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Medical Coding Education
Jari Davis, the coauthor of her training programs and President of Meditec.Com, wrote the following valuable information on medical coding. Meditec.Com offers the Professional Edge Line of courses for Medical Coding, Medical Billing, Medical Transcription and more.

After years of perfecting and streamlining the mechanics and document flow of medical transcription, Meditech, as a natural progression, moved into the area of coding, billing, accounts receivable, and practice management. The training we provide is based on our knowledge and experience in doing what we teach.

What is Medical Coding?
Prior to the 1960s, no uniform methods of billing and paying for medical services existed. Gradually, a system of numbers was developed to represent various problems and treatments. The treatment codes, Current Procedural Terminology (CPT-4), are copyrighted by the American Medical Association. The International Classifications of Diseases (ICD-9 is the codebook with the problems (diagnoses) numerically assigned. The ICD codebooks are published by a variety of companies. The government then got involved and developed their own codes, called HCPCS, Healthcare Common Procedure Coding System. These codes go a step further to apply alphanumeric codes to drugs, medical devices, etc., to allow even more detail for a payer to review and make more logical determinations for payment.

Let's illustrate their use with an example. A hospital intake form or charge sheet is batched and arrives on the desk of a coder who will abstract the following handwritten information, convert it to code and get it in front of data entry:

11 year old male with a broken leg
X-ray shows fracture of femur 17 cm above patella
Procedure: Open reduction internal fixation of fracture

From this simple note, several items may be identified, described and charged. Let's explore a little further. We look at the visit details and discover that a child has fallen from a horse and has broken his leg, which is the "problem," (diagnosis). He's rushed to the emergency room by the camp's nurse where he's seen by an ER doctor. The doctor whisks the child off to x-ray, which shows an open transcervical fracture of the femur, which is the diagnosis. The bone will be set in a procedure called an open reduction internal fixation (ORIF). When this is complete, the doctor places a cast.

The relevant part of the codes on the data entry form, which will result in a printed bill and/or insurance claim might look something like this when the coder has added the codes:

11 year old male with a broken leg- 820.12/ E828.2
X-ray shows fracture of femur 17 cm above patella- 73550
Procedure: Open reduction internal fixation of fracture- 29285/ 27506/ 29345
The text has now been assigned corresponding diagnosis and procedure codes.

When the insurance form is printed (or the statement), the diagnosis would appear in the diagnosis input field as:

820.12 Transcervical Fracture, Open [and] E828.2 Accident, Horse

820.12 translated = 820 is femur fracture, the .1 means it is an open fracture, and the 2 notes it is the midcervical section of the femur. The E828.2 is a code describing how it happened. The 828 tells the payer that it was a result of an "animal ridden," and the .2 tells that the patient was the rider.

The 99284, 27236, 29345 and 73550 are all CPT codes describing the service to the patient.

The information on the claim or bill would appear something like this:

Service Description Diagnosis Amount
99284 ER detailed exam 820.12, E828.2 100
27236 ORIF 820.12 400
29345 Cast 820.12 150
73550 X-ray femur - 2 views 820.12 100

For billing purposes, the use of the ICD codes, when juxtaposed to CPT codes, tells the payer not only what service has been provided but also lists the diagnosis, symptom, complaint, condition or problem (e.g., the reason for performing the service). The codes thus help establish the medical necessity as the first step in third party reimbursement.

The coder determines the codes to be used following each patient encounter. The reviewer/auditor must determine if the coder has in fact used the appropriate codes.

With this specialized training and expertise coders find work any place, any time, any where! In large medical record departments, experienced medical record coders may function as section supervisors, overseeing the work of the coding, correspondence, or discharge sections, for example. Eventually, experienced medical record coders and health insurance specialist-billers may advance to senior technicians who specialize in coding, particularly Medicare coding, or in tumor registry.

Training of medical coders and insurance specialists has a wide range; from two to four years of college earning an associate degree, a technical school diploma, or certificates from vocational or career training courses. Upon completion of such training many coders may seek professional certification.

Career Opportunities
Individuals working as medical coders, Health Insurance Specialists-Medical Billers or in medical office administration are in very high demand among the allied health occupations. According to the U.S. Department of Labor Statistics, health information technicians are one of the ten fastest growing allied health occupations. It is a challenging, interesting career that is compensated according to the level of training and skills, and how effectively these skills are used. Such people are employed by hospitals, clinics, doctors' offices, health maintenance organizations (HMOs), mental healthcare facilities, insurance companies and government agencies; some work from home as independent consultants using medical billing and coding programs and other computer software.

Requires a strong clinical background to analyze the contents of medical records and must be detail-oriented, analytical, and have exemplary organizational skills. Prerequisite is a medical background or our Medical Terminology Course.

Our Professional Edge Medical Coding Training Program will provide everything you need to learn to code successfully. It includes over 600 patient charts for you to practice on, along with CPT, ICD, HCPCS medical coding training, and is well known as a simple, comprehensive and practical way to learn this discipline.

With Meditec's training, the student will receive a practical, straightforward knowledge of this highly complex and prestigious area of expertise now a requirement by all payers on insurance submissions. Opportunities exist in third party auditing, efficiency consulting, insurance company adjudication, and the list goes on.

This program includes the HomeBizBook, to prepare for and find work.

May Coding and Billing be done at home?
Formerly, it was a little cumbersome since one needed various forms and even patient charts; however, with the advent of all the new technology (computerized faxes, scanners, transfer of information back and forth through the Internet), and accessibility to client computers and software, it is now possible and acceptable to do the coding and billing at home either as a contractor or an employee for a hospital or doctor's office. National companies fill a niche too and subcontract the work to home-based contractors.

I invite you to visit Meditec.Com to see their complete description of the Professional Edge Line of courses for Medical Coding, Medical Billing and Medical Transcription. Please tell Meditec that sent you.
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