A community of 30,000 US Transcriptionist serving Medical Transcription Industry
The Best Coders - Linda Andrews
Posted: 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, each of them correct. The industry allows different accounts to handle things the way they want. Coding is different. There is one correct way to code a diagnosis or procedure. Of course there are coders who don't code correctly, but there is an answer. A person who lacks structure might have a difficult time as a coder, unless they are motivated to develop it. What do you think?
Coding - Biller/coder/MT
[ In Reply To ..]I have to agree. I have done billing, coding, and transcription for 17 years, and although I have never gotten my coding certification (doctors I worked for felt this was not necessary and I was still compensated well whether I had it or not), I truly feel that you either have this skill or you do not. I have worked with CPCs and it was just scary how they coded. I think a good coder has to have great analytical skills and should be able to tell when something does not look right. I think it is a skill that can be learned but I think it is also as you have described it about having lack of structure. Some people just never develop that and they will not do well in coding. The same coders that went through the whole training program and got their CPC have no clue when, what, and how modifiers are used. I have worked with them and shared with them what is a proper way to code and some were grateful to learn while others were "offended" because I was not certified as they were. Again, as far as I am concerned, it does take a special kind of person to do this and not everyone can be good at it. The same as if I decided to be a doctor. I am pretty sure I'd just be in over my head and not do well. It's just too bad everyone cannot admit it. I'd be the first to admit that I am a better biller/coder than MT.
Enjoying structure - Coder/Transcriptionist
[ In Reply To ..]Personally, I would not say that structure and enjoying structure has anything to do with why I like coding. I donât know what you mean by âa person who lacks structureâ or what you mean by âenjoy structure.â As a coder and transcriptionist, full-time coder now, I would say structure sounds constricting and canât say I like structure. The profession itself is structured in that you build, build, and organize your knowledge. I love learning and that feels expansive. You DO have to do the work to develop your base of knowledge and that is ever-evolving and growing. You DO have to follow the guidelines and know them. If you didnât want to do this, you wouldnât stay working as a coder. These professions you mentioned: âaccounting, bankers, medical office managers, many nursesâ are repelling to me. So, no, I donât enjoy structure in that sense.
I can also say that you can have 10 coders code a chart and it would not turn out exactly the same but also not incorrect. Coding is not black and white. There are a lot of gray areas that require analytical reasoning and back up with resources and knowledge of the guidelines.
Definitely will agree with Coder/transcriptionist - Biller/coder/MT
[ In Reply To ..]On the point after having 10 coders code the same thing and having it come out differently. So many coders come in with different levels of experience, skills, etc. and there are gray areas and sometimes there are multiple diagnoses codes you could use. Of note, our job is to code it out to the highest level of specificity, trust me.. That is subjective. I had one where the patient had an office visit and a procedure (suturing of a wound) and the office visit was denied stating it was bundled. It was obvious to me that it lacked the -25 modifier on the office visit, but when I contacted the coder to tell her that this needed a modifier so the office visit would be paid, she put it on the procedure. That was amazing....LOL. but apparently that is what she thought it meant. So, yes, it is supposed to be a clear-cut science on how to code, but it depends on who is interpreting.
Characteristics and Credentials of Coders - Linda Andrews
[ In Reply To ..]Thanks so much for all who are participating in this discussion. I hadn't planned to add more, but I do want to respond to the comment about the CPCs.
To the person who wrote the message above, I'm sorry I don't know you're name, it sounds like the job you have is a really good one and it sounds like you know what you're doing. I also spent time coding without credentials and youâll never hear me say that a coder who has chosen not to sit for certification exams is inferior. There are also some excellent coders who have either the CCS and/or CPC. The coders who are teaching in our course have both. Itâs absolutely necessary for me to have credentialed coders teaching our students, of course, because they are better able to advise students and graduates regarding certification.
In my organization, our Chief Coding Instructor has more credentials than will fit on an envelope, but some of them include her CMT, which isn't relevant for coding of course, RHIA, CCS, CPC, CPC-H, and CCS-P.
One of our very excellent coding graduates joined with us as an instructor. As soon as she graduated, she got both her CCS and CPC. I believe she got both of those before she got her first coding job, or almost at the same time.
You mentioned how you are able to present (and defend) your coding decisions. That's an excellent skill to have in coding, something our instructors want our students to know how to do effectively. Not every coder can do that. Iâve heard of some who just say, âI donât want to know how to come up with the right code. Just tell me the code I need right now.â That is an example of a poor coder, no matter if they are credentialed or not, donât you agree?
Letâs say you run into a poor coder, who happens to be credentialed, either as a CPC or a CCS. Is it a matter of getting a credential then being getting rusty or maybe unmotivated, or just having a poor disposition in the first place? I have seen some of our graduates (MT and coding) who were extremely talented, but they had habits or characteristics that kept them from being as successful as they could have been. Sometimes it's financial pressures or illness. More often than not, itâs a matter of, âIâve always done it this way. If it was good enough for my last boss, itâs good enough for this job.â
In your case, you have a great job and it isn't necessary for you to have those credentials. You are doing well. That doesn't mean that ALL people in those same circumstances would have done so well. I'm not sure I'm making my point very well, but I'll keep trying.
All of us see things differently because we see them from our own viewpoint, our own personal experience. Back in the "old" days when we started teaching medical coding, AHIMA's CCS was the only credential available. Now AAPC has entered the picture with the CPC, etc. All the coders I know who have taken tests from both AHIMA and AAPC have said that both were difficult. My own personal experience is that there are some very good coders who are represented by both organizations. There are also some very excellent coders who have not chosen certification at all. That's my main point. For you, youâre doing fine. I would advise most people toward credentials though, because they may not find the ideal job as you have, and their skills will be more marketable if they have the credentials. Thatâs just my opinion, from my own experience. Not everyone agrees with me on that, of course.
Some employers specify CCS and others want a CPC, because of the specific kind of coding duties involved and their own preference. A few years ago there were fierce battles between coders who were credentialed through one or the other organizations. I don't get into those battles, and it seems like most people have moved on from fighting that one anyway.
I don't know if it's okay to post links to the two organizations or not, but I'll do it here and the moderator can delete it if it's not okay. If anyone wants specific descriptions of the type coding being certified, you'll find it described on these web site. http://ahima.org/certification/ http://www.aapc.com/certification/ This is a great conversation. Thanks everyone for addressing my question about structured people and coding.
Please excuse typo(s) above - Linda Andrews
[ In Reply To ..]Need an edit button. :)
I do know the difference between your and you're. {rolling eyes at myself}
I would definitely agree with Linda - Biller/coder/MT
[ In Reply To ..]As I stated above, in 17 years, I have done it all and honestly my first love has always been and will always be billing/coding. I do feel that having your certification is a very valuable asset. I have been lucky to have made a great income as if I had my coding certification but I also know that a lot more doors are going to open with it. As you stated, you only hire instructors with their certification and that makes perfect sense to me. I am currently studying for my CPC but it's a personal goal that I want to have. Ironically, when I first started in this business, I went to school to become a CMA and thus received a certificate of applied science in that and just realized I prefered administrative duties more than clinical and it just went from there. I just think my point is that just because someone has their CPC does not mean they have anymore insight than someone who has experience. Again, I think it depends on the person.
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