How to Become a Medical Coder
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- Medical coders assign universal codes to diagnoses, treatments, and medical procedures.
- Medical billers use these codes to file insurance claims and receive reimbursements.
- Employers often require that medical coders earn coding certification.
- These professionals work in hospitals, private physicians' offices, and clinics.
A medical coder operates as an integral behind-the-scenes healthcare team member. These professionals assign standard codes to patients' medical procedures and diagnoses. These codes are used for data management, patient care, and by medical billers to file insurance claims.
The Bureau of Labor Statistics (BLS) reports that medical coders earned a median annual wage of $46,660 as of May 2021.
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Becoming a Medical Coder Step-by-Step
Earn a High School Diploma
Most positions require, at minimum, a high school diploma or its equivalent. This is also a requirement to sit for most medical coder certification exams.
Earn an Associate Degree
Prospective medical coders may also earn an associate degree in medical billing and coding. Most of these programs prepare graduates for the credentialing exams and take about two years to complete.
Earn Medical Coding Certification
Medical coders require in-depth knowledge of medical terminology and anatomy. They also need to learn the different coding systems, such as the Current Procedural Terminology (CPT) and International Classification of Diseases, Tenth Revision (ICD-10).
Earning certifications such as the certified professional coder (CPC) or the certified coding associate (CCA) demonstrates your qualifications to potential employers. The CCA credential requires passing an exam and recommends attending an approved coding program or six months of experience.
The CPC credential also requires passing an exam. This leads to the apprenticeship designation, which is removed once the medical coder achieves two years of on-the-job experience or completes 80 hours of a coding preparation program and gains one year of experience.
Medical coding preparation programs are offered online and in person. Some are self-paced, while others offer structured class time. Depending on your schedule and the specific certification you pursue, you may be ready to take the exam in as little as four months.
Start Your Career as a Medical Coder
Earning certification lets hospitals and physicians know you understand the latest coding protocols. This ensures they are paid for their services and do not face fines or penalties for incorrect coding. Consider an externship to get hands-on experience. Then, create a resume that highlights your training.
Featured Medical Coding Programs
Learn about start dates, transferring credits, availability of financial aid, and more by contacting the universities below.
Types of Medical Coders
Medical coders may work in outpatient settings like clinics or doctors' offices. If you want to work in this setting, you may consider taking the CPC exam. Others focus on outpatient or inpatient coding and work in hospitals or ambulatory surgical centers. These coders may consider earning the certified outpatient coder (COC) or the certified inpatient coder (CIC) certifications.
Depending on the size of the medical facility or hospital, some medical coders may perform both inpatient and outpatient coding. The certified coding specialist (CCS) certification can prepare you for this position. Some smaller facilities combine medical billing and coding, with one person performing both roles.
What Is a Medical Coder?
Every year, healthcare insurers process over 5 billion insurance claims in the U.S. Standardized coding systems are used to process these claims, ensuring consistent reimbursements for procedures and equipment. A medical coder inputs the correct codes for diagnoses, procedures, and other charges.
What Does a Medical Coder Do?
Medical coders are analytical in nature. They enjoy turning sometimes complex medical terms into universally recognized codes. After a patient receives care, they analyze their medical chart, converting the services they received, whether an X-ray or a type of treatment, into codes.
These professionals require a highly specialized skill set. They should also expect to continue their education to stay current on changing codes associated with payer regulations. Earning additional certifications can also lead to career advancements.
Medical Coder Responsibilities
- Convert complex medical procedures, diagnoses, treatments, and equipment into universal codes.
- Work closely with insurance companies and physicians to discuss the correct coding analysis.
- Review patients' charts and verify the codes for procedures, treatments, and diagnoses.
- Effectively communicate with the healthcare team.
- Search for coding information in unusual or complex cases.
Requirements to Becoming a Medical Coder
Many employers require medical coders to hold certification or to obtain it in a certain amount of time after starting. You need a high school diploma, GED credential, or the equivalent to take a certification test. These tests require extensive coding knowledge, which prospective medical coders may acquire through a certification program or by earning an associate degree in medical billing and coding.
Certification Process for Medical Coder
Although medical coder certification is not a state requirement, those who earn certifications demonstrate their knowledge of the latest coding protocol. Medical coders are essential to the healthcare team, ensuring proper insurance reimbursement. As such, employers look for well-qualified people to fill this role.
While some employers accept a high school diploma and several years of experience, many expect coders to earn their certification. These certifications provide opportunities for advancement and increased earnings.
The American Academy of Professional Coders (AAPC) provides certification and networking opportunities for medical coding professionals. The AAPC offers five certifications for medical coders: the certified professional coder (CPC), certified outpatient coding (COC), certified inpatient coding (CIC), certified risk adjustment coder (CRC), and specialty credentials for expert coders in their specific field.
The American Health Information Management Association (AHIMA) offers the certified coding associate (CCA) and the certified coding specialist (CCS). The CCA is for those just entering the profession, while the CCS demonstrates mastery in the field.
The Practice Management Institute offers a certified medical coder (CMC). This certification is for coders in outpatient settings.
Though not required, these institutions offer programs to prepare you for these exams. Some require work experience in lieu of the completion of foundational training courses.
Medical Coder Salary and Job Demand
The BLS projects 9% job growth for medical coders from 2020-2030. This amounts to an average of 34,300 job openings every year. Due to an aging population and the subsequent need for healthcare, the demand for medical coders is expected to rise.
Medical coders earn a median wage of $46,660, with the top 10% making an annual salary of $74,200 or more as of May 2021. General medical and surgical hospitals employ the greatest number of these professionals, followed by physicians' offices. The top-paying industries include insurance carriers and scientific research and development services. Medical coders in these two fields earn an average wage of $64,170 and $61,080, respectively.
Medical coders find numerous advancement opportunities as they gain experience and knowledge. This includes roles like medical coding auditors, medical claims processors, and medical coding managers. Those interested in management positions may consider earning their bachelor's in health information management or healthcare administration.
Top 5 Paid States
The states offering the top pay for medical coders include New Jersey, Washington D.C., Massachusetts, California, and Connecticut. Those who work in New Jersey see the highest earnings, with average annual salaries of $67,130. Medical coders in Connecticut earn an average wage of $57,480.
Frequently Asked Questions About Becoming a Medical Coder
Do medical coders make good money?
According to the BLS, as of May 2021, medical coders earned a median annual salary of $46,660. Those who work for insurance carriers make substantially more, with average earnings of $64,170. Additionally, states and cities offer varying average wages and demand.
For example, Alaska sees the highest concentration of jobs for medical coders. Medical coders in this state earn an average annual wage of $54,540. Fairbanks and Anchorage in particular have the highest concentration of jobs in this field. In Mississippi, the average salary drops to $37,990. The top metropolitan area for pay is San Francisco, Oakland, and Hayward, California, where medical coders earn an average wage of $66,980.
Is medical coding hard?
Medical coding can be complex. To translate medical symptoms into concise codes requires a basic knowledge of anatomy, physiology, and medical terminology. An analytical nature and attention to detail can help you succeed in this role.
Fortunately, you don't have to memorize thousands of codes. Coders reference coding software programs and codebooks to keep up-to-date.
Medical coding centers around three classification systems used for coding. These include the ICD-10, CPT, and the Healthcare Common Procedural Coding System (HCPCS) Level II. These are universal codes for diagnosis, procedures, treatment, supplies, and products.
What exactly do medical coders do?
Medical coders analyze patient records and translate their diagnosis and treatment into universal codes. For example, the ICD-10 code for cervicalgia, or neck pain, is M54.2. Medical billers use these codes to secure insurance companies' payments. They represent the universal language for medical procedures and diagnoses.
Medical coders work closely with medical billers. These professionals create insurance claims and bill patients using the codes provided by the coders. These positions carry significant responsibilities. Providers may face liability investigation if they bill patients or payers incorrectly. In smaller private practices, one employee may perform both duties.