How to Be Medical Coder - Job Description, Skills, and Interview Questions

Nov 15, 2023 / 5 Minutes Read / By Albert

How to Become

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Medical coders play an important role in healthcare. They are responsible for assigning specific codes to medical diagnoses and procedures to ensure accurate reimbursement for healthcare services. This is done by analyzing patient records and assigning the relevant codes from the International Classification of Diseases (ICD) system.

The cause and effect of this process is clear: accurate medical coding leads to proper reimbursement, which in turn helps to keep healthcare costs down. Furthermore, it can also help to protect healthcare providers from fraud and abuse by providing an audit trail of all medical services that have been provided. As a result, medical coders are essential to the efficient and cost-effective functioning of the healthcare system.

Steps How to Become

Earn a High School Diploma or GED. The first step to becoming a medical coder is to earn a high school diploma or GED. High school courses in biology, anatomy, and physiology can be especially helpful for aspiring medical coders.
Pursue a Postsecondary Education. Most medical coding jobs require at least a certificate from an accredited postsecondary institution. Options for attaining a medical coding certificate include community or technical colleges, online programs, or professional coding organizations such as the American Academy of Professional Coders.
Obtain Certification. After completing a postsecondary program in medical coding, prospective coders can obtain certification from one of several certifying organizations. Certification is not required for some jobs but may increase employment opportunities.
Gain Experience. Most employers look for job candidates with some hands-on experience in the field, so it can be beneficial to gain some experience through an internship or volunteer experience.
Keep Up With Changes in the Field. Medical coding is a rapidly changing field, so medical coders must stay up to date on coding changes and new codes. Most employers provide continuing education opportunities to help keep coders informed of changes in the field.

Staying ahead and competent as a medical coder requires continual education and training. By attending conferences, webinars, and workshops, coders can stay up to date on the latest coding guidelines, changes to regulations, and advancements in the medical field. coders should adopt new methods of coding such as data analytics and artificial intelligence to increase their efficiency.

Finally, to stay ahead and competent, medical coders should also stay in touch with their peers and colleagues to learn from their experiences and discuss coding challenges. Taking these steps will allow medical coders to remain knowledgeable, efficient, and competitive in the field.

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Job Description

Medical Coding Specialist: Responsible for coding patient medical records using ICD-10 codes and ensuring accuracy of coded data.
Clinical Coding Auditor: Responsible for auditing medical records to ensure accuracy of coded data and compliance with coding policies.
Medical Coding Educator: Responsible for training new coders and providing continuing education to existing coders on medical coding standards, regulations, and procedures.
Medical Coding Quality Assurance Analyst: Responsible for performing quality assurance reviews of coded data to ensure accuracy, completeness, and compliance with coding standards.
Medical Coding Billing and Reimbursement Specialist: Responsible for ensuring accurate coding of patient medical records for billing and reimbursement purposes.
Medical Coding Compliance Officer: Responsible for monitoring and enforcing compliance with medical coding standards, regulations, and procedures.

Skills and Competencies to Have

Knowledge of medical terminology and anatomy.
Understanding of medical coding systems (ICD-10, CPT, and HCPCS).
Ability to analyze and interpret medical records.
Strong computer skills.
Attention to detail and accuracy.
Good organizational and problem-solving skills.
Ability to work independently and meet deadlines.
Excellent communication and interpersonal skills.
Ability to maintain confidentiality and protect sensitive information.
Knowledge of HIPAA regulations.

Medical coders are essential to the healthcare industry, as they play a major role in ensuring accuracy and efficiency within the health information systems. Their primary responsibility is to accurately assign codes to medical diagnoses, treatments, procedures and services to facilitate reimbursement and data analysis. The accuracy and speed of their coding is critical, as any mistakes can cause delays or incorrect payments that can affect the financial health of the medical organization.

Therefore, the most important skill for a medical coder to possess is a comprehensive knowledge of various coding systems and the ability to accurately interpret medical records. Being familiar with ICD-10, CPT and HCPCS codes, as well as having a thorough understanding of anatomy, physiology and medical terminology is essential for any successful medical coder. strong organizational and communication skills, along with the ability to multitask and work under tight deadlines, are also important qualities for a medical coder to possess.

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Frequent Interview Questions

What experience do you have as a Medical Coder?
How do you stay on top of changes in coding regulations?
What is your experience with coding software?
Can you explain your workflow process when coding?
What specific coding areas are you most familiar with?
How do you ensure accuracy when coding?
How do you handle complex coding problems?
Are you familiar with ICD-10 and CPT codes?
What strategies do you use to mitigate coding errors?
How would you rate your knowledge of medical terminology?

Common Tools in Industry

CPT Coding Manual. Comprehensive guide to medical coding, listing all codes and descriptions needed to accurately code medical procedures. (eg: CPT Code 99214 for an Office Visit)
ICD-10 Coding Manual. Detailed guide to international medical coding system, used to code diagnoses and treatments for a variety of medical conditions. (eg: ICD-10 Code A04. 3 for Enterocolitis due to Clostridium Difficile)
Encoder Pro Software. Software used to quickly search and locate codes and descriptions, as well as print out coding reports. (eg: Searching for allergy in Encoder Pro will yield all relevant ICD-10 codes)
Computer Assisted Coding (CAC) Systems. Automated systems used to accurately code diagnosis and treatments, based on a patients medical records. (eg: CAC System analyzing patient notes to correctly assign ICD-10 codes for allergies)
Medical Practice Management Software. Software used to manage the daily operations of a medical practice, including tracking patient information and coding procedures. (eg: Appointment Scheduling Software to track patient visits and assign CPT codes)

Professional Organizations to Know

American Academy of Professional Coders (AAPC)
American Health Information Management Association (AHIMA)
American Medical Billing Association (AMBA)
American Medical Informatics Association (AMIA)
Healthcare Information and Management Systems Society (HIMSS)
National Alliance of Medical Auditing Specialists (NAMAS)
National Committee for Quality Assurance (NCQA)
Professional Association of Healthcare Coding Specialists (PAHCS)
The American Medical Association (AMA)
World Health Organization (WHO)

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Common Important Terms

Diagnosis Code. A code assigned to identify a patient's diagnosis.
Procedure Code. A code assigned to identify a medical procedure or service performed.
ICD-10-CM. International Classification of Diseases, Tenth Revision, Clinical Modification; the current coding system used for diagnosis codes in the US.
CPT Code. Current Procedural Terminology; the coding system used for procedure codes in the US.
HCPCS Code. Healthcare Common Procedure Coding System; a coding system used in the US to identify medications and supplies.
Medical Billing. The process of submitting, following up on, and appealing claims to insurance companies in order to get payment for services rendered.
Medical Coding. The process of assigning appropriate codes to diagnoses and procedures in order to accurately represent the services provided to a patient.

Frequently Asked Questions

What is a Medical Coder?

A Medical Coder is a healthcare professional who assigns standardized codes to medical diagnoses and procedures for the purpose of insurance claims and medical records.

What qualifications are required for a Medical Coder?

Medical Coders must possess a certification from an accredited professional organization, such as the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA). They must also have strong knowledge of anatomy, physiology, and medical terminology.

What is the CPT code for a mammogram?

The CPT code for a mammogram is 77067.

How long does it take to become a Medical Coder?

Depending on the individual, it typically takes between 6-12 months to become a Medical Coder. This includes completing a medical coding program and taking a certification exam.