Medical Coding Career

Health information management (HIM) coders are professionals skilled in classifying medical data from patient records. Coders are like detectives, especially if coding hospital inpatient cases, reading through a patient's medical record and then providing an accurate picture of this patient's illnesses and the delivery of health care services. Coders translate patient's diagnoses and care received into numeric or alphanumeric codes that are used for reimbursement, statistics, reports, and other purposes. Coders also abstract and track other vital information.

HIM coders work in all health care settings. They work in hospitals, clinics, physician offices, long-term care, surgical centers, and insurance companies. The choices are plentiful.

Depending on coder's education, credentialing, job setting, and duties, medical coders may also be called billing analysts, certified coders, certified coding specialists, certified professional coders, clinical coders, clinical coding specialists, clinical compliance specialists, coder I/II/III, coder/abstractors, coder/analysts, coding & billing auditors, coding compliance coordinators, coding compliance managers, coding consultants, coding coordinators, coding managers, coding specialists, coding supervisors, coding techs, coding technicians, coding trainers, coding validation specialists, compliance coders, DRG specialists, ED coders, ER coders, health information coders, health information coding specialists, health information technicians, health record technicians, healthcare coding specialists, HIM coders, HIS coders, inpatient coders, inpatient consultants, lead coders, medical biller/coders, medical coding auditors, medical data analysts, medical records coders, medical record technicians, outpatient coders, outpatient consultants, physician billing coders, professional coders, and remote coders.

Medical coders need a solid training in medical terminology, human anatomy & physiology, pathophysiology, pharmacology, data quality, medical ethics, ICD-9-CM codes, CPT codes, and HCPCS codes. Depending on work setting, coders need to be knowledgeable about prospective payment systems and/or medical insurance billing as well.

Many new and inexperienced coders find it very difficult to obtain that first coding job, especially in the hospital setting. Due to compliance and productivity issues, most hospitals prefer to hire credentialed coders with several years of experience. If you have no experience in coding and medical records, your best bet is to go through a formal training program, like those for RHIT's, that includes a mandatory internship. Associate level (A.S. degree) Health Information Technology (HIT) programs provide students a well-rounded education in all areas of health information management, including coding. If you excel in your internship, there's a good change that hospital will hire you after you graduate since they already know you and your work ethic. Or the very least, you can list the internship as experience. After graduation, be willing to relocate or take a lower level job to gain some HIM experience.

See the links page for AHIMA accredited training programs for RHIA's, RHIT's, and coders. These HIM credentials are explained on the credentials page.

Just like the settings, the pay for medical coders varies considerably. The pay depends on the level of the coder's education, certifications, job experience, type of facility the coder works for, and level of management responsibility. Coders work full-time, part-time, on-call, and as coding consultants. Again, choices are many.

Medical coders, especially in the hospital setting, spend almost all their time at desks reading charts and using computers. Coders must be able to concentrate well, often in noisy surroundings, and sit for long periods of time. Over time, coders may suffer from musculo-skeletal problems and nerve injuries related to prolonged sitting and computer use. Reading computer screens may also cause eye strain.

According to some polls, many hospital coders find their jobs stressful due to high coding productivity and accuracy requirements. Coders' work is constantly monitored and audited by internal and external auditors, supervisors, managers, and outside agencies.

Coding and reimbursement rules and guidelines are constantly changing. Coders must spend a fair amount of time reading professional publications or attend educational seminars to stay up-to-date with the latest changes.

According to the 2006-07 Occupational Outlook Handbook (OOH) by the US Department of Labor, job prospects should be very good for medical records and health information technicians. Employment for HIM professionals is expected to grow much faster than average through 2012.

The 2006-2007 edition of the OOH also states that "The majority of new jobs is expected in offices of physicians as a result of increasing demand for detailed records, especially in large group practices. Rapid growth also is expected in home health care services, outpatient care centers, and nursing and residential care facilities."

The 2008-09 OOH states "Employment of medical records and health information technicians is expected to increase by 18 percent through 2016—faster than the average for all occupations—because of rapid growth in the number of medical tests, treatments, and procedures that will be increasingly scrutinized by health insurance companies, regulators, courts, and consumers. ... New jobs are expected in offices of physicians as a result of increasing demand for detailed records, especially in large group practices. New jobs also are expected in home health care services, outpatient care centers, and nursing and residential care facilities. Although employment growth in hospitals will not keep pace with growth in other health care industries, many new jobs will, nevertheless, be created. "

For more career information on health information technicians (incl. coders), see the links page for the Occupational Outlook Handbook.

	Learning to Code With ICD-9-CM for Health Information Management And Health Services Administration by Thomas J. Falen, Aaron Liberman introduction to medical records and coding, learn essential ICD-9-CM coding skills 1st edition, 2007
	Medical Coding: What It Is and How It Works by Patricia Aalseth presents the big picture for the non-coder in clear, practical language this book is ideal as a basic orientation for those contemplating a career in the coding field 1st edition, 2005
	Healthcare Code Sets, Clinical Terminologies, and Classification Systems by Kathy Giannagelo future of healthcare, new technology, electronic health records, the growing field of healthcare informatics 1st edition, 2006
	Being a Medical Information Coder by Laurie S. Dodson, Kay Cox-Stevens textbook 3rd edition, 2003
	Independent Medical Coding by Donna Avila-Weil, Rhonda Regan 2nd edition, 2007 the 1st edition is also still available, 1998
	Being a Medical Records/Health Information Clerk this is not a coding book, but provides an overview of medical record keeping you could work as a HIM clerk while at school studying HIM and coding 3rd edition, 2003
	Opportunities in Health and Medical Careers by I. Donald Snook, Leo Paul D'Orazio includes medical records technicians 1st edition, 2004
	Resumes for Health and Medical Careers 3rd edition, 2003