How Does Medical Coding Work? What Does a Medical Coder Do?

Medical coding is an in-demand profession at healthcare organizations across the country. Despite the surging demand for medical coders, however, many people do not understand how medical coding works.

Today, we’re explaining what medical coding is, how it works, and how a medical coder adds value to an organization.

What is Medical Coding?

Medical coding traces its origins all the way back 17th century recordkeeping in England. During this time, clinics kept crude records for each patient, using specific numbers and ‘codes’ to track the treatment received by each patient.

Today, the American Academy of Professional Coders (AAPC) defines medical coding as, "the transformation of healthcare diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes."

In other words, medical coders translate important medical information into simple codes to document medical records and inform accurate medical billing.Thanks to a standard coding system, medical records can be seamlessly transferred from one organization to another.

What Does a Medical Coder Do?

A medical coder is the individual responsible for translating a physician’s report into useful medical codes.

The coder will look at the physician’s report and determine the treatment that was provided to the patient. Then, the coder will translate all pertinent information into code. This code is used when referencing the treatment in the future and for billing purposes.

A medical coder’s job varies depending on the setting.

A medical coder working at a hospital will document and assign codes for each medical procedure received by a patient, for example.

A medical coder working for an insurance company, meanwhile, will verify the accuracy of incoming claims, checking to make sure the patient received treatment according to his or her insurance plan.

Some medical coders work remotely from home. Many medical coding jobs can easily be performed entirely over a computer and an internet connection, making the need for an on-site office irrelevant.

Why Do We Need Medical Coding?

Without medical coding, doctors would use common language to describe each patient’s treatment plan. That may sound good in theory. However, common language is too inexact to give an insurance company the accurate details it needs.

That’s why a specific set of codes has been developed to define medical procedures. The medical coder’s job is to translate common language into code so information can be efficiently transferred around a hospital and between organizations.

Where Do Medical Coders Work?

Medical coders can work in all types of healthcare organizations, but they can also work in a number of other settings, including all of the following:

• Hospitals and doctors’ offices• Healthcare consulting services• Educational institutions• Home offices• Insurance agencies• Law firms• Government agencies

Obviously, people expect to see medical coders in hospitals, clinics, and urgent care facilities. But many people are surprised to see medical coders in other settings as well – from home offices to law firms to insurance agencies.

What Kind of Training Do Medical Coders Go Through?

Some medical coders have bachelor’s degrees or master’s degrees. However, no formal education is required to be a medical coder.

Some technical colleges have introduced medical coding programs that teach coders the intricacies of the profession. These programs take one to two years.

Prospective coders will also seek specialized certifications – which are similar to the ‘graduate degrees’ of the coding world. Specialized certifications make a medical coding applicant stand out.

Popular specialty certifications include Certified Professional Coder (CPC0, Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC), and Certified Inpatient Coder (CIC).

Final Word

As the healthcare industry continues to grow, demand is increasing for medical coders. The Bureau of Labor Statistics expects medical coding jobs to grow at a faster-than-average rate of 13% through 2026. https://hmi-corp.com/medical-coding-services/

HMI Corp specializes in contract coding, including inpatient, outpatient, same-day surgeries, ancillary departments, and physician E/M. All coding services are provided by credentialed coding staff based right here in the United States. https://hmi-corp.com/contract-coding-services/

Dr. West has more than thirty years of executive management experience in health care. As CEO and Medical Director of American Pathology Resources, Inc. Dr. West joined HMI Corporation as Chief Executive Officer and Chief Medical Officer.