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What is a Medical Coder?
A medical coder is a professional who assigns medical codes to diagnoses, procedures, services, and equipment for patient care. Medical coding translates a healthcare provider’s notes into universal medical code numbers to be used for insurance claims processing. The codes allow insurance companies, Medicare, and Medicaid to understand what procedures were performed and why.
In simple terms, medical coders review clinical documentation provided by doctors, nurses, radiologists etc. and translate diagnoses, procedures, medical services and equipment into numeric codes. This coding data is then used for insurance claims processing, reimbursements, public health statistics, databases and registries.
Medical coding requires specialized knowledge of healthcare terminology, diseases, injuries, anatomy as well as coding guidelines and classifications. The coding systems used are CPT (Current Procedural Terminology), ICD (International Classification of Diseases) and HCPCS (Healthcare Common Procedure Coding System).
What Does a Medical Coder Do?
The typical job responsibilities of a medical coder include:
- Reviewing patients’ medical records including doctor’s notes, laboratory results, radiology reports etc. to understand procedures performed and diagnoses.
- Assigning appropriate diagnostic and procedural codes that most accurately represent the diagnosis, condition or treatment prescribed. This is done using coding manuals.
- Ensuring codes meet legal, ethical and regulatory requirements for reimbursements.
- Using classification software to assign medical codes.
- Submitting claims with appropriate codes to insurance companies for reimbursement.
- Working with insurance companies if there are any issues with claims.
- Documenting coding practices to demonstrate compliance with laws and regulations.
- Keeping updated with latest guidelines and new codes introduced annually.
- Protecting patient’s personal health information and maintaining confidentiality.
- Reviewing rejected claims to identify reasons such as improper coding.
In summary, a medical coder carefully reviews healthcare provider’s documentation, assigns standardized codes using classification manuals, and submits claims to insurance companies for payments. Their coding work impacts healthcare organization’s revenues and compliance.
Medical Coder Job Description
A medical coder’s job description includes:
- Analyzing healthcare provider’s documentation in patient medical records – doctor’s notes, radiology reports, lab/pathology results etc.
- Identifying diagnoses and procedures described in the documentation.
- Assigning accurate medical codes from coding manuals that represent the diagnoses and procedures.
- Using medical classification software to code healthcare data.
- Submitting coded claims to insurance companies for reimbursement.
- Ensuring coding practices adhere to laws, regulations and guidelines.
- Resolving any coding discrepancies and claim rejections.
- Maintaining patient confidentiality and protecting health information.
- Keeping updated with new medical codes and annual coding guidelines.
- Documenting coding processes for auditing purposes.
- Providing support and guidance to clinicians on documentation and coding.
- Collaborating with other departments such as health information management, billing etc.
The role focuses on translating clinical data into standardized codes while maintaining compliance and confidentiality. Medical coding improves the accuracy and efficiency of financial, administrative and clinical processes.
How to Become a Medical Coder
Becoming a medical coder requires completion of a medical coding education program and obtaining a certification. The key steps are:
Prerequisite to Become a Medical Coder
To pursue medical coding, you need:
- A high school diploma or equivalent GED certification
- Proficiency in medical terminology
- Strong knowledge of anatomy and physiology
- Attention to detail and organizational skills
- Comfort working with medical records and healthcare information
- Basic computer and data entry skills
Education Required to Become a Medical Coder
You need to complete a medical coding training program. There are certificate, diploma and associate degree programs available. Certificate programs take 6 months to 1 year to complete while degree programs are 2 years long.
You can choose to enroll in an on-campus medical coding program at community colleges, technical schools and universities. There are also online medical coding programs offered.
Some of the subjects covered include:
- Medical terminology, anatomy and physiology
- Pathophysiology and pharmacology
- ICD-10-CM, CPT and HCPCS level II coding
- Health information and records management
- Billing, insurance processes and reimbursement methods
- Coding software tools
- Coding guidelines and regulatory standards
- Ethics in coding
A combination of classroom lectures and hands-on practicum helps build coding skills and professional experience. Clinical practicums and internships provide real-world training.
What Degree Do I Need to Become a Medical Coder?
You need a minimum of a Certificate or Associate degree in Medical Coding. While certificate programs provide basic training, completing an associate degree expands your knowledge and job prospects. Many employers prefer to hire coders who have an associate (2-year) degree.
After gaining some experience, coders can progress to a Bachelor’s degree in Health Information Management (HIM). This opens doors to senior roles in healthcare systems such as HIM director and coding manager.
Steps to Become a Medical Coder
Follow these key steps to start a career in medical coding:
- Earn a high school diploma or GED certificate. Take science courses.
- Enroll in a medical coding program at a community college, technical school or university. Complete coursework and externships.
- Obtain a certification credential such as CPC, CCS, CCA etc. from AHIMA or AAPC.
- Look for a medical coding job as a certified professional coder. Entry-level positions include outpatient coder, inpatient coder etc.
- Get 1-2 years of professional coding experience. Take continuing education to stay updated.
- Advance your career by getting additional certifications, a higher degree or managerial role.
How Long Does it Take to Become a Medical Coder?
It typically takes 1 to 2 years to become a medical coder from scratch.
A 6 months to 1 year certificate program provides baseline skills to start. After that, allow 2-3 months for certification exam prep and passing the exam.
Finally, plan for 1 to 2 years of professional experience before having adequate competence. Some coders are comfortable coding basic cases after 1 year while complex cases require 2+ years experience.
So in total, if you take a coding program, get certified soon after, and gain professional experience, you can become a seasoned medical coder within 2 years.
Medical Coder Salary
On average, the annual medical coder salary in the United States is $55,717 per year. However, pay can range from $32,299 to $85,027 based on experience, certifications, education, employer, work setting and location.
Top-Paying Cities for Medical Coders
|Los Angeles, CA||$56,847|
How Much Does a Medical Coder Make
|Experience Level||Average Salary|
|Entry Level (0-1 years)||$32,299 – $41,143|
|Mid-Career (1-4 years)||$42,245 – $58,789|
|Experienced (5-9 years)||$59,834 – $77,721|
|Late-Career (10+ years)||$78,571 – $85,027|
A new medical coding professional with less than 1 year experience can expect to earn $32,299 – $41,143 annually while an experienced coder with 10+ years experience can make $78,571 – $85,027 per year. Mid-career coders with 1-4 years experience make $42,245 – $58,789.
Average Salary of a Medical Coder
The average annual salary of a medical coder in an entry-level position is $35,000.
With 1-2 years experience, medical coders can expect to earn $45,000 – $55,000 per year.
In mid-career roles, average pay is $60,000 – $65,000 annually.
Senior-level medical coders with 5+ years experience can earn an average salary between $70,000 – $80,000.
Leadership roles such as coding manager have an average salary of $85,000 per year.
Medical Coder Schools
There are various medical coder schools offering accredited programs at Certificate and Associate degree levels, through on-campus and online delivery formats.
Here are some of the best medical coding schools in the United States:
Best Schools for Medical Coder
|Rasmussen College||Medical Billing and Coding Diploma, Certificate. Online & campuses.|
|Northwestern Michigan College||Medical Coding Specialist Certificate. Campus in MI.|
|Sullivan University||Associate in Applied Science Medical Billing and Coding. Campuses in KY, LO, TN.|
|Mt. San Jacinto College||Certificate of Achievement Medical Coding. Campuses in CA.|
|Purdue University Global||Health Information Technology Certificate. Online.|
Medical Coder Accredited
While choosing a medical coding program, ensure it is accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). This accreditation validates that the curriculum meets professional education standards.
Medical Coder Colleges
There are excellent medical coder colleges and universities that offer associate degrees in health information technology with a medical coding track. This includes:
Best Colleges that Offer Medical Coder Programs
|Lone Star College||Health Information Technology (Coding) AAS Degree. Houston, TX.|
|Ogeechee Technical College||Health IT Coding Specialist Associate Degree. GA.|
|Pioneer Technology Center||Medical Billing & Coding Specialist AAS. OK.|
|Kirkwood Community College||Health Information Technology AAS. IA.|
|Carson-Newman University||Health Information Management BS. Online.|
Medical Coder Program (2-year program for medical coder)
An Associate Degree in Health Information Technology (HIT) with a coding focus provides comprehensive training to start a coding career. This 2-year program covers:
- Medical terminology, anatomy, physiology and pathophysiology
- Classification of diseases (ICD-10-CM)
- Coding procedures and services (CPT, HCPCS)
- Health records and data management
- Reimbursement methodologies and insurance claim processing
- Coding software tools like encoders and groupers
- Revenue cycle management
- Quality and compliance in coding
- Supervised professional practice via internships
The Associate degree and professional experience makes candidates very employable for medical coding jobs.
Online Schools for Medical Coder
For those seeking flexibility, online medical coding schools and programs are a convenient option. Distance education provides the complete curriculum and training online through video lectures, lessons, assignments, virtual labs and web-based practical learning.
Some top accredited online schools for medical coding training are:
- Career Step – Medical Coding and Billing program
- Penn Foster Career School – Medical Billing and Coding Certificate
- Ashworth College – Medical Billing and Coding program
- Southern New Hampshire University – Medical Coding Certificate online
- American National University – Medical Billing and Coding Diploma
Can You Become a Medical Coder Online?
Yes, it is absolutely possible to become a professional medical coder through online education. Reputable online medical coding programs offer the same robust curriculum and training as on-campus programs.
Virtual lessons, video lectures, assignments, discussion forums, projects and externships provide an interactive learning experience. Certification exam prep is also included.
Many online programs are accredited and result in the same diploma/degree qualification. Top employers hire candidates who complete accredited online medical coding programs.
How to Become a Medical Coder Online
Follow these steps for becoming an online medical coder:
- Earn high school diploma or GED certificate. Take science, IT and health courses.
- Enroll in an accredited online medical coding program or certificate course.
- Complete coursework, assignments, virtual labs, projects and externship.
- Prepare for and obtain AHIMA or AAPC coding certification.
- Start applying for remote medical coding jobs and telecommute positions.
- Gain 1-2 years professional coding experience through remote work.
- Advance your career with higher credentials and leadership roles.
Medical coding is a stable, well-paying career with excellent growth as healthcare providers transition to electronic health records. With the right accredited education, certification and on-the-job experience, you can begin a rewarding and meaningful career as a medical coder within 1-2 years. There are also abundant opportunities for career advancement and salary growth in this thriving field.