Emerging Medical Coding - Guide
High-energy Professionals with experience in Managing Health care Reports with Challenging Assignments such as Coding and assigning the Correct ICD, CPT and PCS Codes for the Medical Reports with an organization of high repute, Preferable in the
Healthcare industry.
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What is Medical Coding?
Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The diagnoses and procedure codes are taken from medical record documentation, such as transcription of physician's notes,laboratory and radiologic results, etc. Medical coding professionals help ensure the codes are applied correctly during the medical billing process, which includes abstracting the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.
Types of Medical Coding:
- Facility Coding
- Professional Coding
Facility Coding:
Coding to address specific hospital areas including inpatient coding, emergency departments, ambulatory care, radiology (including interventional radiology), ambulatory surgery centers/same day surgery centers.
Professional Coding:
Coding to address specific Health Care Providers including emergency departments, ambulatory care, Outpatients, ambulatory surgery centers/same day surgery centers.
Subcategories:
- ICD 10
- CPT
- PCS
- HCPCS
| Physician/Outpatient Coding | Facility/Inpatient Coding |
| Utilizes ICD-9-CM volumes 1 and 2 (ICD-10-CM) for diagnoses | Utilizes ICD-9-CM volumes 1 and 2 (ICD-10-CM) for diagnoses |
| Coding for “probable,” “suspected,” or “rule-out” conditions is not allowed | Coding for “probable,” “suspected,” or “rule-out” conditions is allowed |
| Utilizes CPT® and HCPCS Level II for medical/surgical procedures | Utilizes ICD-9-CM volume 3 (ICD-10-PCS) for medical/surgical procedures |
| Reimbursement primarily based on physician fee schedule, insurance contracted rates, ambulatory surgical center rates, etc. | Reimbursement primarily based on the diagnosis-related group (DRG) |
| No hospital stay | Requires a hospital stay (usually with two-day minimum) |
| Code assignment is based on the encounter/visit | Code assignment is based on the entire admission (length of stay) |
Industry Expectations
Coder productivity and accuracy are still the primary factors in tracking job performance. The length of stay for hospital admission varies based on patient condition and services needed: Some stays are short (minimum of two days), while others are longer. Due to the volume of documentation to review (e.g., history and physical exam, ED notes, consultation notes, diagnostic lab/radiology results, progress notes, operative notes, etc.), as well as the complexity of inpatient coding, productivity requirements — in terms of the amount of accounts coded per hour/day — are less than physician coding. Coders are expected to retain a 95 percent accuracy rate, which is standard in the industry.
Where you work mirrors outpatient coding. You may be onsite at a hospital, or work remotely. Because many hospitals outsource their production coding, there is an abundance of remote opportunities available to the experienced coder. Some hospitals now offer an in-house coding transition or cross-training program, in which outpatient coders can learn inpatient coding within their facility. This serves as a great opportunity to take your career to the next level.
What is Inpatient Coding?
Inpatient refers to a patient who is formally admitted to a hospital upon the orders of the physician who then admits the patient for an extended stay. The inpatient coding system is used to report a patient's diagnosis and services based on his extended stay.S
Research, Plan, Study, and Get Certified
If you’re ready for a new challenge, now is the time to consider inpatient coding. First step: Research! Learn as much as you can about the rules and guidelines surrounding this specialty, as well as employment opportunities, requirements, and salary potential. Plan, study, and get CIC™ certified. You will find inpatient coding an area of limitless possibilities.😊👍👍
This is my First Blog if you found any Grammatical Mistake Let me Know,Happy to Learn From Mistakes.👍😀👍🎈🎈🎈
Thank You
GokulRaj Ravi
CPC | Chennai India Chapter.
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