Youth of 90’s had only few options post their 12th completion in field of science, but now students have a wonderful career opportunity through the field of Medical Coding which is buzzing now.
So, hang on by end of this article you will know all details pertaining to role and responsibilities of medical coder, qualification and eligibility to become medical coder, salary, and career growth in this new sector.
Who is a Medical Coder?
Before understanding who is a Medical coder we should have a brief knowledge about what is Medical Coding and a brief history and evolution of Medical Coding in modern era of Health Care Industry.
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How to Become a Medical Coder in India?
Medical coding can be dated back to 17th century in England where the data was collected about the deaths and was called as London Bills of Mortality and that data was encapsulated into numerical codes, eventually to keep a check on the recurring deaths.
This list was fast forwarded for the next decades and named as “International List of Causes of Death” which was used to keep track of international mortality rate. This list had been developed over the time into “International classification of Diseases” and also known as ICD-10-CM/PCS.
When I was at a hospital a question popped up where the accountants keep such huge pile of papers and files of customers. That’s the first time I got to hear the word medical coding that is disrupting the Health care by deleting the concept of record keeping and changing it into just a electronic data of numerical codes.
The transformation of record keeping in the field of health care industry has evolved over the time.
In 80’s the details of every customer regards his disease, doctor consultation, medicines prescribed, diagnosis report, billing, insurance amount, money to be received from third party functionaries are written in the records and are piled up in the office rooms.
The evolving tech industry has led to shifting of handwritten data to the electronic medical record.
Definition of Medical Coding as stated by “American Academy of Professional coders” is “Medical coding is the alteration of health care diagnosis, medical services, billing into alpha numerical codes”. A medical coder takes detailed information from the concerned doctor and also the concerned accountant.
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What Does a Medical Coder Do?
A medical coder once all the information is received from every department, he translates them to numerical codes and in the hindsight tries to keep every information about the patient accurate and transparent with consistency.
Medical coder while reviewing the reports or when awarding the codes to the transcripts is done through the certain classification systems like CPT(R), ICD-10-CM, HCPCS level II. Then they try to settle with reimbursement of the claims with the Insurance companies given by the health provider.
The main task being the access of the patient information at the right time is important for the success. The detailed information is transformed into the codes by the trained medical coder. This information can be explained in various angles like;
- Medical Billing Process (to claim bills by third part insurance providers)
- Medical Underwriting Process (to claim by patients)
- Medical Documentation Process ( to maintain records by hospitals)
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Let’s Look at some of the Medical codes used ICD, CPT, HCPCS
ICD or International Classification of Diseases this creates universal platform for all the injuries, illness and death and this code was established by the World Health Organization (WHO) in 1940’s.
The code that is now used is ICD-10-CM which can also be called as International Classification of disease 10th revision of clinical modification.
This has nearly 14,000 codes and the CM has 68,000 codes.
These codes explain the coder the various illness that are featured and the doctor’s prescription and many more. And the coder should not even make slightest mistake in judging the codes correctly as this could adversely impact everyone in the system.
CPT or (Current Procedure Terminology)
These codes are used inside the doctor’s office and is maintained by American Medical Association and copyrighted by AMA and updated annually. They are 5 digit numerical codes.
HCPCS or (Healthcare Common Procedure Coding Systems)
These codes are more defined for outpatient hospital care and medical services, procedures and equipment that are not part in the CPT codes.
The HCPCS codes are also of two levels, one which is similar to the CPT codes and other being codes with 17 sections
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Qualification for a Medical Coding Career
A student should complete his bachelor’s degree or master’s degree and should be from the science background.
Let’s see some of the courses that are offered in India by the prestigious colleges and get sneak-peak into their modules, eligibility, and duration of courses.
Post Graduation Diploma in the Medical Coding is the first step to enter this career. After completing any degree from life science background he/she should undergo the certification course in the defined area from any private or government institute.
Academy of Medical Coders of India (AMCI) is set up under the sponsorship of “Institute of Good Manufacturing Practice India” which is registered as Non-Profit organization under the ministry of HRD.
The Academy of Medical Coders India (AMCI) offers a Post graduate diploma in Medical coding. The course offered can be completed part time too.
The Certified Modules of this Diploma Course includes:
Introduction of Medical Coding, Basics of Anatomy and Physiology, Medical coding and terminologies in association with diseases, International classification of diseases(ICD), Health care common procedure coding system (HCPCS), Current procedural terminology(CPT), Health Insurance Portability and accountability act(HIPPA), Surgery, Radiology, Anesthesia guidelines for medical coding Professionals.
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The Eligibility for the course varies from the institute to institute and the AMCI has set certain guidelines for enrolling this course, all graduate, post graduate, PhD in Pharma/life sciences/bio technology can enroll.
The duration of course is for six months. The registration dates for this program are regularly updates on the site https://www.igmpiindia.org/.
Examination and Certification:
After completion of the course duration the candidate has to give the examination from the modules that he has been trained in the institute and receive a post graduation diploma in medical coding certificate which could add as huge bonus on his resume. The candidate should complete all his assignments, case studies in order to complete the course.
Placement for the students who have qualified form this institute are at 100% without a doubt as the AMCI has tied up with various companies like Dr.Reddy’s Laboratories, Aurbindo, Glenmark, Cipla and many others.
Executive Diploma in Medical Coding
AMCI has also launched an executive diploma in medical coding course for the professionals who are already working in the medical coding industry with loads of experience. The course structure covers all the real life examples, case studies, and training exercises and as this are professionals the course duration much smaller compared to the post graduation diploma in medical coding.
IGMPI Industry Certificate Program
This is a case study based program where students from across the streams can get certified and can be completed in shorter duration.
IGMPI Certified modules are classified into 22 modules covering various terminologies and diseases.
Clinical Documentation Improvement is another feather in the basket of courses offered by IGMPI which is fast tracked course and has CDI impact and clinical tips based methodology.
This course helps to learn Health Information management (HIM). Professionals certified will have clear knowledge to become clinical documentation specialist.
The person should be a graduate/post graduate or Diploma in the science backgrounds like Pharma, Medicine, Biotechnology, chemistry, microbiology, and any science related courses.
Duration of the course is of 3 months wherein he can complete the examinations and case studies as well.
Other prestigious institute offering these courses:
National Institute of Medical Coding based in Chennai offer a wide variety of courses which could lead to healthy career in Medical coding;
- CMC – Certification in Medical Coding: This course covers Anatomy & Physiology, ICD 10CM, Basic CPT Guidelines, Medical terminologies.
- AMC – Advanced Medical Coding: Lab Tests and procedure, CMS, NCCI Guidelines, HIPPA, CPT, HCPCS, Revenue cycle management.
- CPC Certification Program
- ICD 10 CM Certification Program
- Personality Development
These are few courses that are available in this institute, and there are many private institutes providing such courses to the students with minimal course fee and most of them have a good placement opportunities with the MNC’s that offer handsome pay at the initial stage of your career.
Based upon the course package this certification programs may cost you 25k-30k per person and with training+certification+internship the cost may go up-to 30k-40k based on the institute.
These institutes along with the certification courses also offer us the soft skill set in order to communicate well patients and the doctors. And also offer real time training and also hold mock exams before you enter the certification exam.
Job Responsibilities of Medical Coder:
- Extraction of the relevant details of the patient
- Examining the documents by understanding them through the codes
- Assigning CPT, HCPCS, ICD-10-CM and ASA Codes
- Assign APC and DRG Codes
- Performing the Audits of the reports
- Research and analyze data for reimbursement
- Identify procedural information
- Following the training codes that were learn to analyze the codes
- He should be a perfect trainer for the staff under him
- He should be able to identify the problems within the coding and solve them at the right pace and accuracy
- Should be able to correct the errors and discrepancies and should avoid future mistakes
Medical Coder should also pose some of the Inter-personal skills along with the certifications to evolve in the career like:
- Organizational Management
- Ms Office skills
- Record evaluation skills
- Communication skills
- Analyzing skills
- Interpretation skills
Salary of a Medical Coder:
The fresher in this field earns a package of 2,04,000 annually and medical coder with 1-4 years of experience can earn up to 3,00,000 per annum.
Candidates with experience more than 5 or 6 can make up to 5,00,000 per annum.
Career growth of the Medical Coder:
The person who starts his career as a medical coder initially can grow into the other management positions has the career moves on as;
- Operation Team leader
- Certified Medical coder
- Medical Records Coder
And from being a Operations team leader can get a opportunity to be Operation Manager or Assistant Manager Customer service or also Project manager.
Hence, India has developed in the health care industry when compared to the past decade and the increasing insurance companies and health insurances have led people to take care of their health problems and then claim the Insurance amount. And there is huge scope of medical coders who can keep check on this codes day to day and provide it to the concerned department.