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

our stuff is coded all over the hospital, and they are not coders - confused

Posted: Apr 23, 2013

Hey Everybody! I am in an entry-level coding position. I work at a very small rural hospital. I'm trying to figure out how things work and wrap my brain around the whole "cycle." So...here's where I'm puzzled. I ask different questions like, well, who does the E/M coding and the radiology coding and the pathology coding, etc. It just seems that there are many people who do lots of the coding in the hospital. I just want to know if this is normal. One person does inpatient coding, and she also does all of the outpatient procedures. And...utilization review does our observation time on the observation charts. Billing does our CPT coding (? huh). I want to branch out and do more than just the ancillary reports, so when I ask well, who does what, it seems it's done somewhere else in the hospital, and they are not coders. We are going live on Epic very shortly, and apparently, some of the nurses are even sitting for some of the coding classes. Can anyone shed some light on this? Just confused. That's all. Love the job and the experience is invaluable.

Yes it IS normal. You want it to be that way. - MT2Coder

[ In Reply To ..]
This is normal for a facility. It is not something you should worry about . . . it does NOT mean that there are fewer jobs for coders, or that coding jobs are going away, or anything like that.

Most of those things are uncomplicated coding. Same thing over and over. (Yawn!) You wouldn't want to do it anyway, or at least not for long. About a week of it and you'd be climbing the walls.

Please don't associate this with Epic or EHRs in general. There is no cause-effect happening here. Nothing that will take jobs away from coders.

Your facility is not likely to have any E/M coding. That is because the physicians who come to your hospital have their own offices who code and bill their services. They usually do their operative procedures, their E/M, and everything else. That is why a hospital that has 200 doctors on staff does not need 20 coders . . . their coders work for the doctors directly.

Path and radiology often do their own because they are not actually part of your facility. Their physicians work for their own practices, i.e., a path group or a radiology group. They might work at your hospital, but are not necessarily employees of your hospital. Their offices are managed by their managers and they employ their own coders.

Facilities also use "chargemasters." These are, basically, automated systems that tally up charges, including CPT codes. That is how it happens that billing "does" the CPT coding.

If you have one coder doing inpatient and all outpatient procedures, that tells me your facility is quite small. Larger facilities might have 10 or more inpatient coders and several outpatient procedure coders.

Right now, you seem to be concerned that you are seeing all sorts of other people doing coding and that you aren't seeing the jobs you think coders should have.

The problem is not that there aren't jobs, but that you can't see them. There ARE coders doing that work or that are behind that work, but you can't see them because they aren't sitting in your coding area. They might not even be employed by your facility.

But, they ARE there. Coders set up all those systems for those other people to use. Even if doctors do their own E/M, their path and rad coding, and even if nurses are taking classes for whatever it is they are coding, A CODER IS BEHIND THEM. Some coder sets up and maintains those systems. And some coder audits the coding in those systems.

thank you, thank you, thank you - confused

[ In Reply To ..]
You have put my fears to rest. I do understand the "flow" much better! I appreciate the time you took to understand where I am coming from and to work me through my confusion.

System - Also confused

[ In Reply To ..]
Why would you ask someone who has never set foot in your facility how your facility runs? Wouldn't it be better to ask someone in one of the coding areas where you work how things are done? Then, you thank a total stranger for her explanation, whatever.

A total crazy stranger - Too nm

[ In Reply To ..]
X

Could be that I am a - Total Crazy Stranger

[ In Reply To ..]
But is more likely that you aren't a coder. Or, if you think you are a coder, you don't know as much as you think you do.

The explanation I provided was pretty much industry-standard. That is just the way it is likely to be, given what she told us.

Thanks for the new screen name, by the way. I like it!

My thoughts - Crazier than you

[ In Reply To ..]
I am sure that you know everything that there is to know, and yes I am a coder. However, I would never tell a stranger how the facility where she works does things. Part of the reason for my reply was to try to get the OP to do her own research instead of depending on replies from people on a message board who may or may not know all the details. It's good PR and an excellent way for the OP to introduce herself to others in her workplace.

Thank you for asking the question! - WWW

[ In Reply To ..]
I am finding coders all over the hospital, in many different departments! Plus lots of nurses doing "coder-like" jobs. I have been wondering what is going on with that too.

As far as why you asked the question here -- well, this is a coding forum for people to discuss coding and ask questions so it seems perfectly logical to me. I don't know about you, but we are busy at work. REALLY BUSY. As much as I would like to be able to sit down with my supervisor and discuss workflow concerns, that simply is not possible due to the workload of everyone in the department. With most coders working offsite as well, it makes it difficult to ask another coworker. Don't take the cranky responses to heart. I'm not sure why people come here if they don't want to discuss coding. At least they didn't tell you to read the archives. ;)

I just started with a healthcare facility that also will be - teaching me coding and Im not a coder. SM

[ In Reply To ..]
They also use EPIC.

Wow, what a great opportunity for you! - nm

[ In Reply To ..]
nm.

Yes, it will be. - see msg

[ In Reply To ..]
Granted I will not be working as a "coder" per se, but they will be teaching me as much of it as I need to know to perform my job. This is a big organization and they believe in cross-training their employees. They train their medical office assistants on-site among other things. They offer many opportunities for advancement and pay for your schooling. This probably does not belong on the coding board, but the original post caught my eye. I typically dont post here.

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