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

Inpatient Coders - How do you

Posted: Mar 28, 2013

Deal with the RACs? Is your accuracy rate based on how many they say are in error? How about the stress related to that?

We are audited all the time ... - sm

[ In Reply To ..]
No matter what kind of coding you do, you are expected to be accurate. I am not sure why RAC audits would be any different than any other.

Is your accuracy determined by RAC auditors? I doubt it. Facilities audit their own coders using their own auditors or outside companies, for one. For another, facilities fight CMS audits, so they are unlikely to accept everything a RAC audit said.

Is being audited stressful? Not if you are accurate.

Not all facilities - can afford

[ In Reply To ..]
outside auditors. I think RACs are different because they get paid for finding overpayments or underpayments. They are digging to find. Some facilities are so overwhelmed, there is no fighting back.

Are you the OP? And are you a coder? - ???

[ In Reply To ..]
Wondering what you are asking. The thread started out asking if coder accuracy was based on RAC audits and if coders found this stressful. An explanation was provided, but the next post basically disagreed with every word in it, although it appeared to be written by a non-coder. I'm not sure what this person is getting at.

No facilities like the concept of RAC audits. They don't like CMS' constant changes, restrictions, rate cuts, and denials, either. It isn't like you can do anything about it, though. Facilities just have to deal with it. Facilities, not individual coders.

Again, coders are audited all the time. By both internal and external auditors. You say some facilities can't afford external audits. Well, if you say so, but that does not change what that person told you ... coders are audited anyway. I would say that RAC audit findings are looked at very closely from an educational standpoint. I will also say that any facility that does not audit is foolish. They cannot afford not to audit, especially outside audit, because that is a main defense against CMS claims of error. So, if they aren't doing it, maybe the RAC auditors are right?

Do coders find RAC stressful? RACs find things wrong in more than just coding. Documentation deficiencies, for one. That, along with the need for auditing, is providing higher level jobs for coders. How is having good jobs stressful?

I can tell you this, though ... this should help you understand why automated coding still requires coders. When you have to deal with audits and denials, you do not put blind faith in physician documentation, computer assigned codes, or offshore workers you cannot control.

It should also help you understand why coder salaries are as high as they are.

If the need to be accurate bothers you, and if the thought of being audited upsets or even angers you, coding is not a good career choice for you.

Inpatient Coders - OP

[ In Reply To ..]
I am seeing that auditing is part of the job of course. I was asking because I have been talking to coders at my facility about the job of coding because I am looking into it. They say that is what they are most stressed about. That even though they are accurate RAC can twist it sometimes.

If you are using that to make a career decision . . . - sm

[ In Reply To ..]
I think you need to base a career decision on the career itself, rather than the complaint du jour of the coders at one facility.

It is a lot like deciding against nursing because the nurses at your facility don't like the way they are being evaluated this year.

I realize this may seem crucially important to you because you don't know anything about it. It may be a big issue to the coders at that facility because it annoys them. But it isn't cause to decide for or against an entire career field.

I say that because VA coders (thousands of them) are not affected by it. Coders who work where they do not bill Medicare are not affected by it. And loads more actually make a living defending against it.

On top of that, everyone is so annoyed with it that there are some serious calls for reform. It might not be around all that long. It might go away entirely or morph into something else.

Any way you look at it, it is a benefit to coders because it pretty much eliminates that anybody is going to go with computer-generated codes. Nobody would risk it.

Something else you need to know . . . Coders nearly always use scare tactics to discourage would-be interlopers. If you ask at my facility, our highly satisfied coders will all moan and tell you just how awful it is. I have seen them do it. When I was an MT, the coders where I worked spared no effort in convincing me it was a dreadful job. Dreadful! And impossible to do. No one was ever successful learning it. (I later kicked myself for believing that.)

OK? I hope you see the point I am making. It is that RACs are just a fact of life. One among many. And not necessarily bad, at least for coders. They may not even exist by the time you finish school.

You need to make a decision about the career field based on the career field, not on the apparent opinions of some people you work near.

Please find out more about coding from www.hicareers.com, www.aapc.com, www.ahima.org, and from the excellent career information on www.hcpro.com.

Lots more to it than RACs.

RACS - Anonymous

[ In Reply To ..]
RAC applies to outpatient coders as well as inpatient.

RAC audits are not just coding - sm

[ In Reply To ..]
The top reason for RAC denials is medical necessity, with nearly 2/3 of those being denied for a wrong place of service.

They aren't just looking at coding.

Similar Messages:

Aug 09, 2012

Does anyone work as an inpatient coder only. I mean the only thing you code are the inpatient stays, not a mix of other stuff too. Are there jobs like that? ...

Mar 24, 2011

I am going to start a medical coding course at a community college but they are teaching outpatient insurance coding. What do I need to do to be able to do inpatient coding in a hospital? Is there a different test for certification for doing inpatient coding? ...

Apr 26, 2011

I saw on AHIMA's site that they say you are to work for a while before taking the CCS but here I keep reading people that took it BEFORE even having a job. How did you learn it well enough to pass the test w/o job experience? ...

Mar 21, 2012

My local hospital starts at 26 an hour for inpatient coding. I am wondering how much outpatient coding pays.... not that anyone would know this, but is it generally a lot lower than the inpatient coding? Just curious because I need to gain experience before I can land a hospital inpatient coding position and just curious as to how much outpatient coders make. ...

Oct 07, 2011

? ...

May 11, 2012

Can anyone help me with the code used for inpatient consult and a modifier for Medicare? Having reimbursement problems with this one. Thanks ...

Aug 24, 2011

:) ...

Dec 21, 2009

Where are you all? Enjoying your work? ...

Jan 31, 2010

I would love to get the point of view of others on this topic. I've been watching coders for years, our graduates and others. I've found from my own experience that the best coders are people who enjoy more structure than one might find in medical transcription, for example. People who enjoy accounting, bankers, medical office managers, many nurses, and sometimes burned-out MTs. If you have 10 medical transcriptionists transcribe a report, you may have that many different versions, ea ...

Jan 18, 2012

requirements say that education must be accredited by an accrediting institution recognized by the U.S. Department of Education. If we did not attend an accredited school, can we still apply? It says applicants must only report attendance or degrees from such. So, don't bother reporting if you didn't attend an accredited school? How's that work? ...

Jan 22, 2012

to check out coding and what it is all about before going through a course. I am interested in doing coding but am unsure if it is right for me. Thank you for your thoughts and input. ...

Aug 21, 2013

Two, actually, if that's alright... 1. What do you love most about your job? 2. If you weren't a coder, what would you be? There is no real reason behind my questions -- no ulterior motive as it were -- just plain ole curiosity. ...

Mar 22, 2014

You better be learning the ICD-10. It starts in October. Hopefully you are not just learning ICD-9, because that will be all gone soon. I would ask about the ICD-10, if you are not learning the new up and coming codes, it sounds like this company will use you and then throw you away. ...

Aug 20, 2014

How did the coding program work out for those of you "aces" that got in? I would love to get into coding..I am really getting to where I hate transcription and seriously considering heading for the door..in fact I have applications and resumes circulating and am really hoping for a change. ...

Feb 02, 2010

What is the average hourly pay for coders? How would you say the income compares with medical transcription. I have been a medical transcriptionist for 14+ years, and looking into coding. I actually used to do some light coding and billing years ago, but it was for a OB/GYN practice back in the day. ...

Aug 31, 2010

I spent the better part of today looking at jobs other than MT. Although very few hospitals had openings for MTs (they probably don't even have an MT Dept. anymore), there were coder jobs at almost every facility. None of the ads I looked at gave a wage. What does an experienced (5+ years) coder usually make? Are you paid on production, or by the hour? Is coding done on a computer? What sort of software is used, and in your own experience, is it better t ...

Jul 15, 2011

I am going to apply for the coding program at my local community college. I have just finished the required prerequisite courses. I have been a transcriptionist for 30+ years and am having to start over at 60. Could you please tell me if coders are paid by the hour or are they paid piece work? I'm also wonder if you think there will be jobs to be had after going through school. Thanks! ...

Oct 20, 2011

Do most of you work in hospitals and clinics or at home? ...

Oct 27, 2011

Where do coders go to look for remote and/or in-house jobs? Thanks ...

Dec 15, 2011

Just visiting your board to ask a question out of ignorance. I'm an MT working for a hospital, doing straight transcription. There's been a growing trend for the hospitalists to dictate absolutely HUGE, long H&Ps/discharges ... including every stinkin' lab test and diagnostic procedure the patient has had for the last decade, it seems. Most of the reports are walls o' text, as these docs go on and on and bleepin' ON for at least four to five pages of transcribed dic ...

Jan 17, 2012

Hi all you MTs-to-Coders! I am curious to know why you left MT for coding? Burnout? Better suited to your personality? Better pay? Also, in conjuction to that, what kind of MT eduction did you have? Learn on the job? School? I ask because I'm trying to decide whether to go into MT or coding--I'm leaning toward MT through Andrews right now (for numerous reasons), but am looking for a perspective from the other end of the tunnel, so to speak. Thanks! ...

May 20, 2013

I'm currently an MT for many years, in the process of enrolling to take a coding program at a community college (waitlisted at the moment). I've done much research before making this decision, but have never spoken to someone who actually works in coding. I have some general questions regarding what you think of the profession -- do you like your job? If so, what is it that you like? Do you find it at all monotonous or is there some variety in what you do? I wonder if it ma ...

May 24, 2013

With all of this outsourcing of MT/Editors, what does the future look like for medical coders? I have heard that Nuance has developed software to "assist" the coder. My concern is that it is going to REPLACE the coder. Any thoughts? ...

Aug 09, 2013

Now that I am nearing the end of my coding course, which teaches both inpatient and outpatient coding, I am starting to wonder just how different it is in the "real" coding world compared to what I've been studying. I knew studying coding was going to be difficult and I have excellent grades, but I wonder how this level of difficulty compares to coding on the job. Thank you for any input! ...

Jan 17, 2014

Is anyone willing to share their pay rate per chart for outpatient remote contract coding? I am also curious if you ever get an increase in your pay rate or is this renegotiated in your contract. ...

Mar 21, 2014

Some of us have worked REALLY hard to get where we are, and it is kind of an insult to that. I am happy for you, truly I am, but really . . . would a nursing assistant call themselves an RN? Perhaps you will understand why when you get through all of your training. Secondly, I can only attest to where I work, as an outpatient coder. I do not make $30 an hour and never will. Not close that. So unless M*Modal pays so much more than a hospital (and they sur ...

Mar 23, 2014

I'll start off with some office supply suggestions. Code books have really thin pages, and really teeny writing, so you will want to highlight a FEW choice items. This has to be done *modestly* without ruining them. Regular highlighters will bleed through. Too much highlighting and note-writing will ruin them. AHIMA and AAPC have different requirements for writing in books. Be sure to review that before you staple, paste, glue, tape, write, or highlight. &n ...

Sep 19, 2014

They are usually trained to do only one particular type of report, not everything, and so they are not really trained as MTs. Can coding for institutions be broken down like that? I had a friend who worked as a coder at a local hospital. All she was given to do was outpatient ERs, and the "real" coders did all the inpatient work. Being MM, I'm sure they can make your training as "coders" almost worthless. ...

Jan 20, 2010

I was wondnering if any of you work as coders from home. ...

Feb 07, 2010

How many of you who are working coders work in only one specialty, such as cardiolgy or orthopedics, etc. How many of you do ALL specialties? How many do out-patient vs. acute care (hospital) coding? I'm not sure if there are really many working coders on here, but if you are here, thanks in advance for the information. I'm always interested in learning more. ...