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How to Become a Certified Medical Coder: A Comprehensive Guide to Medical Coding Education, Training, and Certification Options



Understanding Medical Coding: A Comprehensive Guide Download




Medical coding is a vital process in the healthcare industry that involves translating medical information into standardized codes that can be used for billing, reporting, research, and analysis purposes. Medical coding ensures that healthcare providers get paid accurately and efficiently for their services, while also providing valuable data for improving patient care and public health.




Understanding Medical Coding: A Comprehensive Guide Download



But how does medical coding work? What are the different types of medical coding systems? What are the roles and responsibilities of medical coders? How can you learn medical coding and become a certified professional? And where can you find a comprehensive guide that covers everything you need to know about medical coding?


In this article, we will answer all these questions and more. We will explain what medical coding is, why it is important, how it works, what are the benefits of learning medical coding, what are the types of medical coding systems, what are the roles and responsibilities of medical coders, how to learn medical coding, and where to download a comprehensive guide on medical coding.


By the end of this article, you will have a clear understanding of medical coding and how it can help you advance your career in the healthcare industry.


Types of Medical Coding Systems




Medical coding systems are sets of rules and guidelines that assign alphanumeric or numeric codes to various medical terms, such as diagnoses, procedures, services, supplies, equipment, and drugs. There are three main types of medical coding systems that are widely used in the US: ICD-10-CM, CPT, and HCPCS.


ICD-10-CM




ICD-10-CM stands for International Classification of Diseases, Tenth Revision, Clinical Modification. It is the official system for coding diagnoses and conditions in the US. It is based on the international standard of ICD-10, which is maintained by the World Health Organization (WHO).


ICD-10-CM codes consist of three to seven characters, with the first character being a letter and the rest being numbers or letters. The codes are organized into 21 chapters that cover different categories of diseases and conditions, such as infectious diseases, neoplasms, endocrine disorders, mental disorders, etc.


For example, the code E11.9 means type 2 diabetes mellitus without complications, where E stands for endocrine disorders, 11 stands for diabetes mellitus, and 9 stands for without complications. The code J18.9 means pneumonia, unspecified organism, where J stands for respiratory diseases, 18 stands for pneumonia, and 9 stands for unspecified organism.


CPT




CPT stands for Current Procedural Terminology. It is the official system for coding procedures and services performed by physicians and other healthcare professionals in the US. It is maintained by the American Medical Association (AMA).


CPT codes consist of five digits, with or without modifiers that add more information or specificity to the codes. The codes are organized into six sections that cover different categories of procedures and services, such as evaluation and management, anesthesia, surgery, radiology, pathology and laboratory, and medicine.


For example, the code 99213 means office or other outpatient visit for the evaluation and management of an established patient that requires at least two of these three key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity. The code 20610 means arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa).


HCPCS




HCPCS stands for Healthcare Common Procedure Coding System. It is a supplementary system for coding supplies, equipment, and drugs that are not covered by CPT codes. It is maintained by the Centers for Medicare and Medicaid Services (CMS).


HCPCS codes consist of two levels: Level I and Level II. Level I codes are identical to CPT codes and are used to report procedures and services. Level II codes are alphanumeric codes that start with a letter followed by four numbers. They are used to report supplies, equipment, and drugs.


For example, the code A4253 means blood glucose test or reagent strips for home blood glucose monitor, per 50 strips. The code J3301 means injection triamcinolone acetonide not otherwise specified 10 mg.


Comparison Table





Coding System


Purpose


Structure


Format


Level of Specificity


ICD-10-CM


To code diagnoses and conditions


Organized into 21 chapters based on categories of diseases and conditions


Three to seven characters with the first character being a letter and the rest being numbers or letters


Highly specific with thousands of codes that capture details such as etiology, severity, location, laterality, etc.


CPT


To code procedures and services performed by physicians and other healthcare professionals


Organized into six sections based on categories of procedures and services


Five digits with or without modifiers that add more information or specificity to the codes


Moderately specific with hundreds of codes that capture details such as type, site, extent, etc.


HCPCS


To code supplies, equipment, and drugs that are not covered by CPT codes


Organized into two levels: Level I (identical to CPT codes) and Level II (alphanumeric codes that start with a letter followed by four numbers)


Five digits or alphanumeric codes with or without modifiers that add more information or specificity to the codes


Less specific with fewer codes that capture details such as description, quantity, etc.


Roles and Responsibilities of Medical Coders




Medical coders are professionals who are responsible for translating medical information into standardized codes that can be used for various purposes. Medical coders work with medical records, such as patient charts, lab reports, operative notes, discharge summaries, etc., and assign codes to each piece of information according to the coding systems.


Some of the typical roles and responsibilities of medical coders are:



  • Reviewing medical records and identifying relevant information for coding.



  • Assigning codes to diagnoses, procedures, services, supplies, equipment, and drugs using ICD-10-CM, CPT, and HCPCS coding systems.



  • Ensuring accuracy and completeness of codes and resolving any discrepancies or errors.



  • Following coding guidelines and regulations and adhering to ethical standards and confidentiality rules.



  • Communicating with physicians and other healthcare providers to clarify any unclear or missing information.



  • Submitting coded data to billing departments or insurance companies for reimbursement purposes.



  • Maintaining and updating coding knowledge and skills by attending training sessions, seminars, webinars, etc.



Medical coders play a crucial role in the healthcare industry as they ensure that healthcare providers get paid fairly and timely for their services, while also providing valuable data for improving patient care and public health.


How to Learn Medical Coding




If you are interested in learning medical coding and becoming a certified professional, you have several options to choose from. You can enroll in online courses, certificate programs, associate degrees, or other educational and training options that suit your needs and goals. You can also obtain certification from various organizations that offer exams and credentials for medical coders.


Medical Coding Education and Training Options




There are many online platforms and institutions that offer medical coding education and training options for aspiring or current medical coders. Some of the most popular and reputable ones are:



  • AAPC: AAPC is the largest association of medical coders in the world. It offers online courses that cover the basics of medical coding, as well as specialized courses that focus on specific coding systems or specialties. AAPC courses are designed to prepare students for certification exams and provide continuing education units (CEUs) for maintaining certification.



  • CareerStep: CareerStep is an online provider of career-focused education and training. It offers a comprehensive medical coding program that covers ICD-10-CM, CPT, HCPCS, anatomy, physiology, medical terminology, reimbursement methodologies, etc. CareerStep program also includes exam vouchers for certification exams and access to job placement services.



  • ed2go: ed2go is an online platform that offers a wide range of courses in various fields and subjects. It offers a medical coding course that covers the fundamentals of medical coding, as well as advanced topics such as modifiers, evaluation and management services, anesthesia services, etc. ed2go course also includes exam preparation materials and practice tests for certification exams.



  • Herzing University: Herzing University is an accredited institution that offers online and on-campus programs in various fields and disciplines. It offers an associate degree in medical billing and coding that covers both the clinical and administrative aspects of medical coding. Herzing University program also includes an externship experience that provides hands-on practice in a real-world setting.



These are just some examples of the many options available for learning medical coding. You can choose the one that best fits your budget, schedule, learning style, and career goals.


Medical Coding Certification Options




Besides obtaining education and training in medical coding, you can also obtain certification from various organizations that offer exams and credentials for medical coders. Certification can demonstrate your competence and professionalism in medical coding and increase your chances of getting hired or promoted.


Some of the most popular and reputable organizations that offer medical coding certification are:



  • AAPC: AAPC offers several certification options for medical coders, such as Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Risk Adjustment Coder (CRC), etc. AAPC certifications require passing an exam that tests your knowledge and skills in medical coding. AAPC certifications also require maintaining CEUs and membership fees.



  • AHIMA: AHIMA is the leading association of health information management professionals in the world. It offers several certification options for medical coders, such as Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician-based (CCS-P), etc. AHIMA certifications require passing an exam that tests your knowledge and skills in medical coding. AHIMA certifications also require maintaining CEUs and membership fees.



  • NHA: NHA is a national provider of allied health certifications and continuing education. It offers a certification option for medical coders, namely Certified Billing and Coding Specialist (CBCS). NHA certification requires passing an exam that tests your knowledge and skills in medical coding. NHA certification also requires maintaining CEUs and recertification fees.



  • AMT: AMT is a nonprofit organization that certifies allied health professionals. It offers a certification option for medical coders, namely Registered Medical Coder (RMC). AMT certification requires passing an exam that tests your knowledge and skills in medical coding. AMT certification also requires maintaining CEUs and membership fees.



These are just some examples of the many options available for obtaining medical coding certification. You can choose the one that best fits your eligibility, preference, and career goals.


Medical Coding Resources and Tools




There are many resources and tools that can help you learn and practice medical coding, as well as stay updated on the latest trends and developments in the field. Some of the most useful ones are:



  • ICD10Data.com: This is a free online tool that allows you to search, browse, and convert ICD-10-CM codes. You can also find information on code changes, updates, guidelines, etc.



  • Find-A-Code: This is a subscription-based online tool that allows you to access and search various coding systems, such as ICD-10-CM, CPT, HCPCS, etc. You can also find information on code descriptions, modifiers, crosswalks, fee schedules, etc.



  • Coding Clinic Advisor: This is a subscription-based online tool that provides official guidance and advice on coding questions and scenarios from the American Hospital Association (AHA). You can also find information on coding tips, case studies, quizzes, etc.



  • CodingIntel: This is a subscription-based online tool that provides expert guidance and education on coding for physicians and other healthcare professionals. You can also find information on coding rules, best practices, webinars, podcasts, etc.



  • Medical Coding Quickstudy Academic by BarCharts: This is a laminated reference guide that summarizes the basics of medical coding, such as coding systems, symbols, abbreviations, modifiers, etc. You can use it as a handy cheat sheet or a study aid.



These are just some examples of the many resources and tools available for medical coding. You can use them to enhance your learning and practice experience and to keep up with the ever-changing field of medical coding.


Conclusion




Medical coding is a vital process in the healthcare industry that involves translating medical information into standardized codes that can be used for various purposes. Medical coding ensures that healthcare providers get paid accurately and efficiently for their services, while also providing valuable data for improving patient care and public health.


In this article, we have explained what medical coding is, why it is important, how it works, what are the benefits of learning medical coding, what are the types of medical coding systems, what are the roles and responsibilities of medical coders, how to learn medical coding, and where to download a comprehensive guide on medical coding.


medical coding and how it can help you advance your career in the healthcare industry.


If you are interested in learning more about medical coding or downloading a comprehensive guide that covers everything you need to know about medical coding, you can click on the link below and get access to a free PDF file that you can save, print, or share with others.


Click here to download your free comprehensive guide on medical coding.


FAQs




Here are some frequently asked questions (FAQs) related to medical coding:



  • What is the difference between medical coding and medical billing?



Medical coding and medical billing are two related but distinct processes in the healthcare industry. Medical coding involves translating medical information into standardized codes that can be used for various purposes. Medical billing involves submitting claims to insurance companies or patients for reimbursement based on the codes assigned by medical coders.


  • How long does it take to learn medical coding?



The answer to this question depends on several factors, such as your prior knowledge and experience, your learning style and pace, your chosen education and training option, your certification goal, etc. Generally speaking, it can take anywhere from a few months to a few years to learn medical coding and become a certified professional.


  • How much does it cost to learn medical coding?



The answer to this question also depends on several factors, such as your chosen education and training option, your certification goal, your membership fees, your exam fees, your recertification fees, etc. Generally speaking, it can cost anywhere from a few hundred dollars to a few thousand dollars to learn medical coding and become a certified professional.


  • How much do medical coders make?



The answer to this question also depends on several factors, such as your education and training level, your certification status, your experience level, your specialty area, your employer type and size, your geographic location, etc. Generally speaking, according to the BLS data from May 2020, the median annual wage for medical records and health information technicians (which includes medical coders) was $44,090. The lowest 10 percent earned less than $28,800, and the highest 10 percent earned more than $73,370.


  • Where do medical coders work?



Medical coders can work in various settings within the healthcare industry, such as hospitals, clinics, physician offices, nursing homes, rehabilitation centers, insurance companies, billing companies, consulting firms, etc. Medical coders can also work remotely from home or anywhere with an internet connection.


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