Medical Coding Specialists
Diseases are classified in numerical sequences for identification and data collection purposes. This is somewhat similar to the Dewey decimal system of classifying books in a library. This system is used for information purposes and for billing third-party payers. Medical procedures are also coded for the same purposes.
Duties, Activities, and Scope of Practice
Coding specialists review medical records and assign numeric codes for the diagnoses identified and procedures performed. The codes are known as ICD-9 (International Classification of Diseases, Ninth Revision) codes and CPT (Current Procedural Terminology) codes.
The coding specialist may need to make a determination as to the primary diagnosis being treated in an episode of illness, and assign codes to other diagnoses in a specific order according to rules set out in the ICD-9 coding regulations.
The CPT codes are more specific to billing third parties for procedures performed by providers such as practitioners, laboratories, and diagnostic centers. ICD-9 codes are used for reimbursement from Medicare and Medicaid and some other third-party payers when reimbursement is related to the diagnosis.
Education and Training
A high school diploma or GED is required. Coding-specialist training is part of the curriculum for a health information technician program that leads to an associate's degree in health technology. Most coders obtain their AA degree. The curriculum includes medical terminology, disease processes, and pharmacology, in addition to learning how to apply ICD-9 and CPT codes.
The American Health Information Management Association offers seminars and workshops in medical coding.
Certification is not mandatory, but is becoming the standard. Candidates who have completed coding training can sit for the exam given by AHIMA to become certified coding specialists (CCS).
Work Settings and Salaries
Most coding specialists work in hospitals, but many work in practitioners' offices, long-term care settings, ambulatory care centers, home health agencies, and insurance companies.
Salaries range from $20,000 to $25,000 per year.
Career Potential and Additional Information
HIPAA (Health Insurance Portability and Accountability Act) regulations require the use of codes to improve standardization of information, help promote the possibility for electronic medical records, and protect the privacy and confidentiality of health care records.
An aging and growing population will require more medical care and result in the creation of considerable amounts of medical records, which will need to be coded for reimbursement, electronic access, data collection, and research. This will continue to create a need for medical coding specialists. This occupation will grow fast over the next decade.
More information about medical coding specialists is available from AHIMA. Their Web site is