I give up on waiting and I need a new plan

Daytonite, BSN, RN · Jun 6, 2007

clamaity21. . .I am an RN who went into medical coding when my back went bad and I could no longer do the standing required in clinical areas. I worked for a large group of ER physicians as a coder. Coding is part of the billing process. This is a big field. Yes, there are jobs. You won't generally find them advertised in the newspapers because it requires some special training to do this work. There are two types of coders: physician coders and hospital coders. Getting the first job is the hard part. However, this is usually accomplished with the help of your instructors.

Hospitals, in general want their coders to have completed a coding program at a community college where they will have learned about Medicare rules and DRGs. They also want their coders to have a national certification offered by AHIMA (American Health Information Management Association) called the CCS (Certified Coding Specialist). The pay is comparable to an RNs. I am myself completing a community college coding program and I can tell you that it has been rigorous. As much as I knew about healthcare with 30+ years of nursing behind me, there was still a lot I had to learn. I still wonder how people can enter this field with no clinical experience and understand what they are reading and coding.

Physician coders work for physicians or providers who give direct patient care and must bill for their services. This is by far the largest group of coders working today. If they work in a small physician office, they may do other things beside just the coding. When I worked for the ER docs, there were over 200 physicians who provided ER services to something like 30 different ERs (they contracted ER services to hospitals). We had work literally piled to the ceiling with 14 full time coders, 12 of whom worked from their homes. There is also a large group of physicians who only hire RNs as coders here where I live in the San Gabriel Valley of Los Angeles. The national certification for this is the CCS-P (Certified Coding Specialist-Physician).

Having that national certification increases your job opportunities and salary. You can find out more about coding and certification at the AHIMA website (http://www.ahima.org/). Coding and billing falls under Health Information Management. When I started my community college coding program I began to realize that there was more to this field than just the coding. And, Health Information Management (HIM) is it. It used to be called Medical Records, you know, the old patient chart. Well, it has evolved into a big area of healthcare. And, believe me, it is a huge area. What with HIPAA and Medicare, medical records has taken a huge front row seat in the healthcare industry that is recognized by Medicare.

No money gets paid to any hospital, physician or other provider of healthcare services or goods without an ICD-9-CM, HCPCS, or CPT code number attached to it, believe me! And, it's not going away. This involves Medicare and every medical insurance company out there. It is not likely to be totally computerized because healthcare providers must document the care they give and it is from that documentation that these code numbers are determined. Medicare does not stipulate that this documentation be computerized. And, as long as doctors can write one medical diagnosis in five different ways, a human being has to interpret what he meant and turn it into a code number. There was also a liason nurse on the staff of the coding company I worked for whose sole job was to inservice the physicians on how to document so that the company could get maximum payment from the various insurance companies. In today's world of contracted services, every penny you can collect is important. Medicare is urging that every provider have at least one certified coder on their staff. Only urging, not mandating. But, I have to tell you that Medicare is pretty much leading every one around by the nose on this. So, whatever Medicare says, everybody tries to follow. It's not nice to mess around with Medicare, believe me.

With your nursing pre-requisites you could easily go into a coding course or a RHIT (Registered Health Information Technologist) program at a community college that is accredited by AHIMA. You mentioned you are in Georgia, so I found the website of your state AHIMA affiliate.

http://www.ghima.org/ - Georgia Health Information Management Association. There is a link at the left "Careers & Colleges" that I would explore. You will see that there is also a "Job Board". You may not be able to get into it if you are not a member of GHIMA.

If you want to know more about this career and what the classes involve PM me. I find it all very exciting. I've really had to bone up on some pathophysiology and I never knew all the different medical procedures that doctors did. It is absolutely remarkable. One word of advice. . .DO NOT take a medical coding course from a home study company or vocational school. That training is only very basic and NOTHING compared to what is taught by an AHIMA accredited college program. And, as I learned, the companies who pay the top salaries in this field hire college educated coders with national coding certification.