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?'s/thoughts on Coding going the same way as MT - AnonMT10
Posted: Jan 01, 2015
Hello and Happy New Year to all!
I've been an MT for about 10 years now and have been going back and forth over getting into coding for about the last 3 years. I get so excited at the prospect of starting a new career/having more financial stability in a field that I know I am suited to, that I allow myself to have some hope-- but then my mind eventually comes back to all of the potential negatives, and that hope fades....
So today, on this New Year's day, I would like to see if there are any coders/other professionals in the field who would be willing to give their advice/opinions on the following "negatives" in an effort to make up my mind once and for all about pursuing coding.
1. If I do go for it, it will definitely be the Andrews course that I take. Of course, I will give 110% to the course and plan on taking both the inpatient and outpatient certification tests. I am concerned about not being able to secure a position (even with passing the certification exams) without having actual experience in coding. Although I do feel the course is reasonably priced, I cannot afford to invest thousands of dollars, and then hundreds of dollars for exam costs, into a career that does not "pay off."
2. Then there is the investment in my time-- I am going to be 50 years old in a few short weeks. While I know that "50" is really not over-the-hill, and while I do realize that ALL potential new careers have their risks and challenges, I worry that perhaps I should be searching for one where the odds are a little bit more in favor of actually securing a position.... I'm looking at spending thousands of dollars, at least 1+ years of intense studying and giving my ALL to the course, sitting for and paying for 2 certification exams, and then praying that I can secure a coding position with my certifications alone and no actual coding exerpience. Then, if I am lucky enough to secure a position, praying that the position doesn't end up being outsourced/offshored and going down the tubes the same way MT has. If I only get a few years out of it, I will be in my mid 50's by then... too young to retire but too old (in my mind- so no offense!) to want to start all over again...
3. In addition to the above, when I contacted Andrews a few weeks ago to inquire about the program, I was informed that the program centers around ICD-10. In the meantime, the change to ICD-10 hasn't even gone through (who knows when/if it ever will at this point), and the certification exams are in ICD-9. The Andrews rep stated that once I know ICD-10, learning ICD-9 for the exams will be no problem, but this concerns me very much-- and again-- more money/more time to get prepared for these exams in ICD-9.
I know that MT is extremely diffferent from coding, and that not all MTs are "shoo-ins" to excel at coding. However, I did have Coding I and II through an MOA program that I took in a "brick-and-mortar" school years ago, and I loved those classes! I know in my heart of hearts that coding would be a great career fit for me/my personality and skill set, but I am SO very afraid of ending up right back where I am now.... a middle-aged woman about to lose her job and trying to figure out where to go next-- this time even older "middle-aged," with even more debt!
Thank you in advance to anyone who read the whole way through and any advice/opinions, good or bad, you choose to share.
Before we reply, can you answer two questions? - Coder
[ In Reply To ..]The 1st question is ... what is the alternative career that you are considering? The one that is guaranteed to have lower educational costs, never outsourced, never offshored, never electronified, and in which you are guaranteed to be hired no matter what.
I don't think there is such a perfect job, but if you will tell us what you feel comes close I will be able to provide a comparison that may help you with your decision.
The 2nd question is whether you are willing to work outside your home and either live in or can move to a community that has lots of healthcare facilities. What is the job market like there?
Also, at this point ICD-10 is 9 months away. It is unlikely that you can finish Andrews that fast, so learning ICD-10 is not unreasonable. However, since you already took coding once, you should be able to blow through the AAPC online course and pass the CPC in ICD9 and certify in 3 to 4 months. That might be a better choice for you, all things considered.
?s/thoughts... - AnonMT10
[ In Reply To ..]Thank you so much for responding!
To the first question..
I get exactly what you're saying... nothing is guaranteed. The only other two options that I am seriously considering at this time are (a)Tumor Registrar and (b) just taking refresher classes- maybe Excell, Powerpoint, etc. and looking for a clerical/office manager type position (away from healthcare altogether).
Second question: I am definitely willing to work outside the home; however, I cannot move at this point in time and do not see that happening in the foreseeable future. As for the "job market" for coding in my area, I have seen ads for coders in my local area recently. However, I am concerned about the future of coding. I know there is no such thing as a crystal ball, but well-informed thoughts/opinions on what is going on in the industry (from those within the industry) will certainly help I think.
Do you think that ICD-10 will actually come to be next year-- or do you think they will prolong it yet again?
Again, thank you for your help/advice. It is much appreciated!
good luck. Most employers want experience even with - Certification. I know several
[ In Reply To ..]people who are certified and can't get jobs. that't he nature of the beast. personally I would never go into coding on my own but my employer is training me to be a coder with the promise I will work for them for a year.
Good luck with whatever you choose.
?s/thoughts... - AnonMT10
[ In Reply To ..]Thank you for your response!
Are these people that you know certified in inpatient as well as outpatient coding?
Is your employer MModal by any chance?
Thank you again for responding.
M*Modal - anon
[ In Reply To ..]I have been reading some of the other posts and the M*Modal training, apprenticeship, then work for them for 1 year actually sounds really good. I want to try to go in to that field as well (already an MT) Can you give any more information on this? Is this available to people who are not employed by them yet? Thank you for your time!
As of today, right now, they only are training current MTs - and have an apprenticeship for certified coders
[ In Reply To ..]Not sure when they will offer classes again.
I think you need to just go for it - Coder
[ In Reply To ..]Thanks for answering those questions. It helps.
The concerns you have are reasonable and normal, but at some point you have to look at your options and make a decision. Nothing is going to get better otherwise.
You are correct that nothing is guaranteed. If you can accept that about other fields, why would coding be any different? It might be that you associate it with MT, since this board is here, or hear so much negativity about it here.
I am a coder who used to be an MT, and I have a job. I work with about 40 other coders who have jobs. I know hundreds more all over the country and my professional organizations have thousands. Every one of them was once an inexperienced coder who got a job anyway.
Are there new coders who cannot get a job? Yes. It is not necessarily that they have no experience, because inexperienced coders get jobs all the time. Employers would like experience, but cannot always get it. They will hire you without it IF you are credentialed or on the way, if you pass their test, if you impress them, if you look reliable, etc.
Remember that there are experienced coders who can't get jobs, too.
Is this more of a problem in coding? No. New RNs have great difficulty getting jobs. It is so bad that national organizations are concerned. New lawyers can't get jobs, either. Every occupation has new graduates who can't get jobs. For careers like LPN, the jobs are often in undesirable and poorly paid work.
Compared to that, coding seems to be a good choice. It all depends on you, though, and the job market in your area.
Tumor Registrar is basically specialized coding, but the job market is not favorable at all. I would never recommend it to anyone who did not already have a job in a registry. There are very few registrar jobs. Credentials are not optional and they are hard to get. Formal college education is necessary. Pay is also somewhat lower than coders and the job doesn't go anywhere.
If you want to be an office worker, you can learn Office via free online training. You don't need to do anything much for that, so you might see if you can get a job in that field. Pay is going to be lower.
I think ICD-10 just might happen this October. Even if it does not, you are not going to be harmed one bit by taking Andrews course in ICD-10. It is not difficult to switch back to 9. ICD is only ONE of the code sets you will use as a coder. You will use HCPCS (CPT), which isn't changing. There is also SNOMED and several others, which some coders use.
The whole point of a coding course is learning the general principles of coding and the medical science underlying it. It is not to "learn the codes." We do not memorize code numbers. We learn how to find them when we need them. If you know how to code, you can find what you need in any code set.
As I mentioned in my previous post, it is unlikely that you will finish Andrews before October 1. Many programs ARE teaching ICD-10 now. Employers ARE going to be looking for ICD-10 now, too.
?s/thoughts... - AnonMT10
[ In Reply To ..]Thank you so much for your very thorough and thoughtful reply! You make several good points! For me, I guess it comes down to going for it all the way and taking the risks already mentioned/discussed vs. spending less $$ and time taking courses to prepare for a "general" office position that, more than likely will pay less $$, but will also, more than likely, be easier to come by and potentially keep.
With the above statement I am strictly going by the "odds".... the fact that general office positions are advertised far more than coding positions, along with the fact that I personally have never met an office worker whose job has been outsourced/offshored-- not to say that this cannot/has not happened, but in my neck of the woods, it doesn't seem to an issue at all at this point in time....
Thanks again for all of your help/advice! I truly do appreciate it!
Consider this, please - Coder
[ In Reply To ..]It makes no sense to me to go with a crummy office job that pays miserably and is not secure just to avoid paying a few $$ to get a career that pays better.
I think you are imagining the risks here.
What good is all that "security" in an office job when it isn't secure at all and costs you 10, 20, 30 or more thousand a year in income?
I don't think Andrews tuition is anything at all. It is $3800, I believe, which you will earn back the first few months as a coder.
If you have not seen the salary surveys, you need to. The AAPC survey for 2014 just came out. The unemployment rate for new CPC-A coders has dropped to only 9.5%. That is not bad at all. It is much better than other career fields.
CPCs as a whole have only a 1.4% unemployment rate. That is also much better than other fields.
Salaries have gone up, with the average salary for all AAPC members at $50,775. For coders with no college, it is $44,338. With some college, it is $46,815. For coders with less than a year of experience, the average is a bit above 35K.
Hospital inpatient coders do the best, with an average of 56,554.
Considering that, $3,800 is a bargain. I make 70K now, and I would not hesitate to do it all over again.
?/thoughts.. - AnonMT10
[ In Reply To ..]You make a lot of great points! I agree that Andrews is fairly priced and a great investment towards a well-paying career.
I realize from posting here today that my biggest fear is not just spending the $$ and investing my time-- but giving my blood, sweat, and tears to the course (which I did for MT as well) only to have it all ripped out from under me again. However, from the posts here and other research that I've been doing, it seems as though I may have more opportunities for other types of positions (if I cannot secure a coding position right away), at least compared to the MT field, anyway. This just may be the impetus that I needed : )
Thanks for posting the salary information, also! So happy for you that you are doing so well in coding!
You have MT PTSD ... - and about that rug ...
[ In Reply To ..]Your concerns are understandable. It is a kind of PTSD syndrome, I think. You may keep seeing your trauma happen again and again.
However, the rug didn't get ripped out from under you. Your exact job function is disappearing, but the RUG itself, by which I mean the foundation of knowledge you use in that job, is still useful. It is vauable, in fact, and few people have it. You may have difficulty seeing that because MTs have been isolated for so long.
Coding is not like MT. There are jobs around coding that you can move into. There are jobs above coding you can advance into.
MT has basically one job ... sitting at a desk converting voice to text. There are a few QA type jobs, but that's it. There is pretty much nowhere to go from coding. If there was, MTs would not be in the pickle today. They would have moved on already along well-known routes..
Coding is part of a larger HIM field. Coding is, in fact, not just a job, but a *skill* or area of knowledge that many other HIM and informatics jobs use. Look at the Career Map on the link below.
Every one of those careers uses coding to some extent. The entire HIM and informatics career fields use it. Now do you see why we keep saying that concerns about coding "going away" are unfounded?
That whole map grows, too. As some jobs are phased out ... like filing paper records on shelves ... new jobs are created ... like jobs managing electronic records.
You can see that you can get into the field at the bottom and move up and around, with training you can learn on the job or elsewhere.
Note the comment about the two new areas added to the map. Data Analytics and CDI Specialist. Both require coding. CDI Specialist, however, would be a perfect fit for you because it involves working with physicians to improve the content of their documentation for patient care, for coding needs, and for billing. Coders move up into that role.
Your MT background will really help you in coding. Right now, you may think you have to abandon it. You feel a sense of grief over that. However, you will need it for coding and you will use it.
You can already read medical records. You understand what you read, too. You already know the parts of reports and how to find what you need in them. You understand a lot about medical care. You don't have to be taught that.
This might not make sense to you, so I'll give you some examples. You know what pacemakers and leads are, right? If you transcribed them, you know what it means to create a pocket? You know what leads are and can at least Google them? I have never seen an MT2Coder who did not. I have, however, had to explain repeatedly to a non-MT coder (NMTC) that this was an invasive surgical procedure involving an incision and insertion of long wires into the heart. She thought the device was being inserted into a pocket of the patient's pajamas.
She also had difficulty understanding closure in layers, sutures, steristrips, and glue. Also the difference between medical doctors and surgeons. Also the differences between local, regional, general, and epidural anesthesia. She thought local was what we did locally, as opposed to what people did in, say, the mid-west.
Trust me, you have lots of useful knowledge to bring to coding, every bit of which will help you now and for years to come.
?s/thoughts... - AnonMT10
[ In Reply To ..]Thank you so much for this detailed information and the AHIMA Career Map!
LOL at the non-MT coder stories... I guess not everything can be taught in a coding course- no matter how thorough.... but seriously.... the difference between medical docs and surgeons and local anesthesia.... wow...
I have actually decided to take the Andrews course. Now, I just have to quit researching and second guessing and just DO IT! I am hoping to start by Feb. 1.
Thank you again for your help/advice. It is very much appreciated!
In my opinion - sm
[ In Reply To ..]In my opinion, you could do a lot worse than Andrews. They have a good success rate, have a book-based program, have instructors who actually code for a living, and are US based, nice people who have a reputation for scrupulous honesty and ethics.
If you do what they tell you, you will have a hard time coming out of that program not being able to code well. You will have job-ready attitudes, expectations, and skills.
Their payment plan is good, too. Many students earn their down payment through yard sales, cooking for friends and relatives, cleaning houses and cars, etc. I don't doubt that some are getting it funded on one of the crowdsourcing websites.
Good luck to you.
?s/thoughts... - AnonMT10
[ In Reply To ..]I also wanted to add that I truly appreciate the info. about ICD-10! That does make me feel a little bit better about the situation!
?s/thoughts... - AnonMT10
[ In Reply To ..]I also wanted to thank you for the Tumor Registrar info. I looked into it about 2 years ago, was definitely intrigued, and planned on doing some more research this weekend. From the little bit that I've done this morning, it looks as though you are right about jobs being few and far between.
They tightened the education and experience - requirements, too. nm
[ In Reply To ..]NM
I can answer as a new coder (coming from MT) sm - MT to coder
[ In Reply To ..]I became interested in coding a few years ago. I have been an MT for 30 years (still help out my old department). My hospital MT department will be permanently closing their doors in the foreseeable future. Sad but I saw this coming in this field a long time ago thus took the outpatient AAPC course and got certified. I then just bided my time - no one really wants to take a chance on a new coder - too much to teach you on the job. I did get my current coding position in my department because the MT department is closing. The other girls are struggling to either find other jobs or having to take coding courses in order to be considered for a coding position. I am so thankful I had the forethought to take my coding courses before and they moved me into coding immediately because I was already certified. So I was kind of a lucky gal to get into this the way I did. I had applied for other jobs and know they didn't take me because of having no experience.
Also, if it helps, I am reading that the ICD-10 will definitely go through this year - no more delays. It's a pain but they can't keep leading us to believe it is going to happen and then delay it. Our department as well as others I am sure do a lot of preparation. We are starting again this week. They did extensive preparation last year only to have it delayed. We shall see.
We also have a coding service in my hospital because we have a few empty positions and we can't keep up. For my hospital anyway, I can't see jobs in coding going anywhere. Good luck in your decision.
P.S. I am about the same age as you, learning a whole new job. I am using all my brain cells, I'll tell you that, but I do like it and was more than happy to get out of MT. I was very burned out after all these years. Plus, the job prospects were grim.
Another MT to coder - anonMT
[ In Reply To ..]I actually landed a job before I passed the CPC (but I was scheduled for it), and had been an MT for 25 years. You have to be persistent, think positive, and emphasize how everything you have learned as an MT will help you in the coding world. Good luck! I am so happy I made the switch, every holiday off with pay, quarterly bonuses that are fairly substantial...just in time to pay my Christmas bills!
?s/thoughts... - AnonMT10
[ In Reply To ..]Thank you so much for your response-- and congratulations!
It means so much to hear positive outcomes from other MTs who have succeeded!
I am also an MT - who went to coding
[ In Reply To ..]I also transitioned from medical transcription to coding when my medical transcription job at the hospital was outsourced. I could see it coming and had decided to go back to school and earn an associates degree in health information technology. I also have both the RHIT and the CCA certifications. I code clinic and sit on site at the hospital. I am not comfortable putting the name or how much I earn but it is a teaching hospital that has a somewhat rural focus. The hospital has started to move coders home and I am hopeful that I will be able to start working from home soon. Coding and transcription are very different but I am glad I made the change even though it was a lot of hard work and frustration at times. It is totally worth it and I am happy with my decision.
?s/thoughts... - AnonMT10
[ In Reply To ..]Thank you- and congratulations on your associates degree and certifications!
The area that I live in is somewhat rural as well, but there have been positions advertised. They usually ask for *either* the RHIT or one or both certifications. There are just so many changes going on - not only with healthcare in general, but with the system that I work for in particular... every single one of us (all employees within the system- not just MTs) are walking on eggshells about our jobs... I know this is true pretty much everywhere right now, but for us, it is most definitely "on the horizon" (the exact words spoken to me by management). I'm one of only a handful of MTs left at this point, and if I do decide to go for coding, it will be very, very soon...
Thanks again for your response!
?s/thoughts... - AnonMT10
[ In Reply To ..]Wow... thank you so much for sharing that info., and congratulations on becoming a certified coder!!
I kind of feel as though I had the same opportunity and blew it! The system that I work for has advertised for coders on several occasions now, and had I taken the Andrews course 3 years ago (or even 1 year ago)and,of course, went on to become certified, I may have been hired for one of those positions!
I've always been an "all or nothing" kind of gal who always weighs the pros and cons, but unfortunately, this has held me back from several opportunities--if I'm being completely honest with myself. I guess I just don't want the ONE time that I truly "go for it" to end up being a huge mistake-- mostly financially speaking.
Your post has helped me a great deal, however, and I thank you for taking the time to respond!
I am yet another MT who went to coding -- - sm
[ In Reply To ..]I was an MT for 30+ years, was laid off, then got a coding job. I absolutely HATED it and only lasted at it about two years. As another person stated, you use a lot of brain cells! It is completely different from transcription. Everybody is different, though, and you may love it. Good luck!
?s/thoughts... - AnonMT10
[ In Reply To ..]Thank you for responding! Did you take a course and get certified? What did you not like about coding, if you don't mind my asking?
I had Coding I and II years ago. I loved those classes, and I do believe coding would be a great fit for my personality type/skill set. BUT... I do realize that receiving "A's" in Coding I and II is not the same as a full course/preparing for and getting certified, though...
Thanks again for your response!
What I hated about coding - sm
[ In Reply To ..]Hi AnonMT10. I don’t mind your asking at all. I’ll try to keep this as short as possible. I didn’t do only the coding, I did everything related to insurance, starting with verifying benefits, ending with working the monthly aging reports, and EVERYTHING in between. The job was incredibly frustrating and stressful. A lot of what I hated had to do with the billing portion of the job, but there was plenty I hated in regard to the coding.
I was not certified and was trained on the job by the insurance employee who, at that time, had six years of experience and did take a two-year coding/billing/insurance course, but she was not certified. Shortly before I quit, I asked my co-worker if she thought I should go to school and take a coding/billing/insurance course, and she told me not to and that I would just be wasting my time and money as I wouldn’t learn what I needed for our particular job.
I am very detail oriented. However, the details I had to try to remember to do the job were overwhelming! You’ve already taken a course and know coding is a good fit for you. I am not a numbers person. I love words, hate numbers. (There was a tremendous amount of math involved with the billing portion.) Coding was not a good fit for my personality.
What I hated about coding:
MODIFIERS: So many modifiers! One example - the doctor I worked for saw postop patients. So, CPT X gets modifier A for co-management and modifier RT for right side. Patient comes back a month later postop for the other side, CPT X gets modifier A for co-management, LT for left, and XX to say it’s the same procedure on the same patient but on the other side. Well, duh! Wouldn’t modifiers RT and LT explain that?
Another example - CPT for Tests A. B, & C all get modifier X for BCBS. However, for Aetna, Test A only gets modifier X, tests B & C get no modifier. Then for UHC, Tests A, B, & C get NO modifiers. Finally, Medicare doesn’t cover any of the tests with or without a modifier! Who knows why? Just because Medicare has to make everything as difficult as possible.
One more example - hospice patients’ claims get a certain modifier or the claims will be denied. Patient tells the receptionist he’s on hospice, but the receptionist doesn’t think it’s important for the insurance coder to know this info, so claim gets denied and has to be refiled.
DIFFERENT INSURANCE COMPANIES: Coding is done differently for almost each insurance company. Example - BCBS pays CPT for procedure X using ICDs A, B, C, & D. Aetna pays for CPT X using ICDs L, M, N, & Q. Then Humana pays CPT X using A, and Q only. Once again, Medicare doesn’t pay for CPT X using any of the ICDs that are acceptable by other insurance companies, just because they have to be difficult! I’m sure you get my point by now. (Also, the 1500 forms are filled out completely different for each insurance company, but that would be a billing issue.)
ICD-10: You know by memory the majority of ICD-9 codes you use, and now all that is going to change with ICD-10. The “rules” were always changing. Example - BCBS used to pay CPT X but no longer does. You call BCBS and ask them why they denied it when last month they paid it and, well, they just don’t pay it anymore. End of story.
REFERENCES: I had NO references other than the Internet and my co-worker who was in a different office. Hopefully, you won’t have that issue where you work.
I hear ya - billing
[ In Reply To ..]That is working in a physician's office where you sort of have to do it all. I wouldn't like that either. I am a certified coder and I just code charts, nothing to do with billing. We still have a lot of rules and guidelines, but I know what you mean about insurance companies. Thanks for sharing that experience, it tells a lot about the office side of things.
Right, but that is BILLING, not coding. - Call it what it is!
[ In Reply To ..]I agree, that is frustrating. It is billing, though, not coding, and it is why I would not want to do that kind of work.
It might have been less frustrating if she had been trained appropriately and certified. Some of the trouble might have been due to incorrect instructions from the noncertified trainer.
I think it is sad that someone missed out on a good career because of a misunderstanding about what the career entails. I hope she will stop calling it "coding," too.
For the record, the coding I do does not involve satisfying individual insurance companies, nor does it have anything to do with numbers, payments, denied claims, or anything else she mentiined. It is just coding.
She was CODING claims, so how is that - NOT coding?
[ In Reply To ..]Did you read the whole thing? She was CODING claims, choosing the correct ICDs and modifiers. How is that NOT coding? I get so sick of coders saying that is not coding. She specified billing was different from coding.
This is why it is not - coding.
[ In Reply To ..]The fact that there were codes involved does not make the job coding. Billing does involve some code selection, but not at the same level or to the same degree as coding.
Putting codes on claims is not coding. It is billing.
This is not meant to be insulting. The jobs are different. The job she did was billing. Nothing wrong with billers, either.
You are coding when you read entire records and you, yourself, determine the significance of the material in it, identify conditions appropriate for coding in accordance with certain guidelines, correlate labs, imaging, and other clinical documentation, request clarification and additions from physicians, and you, yourself, are responsible for the accuracy and ethical compliance of what you code. YOU are responsible. Not the doctor.
How do I know she was not coding? She mentioned knowing the codes she usually used and did not recognize the problem with that.
To the "REAL" coder - sm - "Biller"
[ In Reply To ..]I'm the one who wrote the long explanation on why I hate coding. I understand what you're saying and how you don't consider what I did as actual coding. There were times I had to read the medical records to get an ICD I knew would pay the claim when the doctor didn't circle anything appropriate on the superbill, but I definitely didn't do what you do.
I am curious, though, as a coder, do you not have to deal with modifiers? If not, why not? That's part of coding I would think. Also as a coder, does the insurance company not factor into the codes you use? As I stated, I had to know which insurance companies would pay for tests and exams and had to know what ICDs to use to get those claims paid.
I didn't mean to imply that I memorized all the ICDs, just the ones used most often for certain tests. Again, just curious, what is the problem with that? It was a one-specialty office, so would think knowing the most-used codes would be the norm.
Thanks!
To the coder, I forgot to say this - Biller
[ In Reply To ..]You're right that it may be a shame that I missed out on a good opportunity because of how I was trained. I hated every second of that insurance billing job and, because of that, I don't ever want any job that has ANYTHING to do with insurance whatsoever! I hated it so much, I quit my job without having a job to go to. I guess I just have to keep hoping there's a reason for everything, and maybe I'll find something I can do well other than MT.
Not the coder you asked, but new coder with thoughts - anonMT
[ In Reply To ..]I understand and I would hate needing to do all of that with the insurance also. In fact, I just turned down a side lucrative job offer where that is exactly what I would be doing. I am working in a group physician practice with several specialties. In my position, we have a program after we code that we run and it has corrections built in. For instance, it will say for Medicaid add this code with this modifier for this diagnosis code. After a while, you learn most of it, but this is a double check and catches those things. I work in a central office along with the A/R and insurance specialists. I hear them on the phone all day fighting with insurance companies and thank God I don't have to do that. So, if you ever get over that negative horrible experience, realize that most coding jobs do NOT include that! Best wishes to you, and I hope you find something you truly love! One of my friends just got out of MT and has a dog sitting business that she started on the side, which now has blossomed and she is making almost twice what she did as an MT!! Many different opportunities are available, but you may need to think outside the box!
Thanks, AnonMT! - sm
[ In Reply To ..]If I had typed ALL the reasons I hated insurance billing, my post would've been five times as long! You are right about having to fight with insurance companies on the phone. It was so stressful and exhausting. What I learned is the insurance companies can make all the mistakes they want (e.g., quoting incorrect co-pays/co-insurance amounts), and don't have to take responsibility and fix their mistakes. Then I would have to bill the patients, who would then call me and scream at me and tell me I didn't know what I was doing because *I* quoted them the incorrect co-pays! Ultimately, patients are supposed to know their benefits, but that was rarely the case.
thanks - nm
[ In Reply To ..]nm
Nope, what insurers will pay for should not be - a factor.
[ In Reply To ..]Coded data is used for more than billing. It forms the basis of national health statistics, as well as the way facilities determine how much work they do, where to allocate resources, and what services to offer. It is even used to determine the quality of a facility or individual provider.
If the coding is not done the same way by everyone, none of this data has any meaning. For that reason, there are rules and guidelines that govern coding and code assignment. They determine what we code and how codes are selected. Those rules are in the front of the code book and online, and there are more instructions in the book, as well as guidance in a publication called Coding Clinic. (CPT has similar rules and CPT Assistant.)
We code according to those rules, for correct coding. What was checked off on a superbill or listed first in a bunch of discharge diagnoses is irrelevant to me. I go from the documentation itself. If there is something wrong there, I go back to the doctor to get it fixed and provide education about doing it right next time.
There are insurance quirks, but they do not change the coding. The coding comes from the documentation and the rules. If you are following the rules, the coding follows, and you should have enough for the claim. If not, it is the physician who needs to change so that the documentation will produce the correct coding.
Correct: Code ethically, code the documentation according to the rules.
Incorrect: Use something from the list of what will get it paid.
Do I use modifiers? Sure, if I am coding outpatient. I use them according to the rules. Granted, there are a lot of insurer whims about modifiers, but I follow rules. Billing uses a crosswalk to adjust them for particular insurers. Coding gave them the crosswalk and coding assists with any issues. That way, the facility coding remains correct even while the claim may vary.
This is a lot less random-appearing if you have a good understanding of the rules and follow them. Modifiers are still annoying, but much less so. LCDs are still annoying, but much less so.
Inpatient coding is strictly by the books. It is a lot more complicated and so much hinges on it that there is an entire career field devoted to clinical documentation improvement.
I do large facility work, not small office, where the coding goes into a permanent record, which billing then uses to generate a bill. The coding does not get entered directly onto a claim form and get changed as required. The coding stays the same forever.
There are AHIMA folks who say that only inpatient coding is real coding and that outpatient is not. I disagree with that, but it is true that the smaller the outpatient venue, the closer you get to it being more billing than coding.
Thank you for the detailed explanation! - nm
[ In Reply To ..]Xx
?/thoughts.. - AnonMT10
[ In Reply To ..]Thank you so much for your detailed reply! The information you provided is extremely interesting to me! I wouldn't be too happy with all of the billing involved with your former position either!
I hope that you've found a position that is better suited and that you're happy with!
Thank you again for your response! It is truly appreciated!
thanks to what I hate about coding - appreciate expl
[ In Reply To ..]I just want to say that your post is very much appreciated. This tells people how it is to work in an office doing "coding slash billing" which is probably how it would be labeled for the job title. So thank you! This is great information to put out there for people who are coming into coding. Also, as a general rule you will find when you do a search for coding, "coding/billing" will come up on Google. So out there in the world, they connect the two quite often. It is good to show the difference. Working for the outpatient side of things using CPT coding, you use modifiers. Working for the inpatient side you only use ICD-9 and there are no modifiers for that. Working in a hospital you may do both. The outpatient side of coding in the hospital is different from the office. Working in a hospital the coding is for inpatient and outpatient side of coding. For the outpatient side: same-day surgeries, ER, sometimes radiology, some ancillary. For these you would be doing both ICD-9 and CPT. Yes, you use modifiers for the CPT, but you get to know them pretty well and it is not that bad. You code them and send them off to be billed by the billing department. Billing is a whole other department. We have coding guidelines which guide us as to how to code. We have CMS (Medicare) watching over us always. You learn the guidelines and follow the guidelines and you're good. There may be offices and clinics who have coders and billers.
MT to coding - too
[ In Reply To ..]I am also from MT to coding. I was your age when I transitioned. Went to Andrews and upon graduation got my CCS and CPC-H. The course is not a piece of cake. You really have to dig deep and work hard, have a few meltdowns, but you can do it. You have a very good attitude. I made it and am glad I did it. I feel like I am all set with a good job and I really have no worries about outsourcing. There are plenty of ways to go with coding so you should be able to find something to get in. I was lucky enough to be able to get into coding where I worked as a transcriptionist. I think hospitals will definitely look at you if you have completed a course and have your credentials. Good luck!
?/thoughts.. - AnonMT10
[ In Reply To ..]Thank you so very much for your response, for being honest about the course/amount of work involved, and for the compliment on my attitude!
I am definitely leaning towards signing up for the course at this point. It may just be the best birthday present ever to myself : )
It is the price of visiting Starbucks every day - for a year.
[ In Reply To ..]$10.41 a day is less than some folks spend on Starbucks, restaurant meals, and entertainment.
I can easily exceed that in the cafeteria and Starbucks where I work. A salad and a latte will do it.
It would make a great present to yourself. Learning something new enhances your life and self-esteem, promotes brain health, and can be entertaining.
Forget about the job benefits ... at least in part ... and do it for you.
?s/thoughts... - AnonMT10
[ In Reply To ..]That's an interesting analogy- and I do love my coffee- lol!
I have decided to definitely go for the Andrews course! I'm hoping to start by Feb 1 (have to get some financing in order first) and plan to totally immerse myself in it!
Thank you so much for your help/advice! It is appreciated more than you know!
but is it boring? - concerned
[ In Reply To ..]I am starting a CPC course in the spring. I'm so afraid the work is going to be monumentally boring, but I don't know what else to do. I can't quit working yet and there's nothing else I can really think of to go into. I'm worried a little bit about going back to work in an office, but more worried that I'll just be so bored (MT is really boring too).
Good grief, no! - Not Bored, LOL
[ In Reply To ..]No, coding is not boring! Not usually, anyway. It might be possible to find a boring coding job somewhere -- maybe if you coded the exact same thing all day -- but you would discover that soon enough and move on.
Believe me, if you are bored coding, you just need to find a more challenging job. LOTS of them out there -- you won't have trouble.
It is more likely that you will find it too complex, i.e., not restful enough.
I know lawyers who are also coders. That should give you an indication of the importance and complexity of coding. If there are jobs for lawyers in coding, there is something more than "boring" going on.
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