Medical Coding Specialist

A Medical Coding Specialist reads and reviews medical documentation provided by physicians and other health care providers in order to obtain detailed information regarding their disease, injuries, surgical operations, and other procedures.

This detailed information is translated into numeric codes. The coding specialist assigns and sequences diagnostic and procedural codes using a universally recognized coding system called ICD-9 (soon to be ICD-10 as required implementation in the United States is in October 2013).

Using this official classification system, coders must insure correct code selection for compliance with federal regulation and insurance requirements. These medical codes are used extensively for reimbursement of hospital and physician claims for Medicare, Medicaid, and insurance payments.

Medical Coders proficient in this process usually have certifications ranging from CPC (physician based), CPC-H ( hospital based), or CPC-P (payor based) from AAPC or similar based certifications from AHIMA including CCA, CCS and CCS-P.

The information compiled by the medical coders is used to prepare statistical reports for use by clinic and hospital administrators for planning, marketing, and other management purposes. Local, state, and federal governments also use this information to identify health care concerns critical to the public at large. Knowledge of both the medical and business sides of health care are essential in this detail-oriented field of health information management.

Careers can be related to the manufacturing, administrative and management fields of medicine. Among all the careers, one of the most intriguing and interesting fields is that of medical coding. Medical coding is a boon to the medical industry; it saves time, money, and effort, and cuts down on the sheer amount of data that is necessary to keep medical records straight for the billions of people who receive medical care.

The profession of medical coding uses alpha-numeric codes to specific illnesses, injuries, and medical procedures. This process of assigning codes is done under the system of a particular rule of coding that is used across the world, from doctors’ offices and hospitals to insurance companies and federal agencies. These codes are greatly utilized by the hospitals, nursing homes, labs and by the doctors for internal data collection and other planning objectives.

The job of medical coding specialists is to read and review medical documentation provided by physicians and other health care professionals. The coding specialists then provide details of the disease, injuries, surgical operations, and other procedures, but this decision is entirely up to the specialists. Then, this detailed information is translated into numeric codes.

They assign special as well as general diagnostic and procedural codes by the use of a universally recognizable coding system. By the help of this code system, one has to fulfill the responsibility to insure correct code selection for all the regulations, and has to abide by the federal regulation and insurance requirements. These codes render great use in reimbursement of hospital and physician claims for various insurance payments.