A community of 30,000 US Transcriptionist serving Medical Transcription Industry

Hello coders! - jan

Posted: Dec 21, 2009

Where are you all? Enjoying your work?

Hi Jan, I'd like to hear from the coders, too! : ) - elaine

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Maybe they don't know we're here.

we coders! - cj

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Hi. I am one of those coders. I had been thinking it odd there was nothing on this forum when it had been used a lot on the "old" board. If you have questions, post away.

Im here. - emils

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I am new here. So how does this work? I am a new grad and looking for a job. Anyone have any advice, email me at emils134@yahoo.com thanks.

Coders - Steph

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I have been interested in this field for quite a while. I have been an MT for 15+ years and am just curious as to whether or not it is worth learning this field - with docs using their inhouse staff,etc..

thanks for any info, good or bad - as long as it is truthful! (:

getting into coding - cj

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In the next few years the demand for coders is expected to increase significantly as ICD 10 is adopted in the US. I am sure you could find actual projections in the US Occupational Outlook. I know the anticipated increase in openings is a pretty big number but don't recall exactly what it was. But do your research before making a blind leap. Make sure you know what you are getting. Coding is not the piece of cake some of the ads would have you believe. It is intense and requires a great deal of knowledge of A&P, disease processes, pharmacology, etc., and also good analytical skills as we sort throughout mountain's of physician documentation, often conflicting or confusing documentation. Doctor's office may use their in-house staff, but physician's offices are not usually the target setting for a coder. generally, you would be looking to hospitals or surgery centers or the like. Personally, I work for coding's equivalent of an MTSO and am contracted to a very large teaching facility in the midwest. I work from my home and access their facility remotely as do most of the coders for our company. We work for hospitals nationwide as well as a few small surgery centers. Coding is very demanding and with ICD10 will be more so as it will be more concise. The pressure can be pretty great, the stress level high. coding drives billing (although it is not responsible for billing as so many people think) so, of course, the facilities are looking for very close turnaround times. Secondly, the implications of coding errors can be very great due the watchdogs who oversee us for fraud and abuse. The govt is very involved in Medicare/Medicaid oversight as are the private insurers. If you do decide on coding as a career move, please be sure to attend a reputable and certified education program. Do not go with these fly-by-night places currently advertising on TV and radio. AHIMA's website has a state-by-state listing of accredited programs and distance learning programs. hope this helps.

Currently Studying Coding - new student

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Hi all. I am currently taking a coding course through Career Step. I have also been a MT for 5 years, but always wished I had taken coding instead of MT; so now I am.

Seems to be taking me forever to get going with it, but it appears to be a great course so far.

I may be on here asking for support/assistance frequently.

Nice to meet everyone.

Action! - Zs

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Glad to see people here! Cj, is it much better going through an electronic chart than the physical one (with handwriting)? Do you find the documentation still not all there? What if you have to query, how does that work? I am sure you have to have specific fast internet service for that company? I am stuck with satellite.

your questions.... - cj

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I don't think the format, i.e., an electronic versus paper record, really makes a huge difference but the way the facility uses the EMR does. Ours sucks. In our system docs can cut and paste old notes into new visits and then add to them. Problem is they forget to edit the old ones so you have so much conflicting info. They also often use this cut and paste to order ancillary services so medical necessity is out the window. They might order a PSA and enter their visit diagnoses from their clinic visit, such as hypertension or something totally unrelated instead of having to put a reason that actually is appropriate for the test being ordered. Or if the patient's visit had, say, 8 or 10 diagnoses, they will copy them all as the lab order. A good system would not allow this cut and paste. Our queries are still done on paper and faxed to them and they fax back their responses. We are looking into an electronic method but have not had much success thus far. As far as our internet service, I do have cable, but I know we have people using DSL and satellite service. I guess that would depend on the demands or your employer. My fear with the EMR is that one day they will use the diagnoses that the providers enter to replace the coders; it won't be accurate but it'll be cheaper. It will go the way of voice recognition in MT. I know there are companies working on this right now in their encoder software. It is called computer assisted coding (CAD).

EMR - Zs

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Oh, this is not the news I wanted to hear. It sounds like one big mess and worse! The EMR system should include a template that prompts them to input info into certain correct areas or some such device, (a shock device maybe!). It should be making things better not worse. I hope this is not the way it goes everywhere. Though I am glad to hear some use satellite. Thanks for answering.

Coding Education - DJ

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Hi Coders! I have been an MT for 9 years, and have considered getting my CMT. However, the more I read on various posts about MTs the more I think maybe coding is where I want to go. Where did you all get your schooling for this? Online, or in an institution or training facility? Is one better than the other? Thanks for listening!

education... - cj

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I got mine through a community college, which had a distance learning (online) program. I did however, go on campus for the actual coding classes. Just did the other stuff online. facility training, as in on the job, is a done deal. No facility is going to do it. It is too labor intensive, tine consuming and costly to take the time to train someone to code. There are online schools, but be very careful of what you are paying and getting in return. Like MT, a lot of them are useless. I would again urge you to check out the AHIMA website, where they have a list of schools with accredited programs. Good luck to you.

I'm here too!! - Chree77

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I am looking for a job also!! Email me at chree77@msn.com Any information would be greatly appreciated!

My Question - Robert

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I have heard that coding is a much higher end activity than MT,is it true and what it entails?

not sure what you mean but... - cj

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What do you mean by higher end activity? Do you mean in terms of difficulty, compensation, or what exactly do you mean?

Yes both of them - Robert

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Yes i meant both,complexity and compensation.

Complexity of coding - J

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There are guidelines to follow. Guidelines for inpatient, guidelines for outpatient, and guidelines for Medicare which are different from other insurers. You must know these guidelines. There are codes for everything, but just looking up a code is so far from what a coder does. That is only the basic idea. Codes change every year and guidelines are added or change every year. You are continuously keeping up with the changes, continuously researching so you understand what is correct. You code from documentation in the chart. Doctors donâ��t think along the path of a code book. They sometimes donâ��t document important information that is needed to complete a code. They often think it is obvious, and it may be, but we canâ��t use it unless it is documented (written in the chart). Then we must query the doctor. There are rules, ethics, and guidelines that go with querying also that you must know. Documentation is also sometimes very clear, but the cluster of codes you want to use may not be. In CPT, some procedures automatically include another procedure, (bundled) even though they are documented as separate. I have found guidance on this sorely lacking and have to stop and research every day and end up without a clear answer. Sometimes rules sound as if they contradict each other. They are not clear cut or written out to be followed to the T. Sometimes the language alone in the explanations takes a few reads before you know that the heck they are saying. Coding is never-ending study, research, and banging your head against a wall. There are some triumphant successes when it all flows and works. If you love the process, youâ��ll thrive. If not, you will move on.

your questions - cj

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I do believe coding is much more complex and difficult. It requires a thorough knowledge of disease processes that would be much more in depth that that required for MT as well as a real understanding of pathophysiology and pharmacology. A coder must also know and understand the official coding guidelines, things like what codes can or cannot be used together, which codes require a second code, which codes have to be or may not be used as a principle or secondary diagnosis, as well as sequencing rules. Plus interpreting what is documented can be very challenging. Additionally, the scrutiny can be overwhelming, the consequences very significant. We have internal QA, external QA (an outside company comes in and audits) and constant reviews by payors, Medicare and Medicaid being the biggest sticklers, and then most insurance companies will follow whatever polices are set by those two looking for ways to not pay! Compensation, however, is very subjective. I know some MTs who can do a couple of hundred lines an hour and make very good money and some who don't do so well. Coding is usually paid by the hour so you know what to expect. Generally, I would say coding is probably better compensated. I know that is definitely true if you are looking at an hourly MT wage versus an hourly coding wage. basically all places will also require a coder to be credentialed so you have a constant requirement for CEs (I need 15 CEs per year) plus credential maintenance. While facilities used to cover these costs, many, if not all, have used the current economic situation, to transfer the burden of these costs to the coders themselves. Coding presents some very real challenges, but for those who love it, it can be really a rewarding job. For right now, I also think it is probably more secure than the MT field. Who knows what the future will bring? The advent of ICD10 in the US will create a huge demand for additional qualified coders as a lot of older coders will not stick around for the transition and the increased level of expertise required will create new demands.

What terrific answers. Thanks so much. I've probably - MissIndigo

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learned more about coding work, short version, from this thread than from all discussion before.

I've been wanting to take a basic coding class or two to broaden my skills a tad as insurance for the future but, since I'm editing now and have no actual plan to move to coding itself, I don't want to take it so soon it'd all be forgotten before it might be useful. From your descriptions, though, I do think I'd enjoy the brain work "over there." :)

What do you mean? "End activity?" What's that?...nm - whaaa?

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nm

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