HIM Insider: Forums

Re: Coding

Cindy Wingert — Sat, 13 Jun 2009 04:18:48 GMT

I am a student in Omaha, NE and am taking courses in Coding/Billing and Insurance and have a couple of questions. I am interested in getting a job at a local hospital in coding and billing when done with my courses but would like to have resources at home to have on hand in order to stay familiar with the terms and such after my classes have ended if I haven't yet obtained a position in the field. One book that I would like to have on hand is the CPT, and then we are also using the AAPC's HCPCS Book for coding/billing class along with the CPT. Are there any other books or resources that anyone can recommend that would be useful to have on hand for my personal library? Both to learn more as I prepare for a job in this field as well as to have for an at-home resource once I enter the field.

My second question is that I have seen many posts about hospital and physician coders, but is there a market for at-home coders and contracting out your services or even medical facilities that allow home coder positions? I'm not sure what the correct term would be for that.

Any information would be welcomed. Thank you.

Cindy

Re: Coding

Christine Goans — Tue, 12 May 2009 16:27:07 GMT

Hi Deidre

I would like to invite you to my website where we discuss this in detail for all of the types of positions the members hold.

I have a student who started a new job 3 months ago and I went to interview her and her supervisor on site to see how it was going. She actually is working for a hospital but not doing inpatient coding she is doing the day surgery coding and the pain management coding in addition to coding the encounters she reviews the patients insurance and verify the codes on the precertification form to the codes for the procedure the provider did if they are different she contacts the insurance and sends over the op report to the insurance so when they get the claim it won't be held up. Originally she was only going to be doing the coding but due to budget cuts they decided to combine the two positions and since she had insurance knowledge she has worked out very well. She is certified as a CCS-P.

Please feel free to join my website www.medical-coding-resources.com

Re: Coding

Deidre Bass — Mon, 13 Apr 2009 17:39:05 GMT

Hello my name is Deidre. I am currently a student at West Georgia Technical college, I will receive my certification in June. I was just wondering if you could tell me what to expect as far as being a medical coder. I am just now about to begin the major classes. What are some of the things you do at work?

Re: Coding

Tomomi Gallagher — Thu, 02 Apr 2009 14:40:20 GMT

Hello Christine, I am currently taking medical coding certificate online course, living in Ft Lewis WA. If you donot mind, Could you answer a couple questions about coding? also, I am looking for your website.

Thanks

Re: Coding

Cathy Pearson — Tue, 17 Mar 2009 20:29:33 GMT

Why would a school not teach both inpatient and outpatient? Is it a AHIMA approved coding school?

Re: Coding

Christina Benjamin — Sat, 07 Mar 2009 21:59:43 GMT

One argument presented for starting with physician office coding is the fact that in a hospital, a coder is not exposed to the ancillary departments as the front desk and back office billing in a hospital setting like they are in a physician office setting. The billing, business office and patient accounts as well as the admissions/registration areas are in separate locations of the hospital from the coding department. And typically, the coders are not involved with those functions---they only code.

However, I worked in a hospital and my experience was that there was still some interaction between the coding department and the billing or other staff via phone or in person. For example, many times the billing manager or patient accounts rep would come down to the coding department to discuss issues or they would email or call to that department regarding denials, coverage issues, missed charges, and so forth. I recall one case that the assistant manager had me handle when I volunteered at my local hospital. Billing had called down to our department because they wanted to know if a charge could be assigned for a foreign body removal, because the coder had not assigned a code for it. So although, the exposure may be limited, in a hospital where the reimbursement is handled as a team with multi-departmental interaction, in my view, a coder can still get a view of billing, especially from the standpoint of how coding practices affect billing and reimbursement.

But here is an alternative: start working in the hospital billing or patient accounts department, work there for a while to get familiar with back-end billing issues as a way to get your foot in the door and then when a coding position comes open, move on into actual coding.

Check out this post too for more information on the challenges of hospital billing and coding: http://medicalassociationofbillers.yuku.com/reply/14794#reply-14794

Re: Coding

Kelly Snitker — Sat, 07 Mar 2009 19:24:48 GMT

Why is it better to work in a physician's office when first starting out coding and billing then in a hopsital? I will be starting my career in this field in the winter as I am just finishing up with the remainder of my classes.

Re: Coding

Christine Goans — Sat, 07 Mar 2009 01:12:29 GMT

Barbara

What I have my students do is go apply to 10 places where they think they want to work. They ask to speak with the manager and explain they are a coding student and as part of their course they are required to learn about the facilities that interest them. Most managers do take the time to talk to them and explain the functions of their facility and the types of positions they have for newly graduated students.

This task has developed over the years and most find that the ASU, ER, or physician office is a good starting point they get to see the whole picture of how accurate coding and billing can make a big difference. Each person from the receptionist taking the insurance info to the person calling and verifying benefits, the biller and the coder work together as a team. Those that started in a hospital never saw the whole process. Working the denials on insurance vouchers teaches you alot about the coding field and makes your course work make more sense all those modifiers really do make a difference.

Once you have worked in a outpatient setting it is my opinion from almost 30 years experience both from working in the hospital and outpatient setting and as an instructor I would say starting on the physician side is best or was for me.

Feel free to contact me if you have any other questions; or visit my website or Yahoo groups.

Christine.Goans@gmail.com

Re: Coding

Kevin Shields — Thu, 05 Mar 2009 00:18:30 GMT

I wholeheartedly disagree with Christina.

In my nearly 8 years in HIM, time and again I've seen physician coders successfully traverse to IP facility coding while facility coders frequently struggle with the level of detail required of CPT and E/M coding. In fact, most of the coders I know in my age group are making or have made that transition. The folks who've years of hospital experience tend to get mired in that arena.

Re: Coding

Brenda Mitchell — Tue, 03 Mar 2009 23:32:18 GMT

I was told it is better to start in a physician office by my coding instructor.

Re: Coding

Tahnee Farley — Tue, 03 Mar 2009 21:27:31 GMT

Hi Barbara , My name is Tahnee , i am curently a student at Heald College in Roseiville , and i remember my ICD-9 and CPT instructor telling us this morning that they do not train us in hospital coding. So i guess we should go strait to a physicians office unless we continue our education, or get more hands on experience before we try to get a job in a hospital. So i would base the desicion on the training you have gotten.

Re: Coding

Christina Benjamin — Tue, 17 Feb 2009 16:45:51 GMT

In my 4 years of experience, I have found that it is much easier for an experienced hospital coder to transition to the physician office setting than for an experienced physician office coder to transition into the hospital setting...I have had numerous emails and seen several posts from long-term physician coders who are wanting to get into the hospital coding field, but are having a tough time of it. A current example for illustration is a recent post on this very forum at this link: http://community.advanceweb.com/forums/thread/36314.aspx The pay is usually higher in the hospital setting as well which makes it attractive to physician coders. I also know several colleagues who were in the hospital arena for an extended time and transitioned into the physician office setting... just my observations for consideration. I started with hospital.

Re: Coding

Yolanda Phillips — Wed, 04 Feb 2009 00:01:50 GMT

[i am a Medical assistant student i would like to know where would the best place to start out? Doctors office, Med center or hospital.

Re: Coding

Soyeb — Thu, 29 Jan 2009 17:08:09 GMT

I would say hospital is a great place to begin your coding career. However, some hospitals require to have little background in HIM field, while others would take you as a fresh graduate. Depending on the size, type, or the need, they’ll offer you an entry to mid-level job in HIM dept.

Coding

Barbara Comeau — Tue, 13 Jan 2009 03:48:28 GMT

Is a physicians office or hospital to begin a coding career ?