Question for billers and coders..(sm)

Transcription question [2008-05-14]
Hello, I have a few questions. I amcurrently taking a medical transcription course. It actually is the final part of my program I have been taking.I am doing the Hillcrest Medical Center book. I am having lots of trouble with the cases in the book. Trouble hearing them and understanding them. My teacher says that I need to be flexible in my working conditions. See I am doing this transcription in a classroom with about 15 other women that are working all kinds of other things. Lots of talking, and other activities going on. My question is....Is this typical in an office? I have read that typically a Transcriptionist is working in a quite part of the office or at home. Also, transcription isn My other question is how do you get your foot in the door?? I only have a small amount of experience in an office and, that was a distribution office at that. I have no medical office experience. It is just so hard to get into any place because they want experience. I can Thanks

I think the pay is about the same for coders as MTs..(sm) [2008-05-07]
I see jobs advertised for coders a lot at 2 local hospitals around where I live. There are other hospitals in outlying smaller towns that have jobs occasionally. I haven It may be hard to break into coding,but even at age 55, I want to try. III have to earn regular money and not just when work happens to be in the system. I still think I will continue to look into switching to coding.

Pay scale for certified coders [2008-05-01]
Anybody have any info on the pay scale for coders in South MS? I have been an MT for 13 years and need a change. Thanks.

Question for billers and coders..(sm) [2008-04-28]
I know next to nothing about billing and coding. First of all, which is better to pursue, billing or coding, or both? Is one better than the other? ls there any waybilling and coding will go the way of MTing and be outsourced, or is it starting to already? Sorry, but like I said, I know practically nothing about it and after 18 years I am ready to get out of MTing. IMT companies who have plentyof work where I can actually start making good money again.I am seriously thinking of switching to billing or coding. Any input into this will be much appreciated. TIA.

Question about MT required to do the coding at new job [2008-02-24]
Hi everyone, just a quick question to all the coders and billers out there...I just started a new job at a facility where one of the responsibilities of completing the EMR record for each patient...I am to also assign the coding (not too comfortable with this, as I have only very, very limited knowledge of coding after unfortunately paying for an online course, only to realize it really was not something I would enjoy, or be very good at?)...is this legal?.... I feel like the prior transcriptionists were at times making their best guess (which seems very dangerous and costly to the company, etc....)... if this is not something I should be doing...should I respectfully bring this up to my new supervisor (who has herself taken over the MT department, as it was run by another level as part of their nonprofit, government funded mental health facility. Thank you for all of your insight... I appreciate your time. Sincerely, Jen

That's a good question. Try the coding board [2008-02-01]
at MTChat. You may get an answer there on the Andrews School board, and I think there is another. The instructors sometimes give great answers.

pay for certified coders [2007-12-17]
Just out of curiosity, what is the normal rate per hour for certified coders with 12 years coding experience? Thanks

Medical Billing & Coding Question [2007-09-20]
I am currently an MT and I am considering training in Medical Billing/Coding but have a couple general questions: Are these one in the same - billing/coding or two completely different positions? How do you get paid? Is it by production? Any information would be much appreciated. Thank you!

thyroid question [2007-06-25]
I have an enlarged thyroid with 3 nodules. My thyroid blood tests were normal. Today I had a thyroid uptake scan. Is it possible to have thyroid nodules, normal blood tests and to NOT have cancer?

Good Question [2007-04-18]
Hi confused: I am currently a medical Transcriptionist and am looking to get into coding as well. I am getting ready to start an Associate degree program with North Dakota State College of Science Health Information Technician class in June. I choose this school because I can take it online and it was recommended by the AHIMA. I spent the last few months researching and finally narrowed it down to either DeVry or there. I had just finished some classes with University of Phoenix and decided I would rather go with NDSCS. Anyway, I wish you luck! Paulette

biller & coders [2007-03-23]
Career Step has Coding and Billing education available.

Billers... [2006-07-28]
Yes, I am Certified in.. Med.Coding Billing and am attempting to net-work to find any web-based,contract like work that I can do from home like..(claims processing).Iv'e been in the field since 2003 and am finding that alot of it is about net-working. How long have you been in the field?

Any billers out there? [2006-07-07]
x

They like the $$ they get sounds intriguing, what would you [2008-11-28]
say is a pay range for coders, beginner, experienced, and very experienced?

Since you were curious . . . [2008-11-04]
It's not a factor. I work for a very large, university affiliated, tertiary care facility. I think the problem is that I am talking about *learning coding,* while you are talking about everything else that goes with coding, especially with knowing what you're seeing on a day to day basis. Yes, new procedures crop up constantly, CMS changes its policies constantly, physicians document poorly constantly . . . those things you deal with as they occur. As it happens, I'm one of the people at my organization who determines how to deal with them, so I'm aware just how much of that there is. However, I took the original poster's question as an inquiry about *learning coding,* not all the other stuff. Let's look at what the OP asked about. She's STUDYING coding, so she's not seeing level 1 trauma and the newest procedures on the block. She's just having trouble learning to code--trouble learning to use the code sets. That might be ICD-9 or CPT, but the things she's trying to code are textbook examples, and those aren't cutting edge. It looked to me as though she was having trouble finding, say, 401.9 when asked to find hypertension or the code for a hernia repair or a chest x-ray. At that level, it's only difficult if there is something gone wrong. I offered help with that, because I believe it doesn't have to be that hard.

Coding is [2008-11-03]
I like coding because it It is truly a rare bird that calls coding straightforward and clear! It is straightforward and clear to you. I doubt there are many very experienced coders who would use those words to describe coding. You are a rare bird.

Not so rare a bird [2008-11-03]
I hope itday job, as well. I might be prejudiced, but I don't think so. I work with loads of coders -- upwards of 35-40 -- who don't have much trouble with it. They also like the $$$ they get for doing it. As with anything, I think it's a matter of experience, education, and expectations, with a good bit of innate ability thrown in.

Redpen, mind answering a couple of questions? [2008-10-31]
What is a realistic expectation of pay for a certified coder? How are certified coders paid in a virtual position? (Ex: MTs are paid by line.) Thanks for any answers you can provide.

Pay [2008-10-31]
There are fairly accurate salary surveys on www.aamt.org, www.aapc.com, and www.advanceforhim.com. You can see the exact salary VA coders make. Their grades are typically GS-6 (entry level), 7, and 8 for straight coding positions. If you enter as a 6, you should be an 8 in three years. A lead coder would be a 9 and compliance or supervisory positions would be a 9 or 11. You can see the salary range on the federal salary spreadsheets. Be sure to look at the one for the geographic area you're interested in, since those include the locality differential. ttp://www.opm.gov/oca/08tables/indexGS.asp

What is the "typical" day for an inpatient coder like? [2008-10-23]
I'm at the beginning stages of investigating hospital-based coding as a career, and I'm just trying to get a feel for what the job is like before I sign up for some expensive schooling (although so far, it all sounds fascinating). I Do you always have a stack of manualsto consult, or is there specialized software you access in order to enter the codes? How do you know what documents to access? How long was it before you first felt competent at your job? Assuming I start school in January, what can I be studying beforehand to get a headstart (I have the medical terminology down, and IP course).

Coding certifications [2008-10-22]
It is getting so that you really will want a certification to enhance your chances of getting a best-paid job. Employers are looking more toward certifications, since using certified coders helps them ensure accuracy, reduce training costs, and demonstrate that they did everything they could to ensure compliance with standards. Which certification you would want will depend on the type of coding you wish to pursue. Right now, there are fewer inpatient coding jobs (understandably) than outpatient. That's going to affect your choice. The AAPC CPC certification is primarily for outpatient coding, so that's a good place to start if you want to do outpatient coding. If you want to do inpatient coding, then you'd go for an AHIMA CCS. That's another good place to start. The AAPC CCPC-H and AHIMA CCS-P can be added on, as well. The best plan is to get one from each organization. That way, you're covered no matter whether the prospective employer is more familiar with AHIMA or AAPC credentials. If you're leaning toward hospital or medical center coding, an AHIMA certification will help. For outpatient clinic settings, AAPC certifications are far more common.

Coding test for job... [2008-10-20]
Open question, I have been transcribing for 14 years, have 6 years experience in coding but not recent. I have an opportunity for a coding position which requires testing, any tips from current coders on how to do well on this test? TIA for any help.

You made a good [2008-10-12]
Salaries are better in coding than other HIM areas until you get to the RHIA level. With coding training, you can get a job and begin earning the higher salary, then do the RHIT and RHIA at low-cost state schools. RHIAs make the most, but there aren't as many jobs. Coders have high salaries and lots of job choices. RHITs are beginning to be pushed to the bottom of the heap. Their only way out is pretty much through coding. AHIMA is working on requiring a masters degree for an RHIA, so if the RHIA is a direction you want to go in, best go now while you can still achieve it.

AHIMA [2008-10-07]
AHIMA is the Association for Health Information Management. They are the credentialing body for CCAs and CCSs as well as RHIT and RHIA. CCA is certified coding associate, entry level credential, and CCS is certified coding specialist. The CPC exams and credentials are from an organization AAPC which I am not sure but I think is American Assoc of Professional Coders. AHIMA does actually offer an on-line coding program, but that is not actually the focus of the organization. I don't know what is more prevalent in your area, but in my area generally hospitals are looking for AHIMA credentials. That may not be true in your area. If you look at the review books for both CCS and CPC you will find the CPC is more CPT coding and CCS is more ICD coding. They do both, however, cover both ICD and CPT. Advance for HIM is a publication that is available on line and I believe for free as is Just Coding News, both of which might provide some useful info for you. There are others, but the names escape me right now. Boot camp is 4-day intensive but really not the best investment if you have no coding knowledge at all.

your percentage is a little bit off [2008-10-07]
Actually about 50% fail the test, not 70%. and that is of the total people who take it, not just those who have taken college-based coding programs. I do not believe there is any such breakdown. The simple office coding you talk about isn't actually coding if you are copying the codes the doctor wrote on the chargemaster and doesn't really require any book as anybody can copy codes! It is the billing aspects that would require the specialized knowledge in that setting. And yes, it is difficult to learn inpatient coding on your own but a motivated person can do it if they set their mind to it. I have a good friend who is a CCS who is completely self-taught. But not everyone wants to be an inpatient coder. Our hospital has ED coders, outpatient coders, and day surgery coders in addition to inpatient coders.

Starting out in Coding or billing [2008-10-06]
Hi, I've been an MT for about 8 years but would like to learn medical billing and coding procedures. I plan on teaching myself as much as possible (and asking people that I know who are professional coders questions) and then taking the 4 day boot camp & take the CPC-A (apprentice) exam. What would you ladies suggest I start with? A CPC study guide? I am about 90% sure I can obtain a job in my hospital once I actually have a certification. Thank you so much in advance! By the way, I already have med term., a&p I and II w/ labs, and have an extensive knowledge about anatomy. The thing I need brushing up on are meds/surgical instruments, etc... Thanks again for your help!!

I am in NO way confused.... [2008-10-02]
Iworked in medical records for a few years before working from home, so I know exactly how it runs and what the job duties are because I participated in many of them. I also worked with coders who had worked in the field for 10 years and stillhad to go through an accredited program before being eligible to sit for their exams. The program that I am taking is heavy in coding, so sorry dear, but I won Also, once I complete all studies that I plan to take I will be eligible for the RHIA exam. I

You can sit for the exam with NO course. [2008-10-01]
You seem to be confused about the exams and credentials. You are warning others to be careful of which school they pick because just because you finish a coding course doesn That's not correct. You can sit for any CODING certification offered by AHIMA or AAPC even if you DON'T finish a coding course. You don't even have to start! They only require a high school diploma. AHIMA doesn't even require experience. You do need to be careful of what school you pick because some of them don't produce employable coders. As for you, your course is a 2-year RHIT program. You DO need the course in order to sit for the RHIT exam. However, an RHIT program is not a degree in management. It is a technical degree. ThatT is for--technician. It will qualify you to be a worker bee in a medical records environment--the same job people off the street can get. You can put together patient records, shelve and retrieve them, make photocopies to release patient information, check reports for signatures, etc. A better job would be coding. It pays better and it's more interesting. It takes less time, too. You could do all the coding first, then get a job while you do the rest. The RHIA is the management degree. There are RHITs who work their way up into management in small facilities, but most of them end up filing records or coding. RHIAs run the show.

ICD-10 is not being taught now [2008-09-26]
The U.S. is still using ICD-9 and implementation of ICD-10 is constantly being pushed back and back (thank goodness!). You will need thorough knowledge of anatomy and physiology and also need to really know and understand disease processes. Of course, the ICD and CPT classes and reimbursement systems, for POA, DRG, APCs and chargemaster. ICD-10 will be much more in depth so the knowledge of A&P and disease process will be even more important. You will also need some pharmacology (need to know what drugs are used for what diseases/conditions) but also need to how those drugs work, their method of action. Biggest deficit we see in our new coders is understanding of disease processes and the pharmacology. Since one of the guidelines in coding is not to code symptoms that are integral to the disease, this is really important to understand. Also, in the coding classes you want to get to really know and understand the Official Coding Guidelines. We have schools in our area that actually don't teach them. I can't figure out how that works because you can't be a coder without knowing them!

Outlook for coding [2008-09-21]
The outlook for coding is very good. There is an increasing need for coders, due to the type of reimbursement system used in the United States and an ageing population which requires more medical care, among other things. There are already a huge number of coding positions going unfilled due to a shortage of coders. Within the next several years, the United States will likely be switching to a more complex coding system. It is expected that many older coders will choose to retire and less competent coders will seek other work rather than try to make the switch. It is thought that a huge number of jobs will open up just prior to the changeover to ICD-10. Large-scale outsourcing the jobs to India is unlikely. There has been an actual decrease in interest in this, with some of the federal sector healthcare entities banning offshoring entirely. It is expected that the private sector will follow. Unlike some other jobs, there is a high need for control of the coding and reimbursement process. Coding has a critical effect on reimbursement, with errors resulting in lost income and the potential for huge fines and criminal sanctions. Offshore workers cannot be held liable for this, which has served to squelch interest in offshoring. Recent developments in privacy and security requirements (HIPAA), with the threat of medical identity theft, are cooling interest in offshoring, as well. As an occupation, coding offers good potential for advancement. Even if it becomes possible to assign codes via software, the higher level jobs will still be necessary and available. Coders will move easily into other roles.

Re: coding jobs [2008-08-31]
It can be hard to get a coding job right out of school, and I am always telling people I know with the same question; if you I have known people to work their way in by doing this. I did it myself over a year and a half ago, and I am now the clinic division Billing coordinator for a hospital system. Also, let your schooling intentions be known to those you are applying to.Get all the practice you can with coding, from practice workbooks. There are quite a few available from Ahima, AAPC websites bookstores, Borders online, etc... You need to know what you and once you have one of those, getting a job should be easier. But, the exam is not easy! So again, practice, practice, practice.

CPT code [2008-08-30]
My boss has purchased a module for me to practice CPT coding. Although I will only be doing pathology this module covers alot. There are short QA's to answer that I can print out and use my books and take my time. This is only for my knowledge I get no credits, no nothing for this so there is no cheating going on. Its just a $12 module for CPT Concepts. Just wanted to explain that before I asked my question. This question pertains to CPT code 62278 and a modifier to go with it.Herein the CPT book. Is this maybe a typo in the question. I have the CPT 2008 Professional Edition. Cany anyone help me with this. I have been racking my brain on this for 2 days now. Thanks

You're right! It's has to be a typo. [2008-08-30]
There is no 62278. The codes go from 62273 to 62280. There aren't even any discontinued codes in there. I've sent you an email. If you'll tell me what the question is, perhaps I can figure out what it should have been.

It does help the transition [2008-08-28]
It really does help in learning the new job. It might not have seemed so to you, but we see it often. The best coders we have are former MTs. They learn coding much faster because they have a familiarity with reports and procedures. Itteach them how to read op reports, for instance. They just know. They also have a command of language that is better than most, so they read faster and more accurately. This might not have been apparent to you. You might not be aware of how much more difficult learning coding would be than it was. Obviously, some MTs might not do well in coding, but there are skills and knowledge that transfer.

You need training! [2008-08-27]
No, you need training. Coding isn't really any more difficult, but it is a different set of skills. MTs make great coders, though! Familiarity with reports and their contents, gives them a biiiig head start.

Things you can to to improve your prospects. [2008-08-26]
There aren't too many work-at-home jobs for new coders. You might need to bite the bullet and agree to work on-site for a short while. Start now to prepare yourself to take and pass a CPC, CCS, or CCS-P certification exam when you graduate, because that is the key to getting hired. In your courses, do not aim for a passing grade, but for a perfect grade. Squeaking by is not enough--the deficit will accumulate. If your course uses only one coding textbook, get different textbooks and learn everything they teach, too. Work every problem in every textbook, as well as in Clinical Coding Workout, and Marsha Diamond's Medical Coding Practice and Review, and every other review book you can find. You might be able to get them on interlibrary loan. Find out the certification requirements NOW for both AAPC and AHIMA, so that you won't waste time barking up the wrong tree. Those exams require you to be able to CODE, so that is what you need to learn to do. You need to know the anatomy, pharmacology, lab, and med language cold, but you must be able to code. If you can demonstrate to an employer that you can do that, they may hire you and you can move home quickly.

That's a different story. [2008-08-23]
What you had, then, was a poor documentation issue rather than a coder problem. Billers have a long tradition of thinking the coders are terrible and also of thinking the job isn't as complicated as it actually is. It's a lot like having the receptionist think the billers' jobs are easy and that she could do it without training because all she sees is typing and she can do that. That's not saying YOU are seeing it that way, but just pointing out that the situation from the coders' side might not have been quite what you thought. Coders code only from what is in the documentation. You donled to do so, in which case it was still not ok. Hospitals are constantly being investigated and sanctioned for this. Just having a supervisor approve it is no guarantee that it's ok--a supervisor and some other corporate sorts from 30 miles south of me are in federal prison right now for doing the same thing. But, if you are able to know what should have been coded from seeing a bill, then you might be an expert already. In that case, try taking the CCS exam and see what happens. If you pass and can get a job, then you're ahead of the game. If you can't, then you'll know you need more education. I can say with some certainty that you will not get a job working from home coding inpatient records without on-site experience, even with a CCS. It's even less likely to occur with a CCA, and your chances of being hired at all for inpatient coding with a CCA aren't great. Keeping the job would present a difficulty, too, considering the productivity requirements employers have. In truth, your chances of getting a job doing remote billing are better. It would certainly be less trouble.

Actually, [2008-08-22]
Well, in the interest of brevity, i left out the part, where i went to the coders and talked to them, and they went to the doctors and got the correct documentation, it was all done legally and with my supervisor's and the Medical records supervisor's permission. I worked for a very large hospital, and no fraud was committed.