The documentation is then passed along to medical coders, who transfer the narrative clinical information into a standardized form, which they submit to insurance carriers for reimbursement.

A medical coding career is ideal if you’re interested in healthcare but do not want a role that requires direct patient contact. Opportunities in the field will continue growing as our population ages and demand for healthcare rises. There is a clear path to employment with training from a vocational school.

What are the Core Duties for Medical Coders?

Medical coders, sometimes called medical billing specialists, complete various administrative tasks to secure payment for medical services rendered by physicians and healthcare facilities. Medical billing and coding specialists primarily work on computers, using multiple programs to review clinical documentation, create invoices using alphanumeric codes, and track a medical bill’s progress through the revenue cycle.

As a medical billing and coding specialist, you will also serve a quality-assurance role by overseeing clinician compliance with documentation standards. You will perform bill reviews to ensure compliance with internal policies and industry-wide regulations. You will also review rejected claims, research reasons for an appeal, and issue reconsideration requests to insurers.

Review and Interpret Medical Records

As a medical billing and coding specialist, you will review clinical records to ensure each documentation requirement is met, necessary signatures are present, dates are correct, and information is accurate. You will focus on compliance with institutional policies that govern the minimum standards of required documentation.

When you note omissions or errors, you must follow up with clinicians to obtain supplemental documentation or amendments. This duty protects patients because contemporaneous and complete records are necessary to ensure the continuity of care and that future treatment is safe and consistent with the patient’s medical history.

Code Medical Records and Generate Invoices

After you complete your record review, you will code the case. Each examination, service, procedure, and treatment corresponds with a standardized alphanumeric code. The codes are detailed and must be consistent with the medical record.

Effective medical billing and coding specialists are attentive readers and strong researchers. These skills ensure the codes they select are appropriate and justified by the available information. Insurers will reject codes that are unsupported by the clinical data. Coding will account for the majority of your time. You’ll have to work efficiently without sacrificing accuracy. Coding errors cause a ripple effect, leading to denied payments and the need to generate a new bill or appeal.

Submit Bills and Complete Follow-Up Tasks

You will transmit completed bills and supplemental medical documentation to insurance providers for remittance. The insurer then reviews the invoice and issues payment or a denial. You then track outstanding claims to ensure they were received, reviewed, and addressed. Due to the ongoing exchange of information between healthcare facilities and insurers, timely follow-up is necessary to ensure claims are not overlooked.

This role is crucial because medical claims are subject to strict filing and response deadlines. If payment is issued, you may be responsible for ensuring it is received by your employer. If a claim is denied, there is a small window in which you must research the reasons and issue an appeal to obtain the outstanding payment.

What is the Best Way to Start a Career in Medical Coding?

Medical coding is not a skill you can easily learn on the job or teach yourself. Performing the job effectively requires a comprehensive understanding of anatomy and physiology, medical terminology, healthcare reimbursement standards, federal regulations, and coding best practices.

Completing a comprehensive training program through a vocational institution is the best way to learn medical coding and secure a quality position at a medical facility. Schools teach the science needed to interpret medical records, how to code, and the fundamentals of medical billing. Vocational educators help you strengthen the communication, investigatory, and critical thinking skills needed to work alongside doctors and other healthcare professionals.

What Will I Learn in My Billing and Coding Program?

Your curriculum will blend practical skills with textbook learning to give you the knowledge and skills needed to be an effective medical billing and coding specialist. Instructors use case studies, simulated billing tasks, group work, and skills development exercises to prepare you to enter the workforce.

Billing Basics

You’ll learn the rules and standards applied by the government, insurance providers, and regulatory agencies concerning billing best practices. Topics will include HIPAA and privacy laws, the billing cycle, regulations and statutes, bill generation, understanding insurance plans, and denial appeals.

CPT, HCPCS, and ICD-10

Courses will cover the coding systems you’ll use every day. All bills have codes from the Current Procedure Terminology (CPT-4), Healthcare Common Procedure Coding System (HCPCS), and International Statistical Classification of Diseases and Related Health Problems (ICD-10). These globally used systems ensure consistency, transparency, and accuracy.

Rather than simply memorizing codes, instructors will teach you how to navigate the relevant manuals for research. You’ll develop strategies for quickly and accurately choosing appropriate codes.

Coding

The bulk of your work will involve each aspect of the coding process. Vocational education will help you understand how to code and explain the underlying theory behind each step. Coursework will involve learning to read and interpret medical records, how to understand insurance plans and their documentation requirements, code selection, and bill creation.

You’ll learn about different subsets of coding, allowing you to specialize in your career. The curriculum will include in-depth instruction on inpatient coding to prepare you for work in a hospital or skilled nursing facility. You’ll also learn how to code from operative reports, preparing you to take on complex surgical cases.

Health Information Technology

Vocational schools will prepare you for the workplace by introducing you to healthcare software and computer systems used in hospitals and medical practices. You won’t only learn to code, but you’ll complete mock exercises in real-world computer systems.

Instructors will also cover cyber-security and best practices, making you aware of potential threats and pitfalls to your success in the field.

Where do Medical Coders Work?

Completing a medical coding program offers you flexibility when selecting your job after graduation. Every healthcare provider needs someone to code and bill. As a result, well-trained and qualified medical billing and coding specialists can work in many settings. Each offers distinct advantages and challenges.

In general, medical billing and coding specialists work a typical Monday to Friday day shift. While you’ll be working in healthcare, your administrative duties will require you to be available when insurers and other agencies are open. Most positions are in a professional environment, separate from clinical care areas due to the sensitivity of protected health information.

Physician’s Offices

Doctors with independent practices or group practices operate much like a small business. Medical billing and coding specialists are an essential part of their team because they secure reimbursement so the practice can continue operating. These positions usually offer a consistent type of coding based on the doctor’s specialty, a volume of work based on the size of the practice, and a schedule that mirrors the provider’s office hours.

In this setting, you’ll likely handle every step of the billing process and may be responsible for accounts receivable, collections, and supervisory duties. You may also need to be in close contact with insurers to maintain effective working relationships and compliance.

Hospitals, Clinics, and Long-term Care, Facilities

Hospitals, urgent care clinics, specialized treatment centers, rehabilitation facilities, and nursing homes employ teams of medical billing and coding specialists. These are larger employers with multiple layers of supervision and management. You’ll work as part of a department to complete coding tasks.

You may specialize in one phase of the billing cycle or be assigned to a particular clinical department, completing billing and coding tasks from chart review to claim submission.

In these roles, you’ll perform inpatient and operative coding depending on how your department allocates tasks. You may also specialize and complete coding tasks for a specialty, like oncology or rheumatology. Their hierarchal structure may mean rigid policies and structured advancement opportunities.

Insurance Companies

Rather than generating bills for a healthcare provider, you may elect to review bills and issue determinations by working for an insurance company. You’ll review submitted invoices to ensure the codes match the narrative information. The tasks require the same skill set as working for a healthcare provider, but you process the claims in the opposite direction.

You’ll then select reasons for your approval or denial and transmit documentation to the healthcare provider. Insurance companies are large-scale employers. Beyond being a strong medical coder, you’ll need to become an expert on the insurer’s policies and coverage plans to make accurate claim determinations. You won’t interact with patients or clinical personnel like healthcare billing and coding specialists but collaborate with your peers and administrative staff.

Government Agencies

Medicaid, Medicare, and other governmental agencies, like the Department of Veterans Affairs and Department of Health and Human Services, employ medical coders to conduct bill reviews, compliance investigations, and audits related to accreditation and licensure.

Working for the government offers competitive benefits and relatively strong job security. You may work in an office or travel to healthcare facilities to conduct on-site investigations or reviews.

There are fewer opportunities with the government than with healthcare facilities or insurers. You’ll need strong coding skills that allow you to spot errors and fraud in billing as well as an in-depth understanding of laws and regulations.

Final Thoughts

Now that you know what medical coding is, it is time to learn more about the Medical Insurance Billing and Coding program at Meridian College. We prepare you for this rewarding and challenging career with an extensive curriculum and career services to help you find a job after graduation. Take the first step and learn more about Meridian College today.

Want to Learn More?

Ready to attend the Medical Insurance Billing & Coding program at Meridian College? Medical Billing and Coding professionals are responsible for keeping the records, charts, and bills in a medical office in order. In addition to the classroom experiences, students will also complete an externship for on-the-job training that will bring them further expertise. Contact us to learn more about.

Contact Meridian College today to learn more about becoming a medical billing and coding specialist.

The post What is Medical Coding? appeared first on Meridian College.

The day-to-day tasks of medical billing and coding specialists require a high-level understanding of health science, fluency in medical coding terminology, and familiarity with the conventions of medical bill generation. The necessary knowledge is not intuitive. Learning to bill and code requires commitment and time. The tangible rewards, sense of accomplishment, and opportunity for personal development justifies the commitment to your education.

What Does a Medical Billing and Coding Specialist Do?

Medical billing and coding specialists are administrative professionals who support patient care by ensuring documentation compliance is met, generating bills for medical services, and collecting reimbursement from insurance companies. They complete various tasks during each phase of the billing cycle by collaborating with practitioners, other billers, and insurance representatives. A medical billing and coding specialist’s primary duties include:

• Auditing medical records to ensure they are complete and adhere to regulatory standards
• Reviewing clinical documentation, translating it into an alphanumeric coding system, and generating bills for submission
• Verifying bill submission, following up on outstanding bills, and resolving discrepancies with insurers
• Reviewing denied claims, compiling supplemental documentation, and submitting appeals
• Collecting payments from insurance companies and patients, partnering with accounts receivable to ensure payments are processed and posted
• Educating doctors, nurses, and other clinical staff on documentation standards and compliance issues

Can I Teach Myself Medical Billing and Coding?

While it’s possible to learn medical billing and coding on your own, it can be a highly challenging path filled with uncertainty. Self-teaching may leave knowledge gaps because you need to know the rules that govern billing and develop practical skills to succeed in the field. You also won’t be able to gain experience interpreting records or creating bills through self-study.

Medical billing and coding directly impacts a healthcare facility’s ability to operate because it’s the only way to secure payment for services. The tasks are time-sensitive and detailed. Many employers cannot afford to let people learn by doing because errors or delays impact operations.

What is an Easier Way to Learn Medical Billing and Coding?

Attending a vocational program is an easier way to secure a quality position as a medical billing and coding specialist. Formal education at a vocational school provides the theoretical knowledge and practical application needed to excel in the industry. You’ll complete simulated billing and coding tasks using real-world cases and data. This type of classroom preparation allows you to make mistakes and learn from them. Learning by doing is the best way to prepare you for the field. Medical billing and coding specialists with formal education are the most attractive candidates.

What Do You Learn During a Medical Billing and Coding Program?

Vocational programs cover the knowledge and develop the skills you need to become an effective medical billing and coding specialist. Your coursework will include traditional courses as well as hands-on learning while completing simulated tasks. The work is rigorous and challenging, but vocational schools provide the structure and guidance to help you succeed.

Billing Basics

Every examination, test, procedure, and operation must be documented and billed. You’ll receive a comprehensive education about the billing cycle, from medical documentation to payment processing and each intermediary step. Your instructors will teach you every phase of the billing process, so you understand how each step informs the next.

Coursework will also touch on the standards and conventions of bill generation, submission, verification, appeal, and remittance. This holistic view will help you thrive in the workplace.

ICD-10, CPT, and HCPCS coding

Your medical billing and coding career will require you to read and interpret medical documents to categorize diagnoses, tests, and services using a specialized alphanumeric coding language. You’ll learn Current Procedure Terminology (CPT-4), Healthcare Common Procedure Coding System (HCPCS), and International Statistical Classification of Diseases and Related Health Problems (ICD-10).

Mastery of these coding protocols is vital to your career success. Instructors will teach you how to read the relevant manuals, research complex codes, and investigate new and emerging procedures so you can code medical data quickly and accurately.

Advanced Clinical Coding

Every medical record, from primary care documentation on routine physicals to oncology records for late-stage cancer patients, has to be reviewed and coded. You’ll learn the pathophysiologic terminology, nuances of clinical documentation, and use of reference indexes so you can effectively code for any medical specialty. This deep dive will provide you with versatility so you can work for a wider number of medical facilities.

Inpatient Coding

Inpatient facilities and hospitals have high compliance standards. During the coursework, you’ll learn the components of inpatient medical records and the distinct phases of care for admitted patients. Your instructors will cover intake, triage, treatment, medical care, and discharge reporting and documentation standards. You’ll learn the intricacies of how to code and generate bills for long-term admissions and other unique cases exclusive to inpatient care.

Coding from Operative Reports

Every surgical procedure, from routine diagnostic testing to complex cardiac surgeries requires detailed operative reports that explains what happened during the procedure. You’ll learn surgical terminology and cover special topics in anatomy and physiology particularly relevant to invasive surgical procedures. Your instructors will walk you through the conventions of narrative operative reports and teach you strategies for reading them effectively.

Health Information Technology

Federal regulations mandate that medical documentation be kept electronically. Your courses will cover best practices for health data management and input using industrywide computer systems. During this coursework, you’ll learn best practices, health information security, data risk management, and electronic medical record ethics.

What are the Benefits of Formal Education?

A self-guided education lacks the structured framework to prepare you for a career. Formal education from a vocational program provides you with the necessary knowledge and skills to prepare you for the workforce. Successful medical billing and coding specialists are strong thinkers, problem-solvers, and communicators. Beyond teaching you how to bill and code, a formal education will help you develop the attributes needed to thrive in the workplace.

Comprehensive Curriculum

While teaching yourself is possible, you may have trouble covering all of the topics necessary to be a successful medical billing and coding specialist. Vocational schools design complete curriculums that build upon themselves. The specificity and difficulty of the material progresses with each course. Each phase of your schooling adds a bric to your developing foundational knowledge. Vocational programs help you crawl, then walk, and finally run.

Industry Experienced Instructors

The educators at vocational schools are experienced medical billing and coding professionals. They possess the formal education and real-world experience to prepare you for life in this field. Instructors are dedicated to the profession and may complete ongoing continuing education to stay current on industry trends and advancements.

Your instructors will teach the material while providing workplace examples of the challenges you’ll face once you’re employed as a medical billing and coding specialist. Their insights are invaluable as they alert you to potential stumbling blocks and help you develop strategies to overcome them.

Hands-on Learning

Independent study can help you learn the basic theory behind medical billing and coding. A vocational school develops and sharpens the skills needed to complete coding tasks. Schools have the same software and computer systems used at medical facilities. You’ll follow case studies of actual billing situations, complete simulated coding tasks using real health data, and generate mock bills using live software. This type of active learning gives you the freedom to make mistakes, grow from them, and begin building your confidence. You’ll enter the workforce having already performed the daily tasks you will be expected to complete from your first day on the job.

Stronger Applicants

Completing a formal educational program will make your resume stand out from fellow applicants. You’ll be a more appealing prospect than those without vocational training. Many employers, especially the best ones, recommend the pre-employment completion of a medical billing and coding program. Choosing to teach yourself may preclude you from opportunities with employers offering the best opportunities.

Once you are employed, graduation from vocational training will help you rise through the ranks. Those with appropriate training are best suited and most hirable for advanced coding and supervisory positions.

Career Services

Vocational programs want to help you secure quality job placements. Schools have career services centers to support you and help develop the soft skills needed for professional success. They cover potential questions to help prepare you for job interviews and advise on crafting a strong resume.

Schools have strong ties to local employers to help mentor students and match them with quality job opportunities. Career services also help you prepare for certification exams that can help bolster your job prospects.

Want to Learn More?

Ready to attend the Medical Insurance Billing & Coding program at Meridian College? Medical Billing and Coding professionals are responsible for keeping the records, charts, and bills in a medical office in order. In addition to the classroom experiences, students will also complete an externship for on-the-job training that will bring them further expertise. Contact us to learn more about.

Contact Meridian College today to learn more about becoming a medical billing and coding specialist.

The post Can I Teach Myself Medical Billing and Coding? appeared first on Meridian College.

What are the Types of Medical Coding?

To better understand medical coding, you must first understand the different medical coding types. As a medical coder, you will work with multiple types of coding, depending on your position and your employer. The following are the types of medical coding.

CPT Codes

CPT Codes (Current Procedural Terminology) provide a standard language for doctors, nurses, and other healthcare providers to simplify the clinical reporting process and ensure precision and productivity.

CPT Codes are the most common and widely adopted codes in the United States. These codes help report services for anesthesiology, medical, surgical, laboratory, genomic sequencing, and evaluation and management.

You can differentiate CPT Codes from other medical codes because all the codes are five digits. These codes can be both numeric and alphanumeric, depending on the category.

HCPCS Codes

HCPCS Codes (Healthcare Common Procedure Coding System) have level I, II, and III. These codes are used by healthcare systems and medical providers to bill Medicare and Medicaid. HCPCS Codes are representative of services, products, and supplies that are provided to Medicare and Medicaid patients.

• Level I HCPCS Codes are numeric. These codes contain CPT.
• Level II HCPCS Codes are alphanumeric. These codes are for non-physician services, products, and supplies that are excluded from CPT.
• Level III codes are often referred to as HCPCS local codes.

ICD-10 Codes

ICD-10 Codes (International Classification of Diseases) is the 10th addition of this classification system. This system helps diagnose patients, report symptoms, and code procedures by physicians and many other healthcare providers. This system is periodically updated to include expanded diagnoses.

CPT Modifiers

As a coding specialist, you will also need to know the CPT Modifiers. These are often referred to as Level I modifiers. These CPT modifier codes offer supporting details for the services provided by a physician or healthcare provider.

These codes contain two-digit alphanumeric characters. You will find these modifiers are often used to notate the part of the body where the medical procedure was conducted on the patient.

Translating Medical Codes

As a medical coder, you will be responsible for translating the diagnoses of patients, medical procedures, and supplies into codes that can be used by the provider to bill insurance companies. Medical coders translate patient records into codes that reveal the following information to insurance companies.

• The patient’s diagnosis
• The medical necessity of any services or supplies
• Treatments, services, and supplies that a patient received
• Unusual medical conditions or circumstances that affected the treatments or services provided to the patient

As a medical coder you are responsible for deciphering the medical records of patients and using the correct medical codes. Right now, these codes seem like a new language to you, but as you progress in your training, you will learn these codes and feel confident performing your job duties.

What Are Medical Codes Used For?

Medical codes are used for multiple reasons in the healthcare industry. These codes provide information to insurance companies, so hospitals, doctor’s offices, and other healthcare providers receive reimbursement for the services rendered to patients.

These codes are also used as an important part of patient charting. Accurate diagnostic, procedure, and supply coding is essential for ensuring a patient’s records are accurate and up to date.

Medical codes are also used to track community health. These codes help identify specific experiences, problems, and circumstances experienced by members of communities. They can also track the spread of viruses and other health concerns in the community.

Who Created Medical Codes?

The medical coding system comes from humble beginnings, first used in England in the 17th century according to Coding Clarified. Using a system called the London Bills of Mortality, statistical data was collected and observed. This data was organized into a system of codes to help determine the most prevalent causes of death at the time.

Much later, the World Health Organization (WHO) used the International List of Causes of Death to track causes of death effectively. Since 1977, the National Centers for Health Statistics (NCHS) has ensured the medical coding system included causes of death, injuries, illnesses, and clinical diagnoses.

The International Classification of Disease, Tenth Edition was created by the World Health Organization. This latest edition was released in 1994. On January 1, 2022, this edition will be replaced by ICD-11.

Some of the medical codes you will use on the job have also been developed at the state level. Local codes, as they are often called, are not nationally or globally recognized.

Why Is It Important to Know Medical Coding?

In any medical practice or hospital, medical billing and coding are essential. Medical billers and coders must be highly precise and accurate in their job duties to ensure patient safety, efficient service, and prompt payment from insurance providers.

Medical coders are essential employees in the medical field. Without receiving funding from insurance providers and healthcare programs, hospitals and doctor’s offices would not be able to serve their patients.

Many do not realize the vast expanse of work that is required in the medical coding field. Every patient who visits a hospital, doctor’s office, or healthcare facility has a record that needs to be coded. Accurate medical coding is essential for ensuring insurance companies are billed correctly and pay efficiently. Medical coding is also important for protecting patients against inaccurate billing information that requires them to pay for more than they owe.

The primary duties of a coding specialist is to decipher medical records and enter the proper codes and data into the provider’s database. Most healthcare providers have at least one coding specialist. Large facilities often require multiple coding professionals.

What Is the Easiest Way to Learn Medical Coding?

The easiest and fastest way for you to get started learning medical coding and becoming a medical billing specialist is for you to enroll in a medical billing and coding diploma program at a trade school.

This straightforward approach to your education will fast track your studies, allowing you to learn medical coding and get your credentials. If you have been putting off learning about medical billing and coding diploma programs, now is the time to get information. With these programs, you can be on your way to a satisfying and beneficial career.

What Are the Benefits of Medical Billing and Coding Programs?

Multiple benefits are afforded to you by attending a diploma program. Being aware of these benefits will help to encourage you to get started as soon as possible.

Benefit #1: Length of Training

Instead of graduating in years, you can learn what you need to know to become a medical billing and coding specialist in months. You will earn your diploma and launch your career in the healthcare facilities in your community.

Benefit #2: Full Curriculum Study

With this medical coding diploma program, you will receive a full curriculum. You will gain the training and skills you need to become a medical coding specialist. From anatomy and physiology to medical terminology, you will gain the knowledge you need to flourish as a medical coder.

Benefit #3: Expert Instructors

You will receive full instruction from expert instructors in the medical billing and coding profession. These professionals will give you inside information that will help you excel on your career path. They will also offer one-on-one attention so that you don’t fall behind.

Benefit #4: Supportive Classmates

In addition to receiving expert instruction, you will also benefit from studying with like-minded classmates who will help you reach your full potential. Success begins by surrounding yourself with those who have the same goals as you. Building networking relationships with classmates will help you reach success.

Benefit #5: Career Services

Once you graduate with your medical coding diploma, you will have access to career services that will help you with job placement. These services offer you a great advantage to seek employment right away. From resume building and mock interviews to job fairs, the school’s career services will identify the right job match for your passion and interests.

Is Medical Billing a Good Career Choice?

If you are considering your options for career choices, medical coding may be what you are looking for in the medical field. Medical billing and coding specialists are in high demand, and the upward trajectory of this job outlook continues to grow. Projected growth is expected to rise as much as 9 percent over the next decade, according to the U.S. Bureau of Labor Statistics.

Becoming a medical coding specialist affords you options for working in a variety of healthcare settings. You may work in hospitals, doctor’s offices, assisted living homes, and laboratories, among many others. As a medical coder, you will be ready to support the frontlines of healthcare. You will also ensure healthcare facilities receive the reimbursement they need and patients are protected.

Final Thoughts

The healthcare industry is growing, and not only doctors or nurses make a difference in the lives of people in your community. Now is an time to launch your career as a medical billing specialist. After gaining your diploma in just months, nothing will hold you back from making your career dreams a reality.

Did learning about how to become a medical billing and coding specialist interest you? Ready to attend Medical Insurance Billing & Coding program at Meridian College? Medical Billing and Coding professionals are responsible for keeping the records, charts, and bills in a medical office in order. In addition to the classroom experiences, students will also complete an externship for on-the-job training that will bring them further expertise. Contact us to learn more about.

Contact Meridian College today to learn more about becoming a medical billing and coding specialist.

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