Individuals with a background in healthcare, such as nurses and medical assistants, are often drawn to the world of the medical coder and/or biller. Although a strong background in healthcare is NOT required for individuals interested in medical coding and billing, it is certainly an advantage to come into the field with an understanding of the healthcare industry.
An understanding of the terminology unique to medical care providers is especially valuable to the healthcare employee desiring a change in career, but not a change in industry.
Often, people from other facets of healthcare tell us that they are drawn to medical billing and coding because they seek a less physically demanding job. Working as a medical coder or biller is a great way to stay within a vibrant and growing industry while transitioning into a new area of expertise.
For those unfamiliar with the terms medical biller and medical coder, according to chron.com, medical coding and billing can be two separate jobs. However, in some offices, tasks are combined into one job. Basically, a medical coder “translates health care services into coded items that are used in the (medical) billing process.”
Here’s a quick look at some of the acronyms that medical billing and coding professionals must become familiar with:
- CPT® – Current Procedural Terminology is “a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations,” according to the site searchhealthIT. CPT® is a registered trademark of the American Medical Association.
- HCPCS – According to the AAPC, HCPCS is an “acronym for Healthcare Common Procedure Coding System (HCPCS)…HCPCS Level II coding system is one of several code sets used by healthcare professionals, including medical coders and billers.” The AAPC goes on to explain that “the code set is made up of five-character, alpha-numeric codes mainly representing medical supplies, durable medical goods, non-physician services, and services not represented in the Level I code set (CPT®).”
- ICD-10 – The website Athenahealth explains that ICD-10 is an update to the long-popular ICD-9, the International Classification of Diseases. The ICD provides “information about epidemiology, managing health, and treating conditions.” The newest version of ICD was created in part as a companion to the Health Insurance Portability Accountability Act (HIPAA) and it contains increased diagnosis codes.
More About the Medical Coding and Billing Field
There are several certifications available for professional medical billers and coders. One is the Certified Medical Coder® (CMC®), a currency that validates personal achievement, demonstrates a person’s commitment to the profession, improves employer confidence, and can help guard the practice against fraud and abuse. According to field professionals, a Certified Medical Coder® plays an integral role in the reimbursement processes, ensuring that proper documentation guidelines are followed and that codes are submitted to the highest degree of specificity to ensure that the physician receives every dollar entitled for the services rendered.
PDI’s Medical Billing/Coding Certificate Program offers professional certificate courses that give participants the specialized skills needed to succeed in well-paying positions within hospitals, clinics, physicians’ offices and insurance companies or billing agencies. Graduates will be prepared to perform administrative support functions such as: Medical billing, admitting clerk, ER registration, hospital cashier, claims processor, collections clerk, medical front office, insurance follow-up and hospital accounting clerk. The program requires no prerequisites and provides introductory instruction in anatomy, medical and insurance terminology, office policies and procedures. The program will prepare you for ICD-10 coding, CPT coding and HCPCS coding.