management. When done efficiently and accurately, it helps ensure hospitals are properly reimbursed for the services they provide.
Here are 15 things to know about medical coding:
1. AAPC, formerly known as the American Academy of Professional Coders, describes medical coding as “the transformation of healthcare diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes.” The codes are from transcription of physician’s notes, laboratory and radiologic results or other medical record documentation.
2. Medical coding professionals take information from the medical record documentation and assign appropriate diagnoses and procedure codes, according to AAPC. They then develop an insurance claim, which indicates how much the insurer owes for the care and helps determine how much the patient will be billed.
3. The AAPC notes that medical coders are not the same as medical billers. Medical coders use classification systems to assign codes, including the International Statistical Classification of Diseases and Related Health Problems. Medical coders may also audit and re-file appeals of insurance claim denials. Medical billers process and follow up on claims.
4. Accurate coding of claims requires correct clinical documentation. Coders are unable to assign proper codes when documentation is incorrect or lacking, which could result in a claim being denied by an insurer.
5. In 2018, the most common medical coding errors identified by the American Medical Association were unbundling codes, or using multiple current procedural terminology codes for parts of a procedure, and upcoding.
6. The first medical coding system, introduced by French physician and statistician Jacques Bertillon in the late 1800s, was known as Bertillon Classification of Causes of Death, reports The New York Times. The system was used to classify and track mortality.
7. Dr. Bertillon’s system was renamed the International Statistical Classification of Diseases, Injuries and Causes of Death in the 1940s, reports The New York Times. It is now known officially as the International Statistical Classification of Diseases and Related Health Problems, or ICD, and has continuously been updated.
8. The U.S. currently uses ICD-10, which launched nearly two decades ago but has only been used in this country since October 2015. In June 2018, WHO released a version of ICD-11. The organization said on its website that it expects to present ICD-11 to the World Health Assembly this year for adoption by countries.
9. The number of medical records and health information technicians, which includes medical coders, is projected to grow 13 percent between 2016 and 2026, according to the U.S. Bureau of Labor and Statistics. There were 206,300 such jobs in 2016, and 234,100 are projected for 2026.
10. The average annual salary for medical coders is based on the person’s credentials, as well as where they work and their job responsibility, according to AAPC. The association estimates the average annual salary is $52,441. According to AAPC, the average medical coder with no certification earns about $45,035 annually compared to about $51,477 for those with one certification.
11. Certified coder/medical coding technician is among the most sought-after healthcare jobs this year, according to a salary guide from staffing firm Randstad US.
12. Medical coders don’t have to have bachelor’s or master’s degrees, but they must be well-versed when it comes to anatomy, physiology and medical terminology education, according to AAPC.
13. Patty Buttner, director of health information management practice excellence for the American Health Information Management Association, told Becker’s coding professionals also need to be involved in the revenue cycle, need to know the impact of their job on the organization, and must work in collaboration with colleagues such as clinical documentation improvement professionals and quality staff.
14. Ms. Buttner’s advice for hospital revenue cycle leaders is to ensure their organization has an internal auditing process in place.
“That’s so vital to identify and correct any issues that may be related to coding [and] make sure the most quality and accurate work is going out the door,” she said. “You really want those codes to represent the whole story of that patient.”
15. Additionally, Ms. Buttner stressed the importance of continuing education for medical coders. She said healthcare organizations must support these professionals in their education endeavors so they can be informed and grow in their job.
Photo courtesy of: Becker’s Hospital Review
Originally Published On: Becker’s Hospital Review
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