ICD-9 coding

Andrew, RN · Dec 11, 2008

No clue. I'm a RN because I want to treat a patient, not their wallet.

3rdcareerRN · Dec 11, 2008

I'm a clinical RN who earned a Certified Coding Associate credential and I don't treat wallets.

In my branch of informatics, having a basic knowledge of coding is crucial for setting up clinical information systems.

To the original poster: Start here http://www.ahima.org/certification/cca.asp for an industrywide-recognized credential; there are private organizations that also provide coding credentials. Just do a basic Web search for ICD-9 coding certification...

pagandeva2000, LPN · Dec 11, 2008

Community colleges sometimes offer programs in medical coding via their continuing education departments and will provide information on certification. I almost attended a private school for medical coding, but after the first two classes, I dropped out because they made a clerical error thinking that I didn't pay them their weekly installments when I did, but I had left the receipt at home. Turned me off and never went back. The tuition was too expensive, anyhow and had I known better, I would have gone to the nearest community college.

noc4senuf · Dec 11, 2008

After I got rid of my previous medical records person, I placed the back-up person permanently into this spot (she was a CNA). I sent her to a local community college which offered a two day coding class and she is doing wonderfully.

Ginger's Mom, MSN, RN · Dec 11, 2008

First of all many nurses are self taught, you can take a coding exam. Now here is the tricky part, you may now the patient has a DX like cancer, unless the doctor documents like it doesn't count.

Daytonite, BSN, RN · Dec 11, 2008

I became a coder as my back was going bad and it was getting more and more difficult for me to do the long hours of standing that clinical nursing required. I took my first training in a one-year program at a vocational school at a cost of $7,000. You can get Stafford loans to cover the training if your credit is halfway decent. I was hired as a physician coder for a huge ER doctors group, but only because I passed a coding test with a 95% pre-hire and was a licensed RN. I was told later that they almost never hire coders coming out of vocational schools because their training just isn't up to par. I was hired because of my nursing background. Since, I have gone to an AHIMA accredited coding program at a community college and I see that the vocational school was a rip off. The community college is way cheaper because it is out here in California and I have learned way more than what I was ever taught in the voc ed program.

You really need to take a certification test after training. Certification is voluntary and pretty much the same as being licensed. It says you went the extra miles to be better. The places that really care to be coding right (like the ER docs I worked for) only want certified coders and are willing to pay them well for it. My coding instructors, one of which who is an official in the state HIM organization, has said that AHIMA is pushing for mandatory licensing of coders. It will probably be years before that is ever realized.

If you thought nurses were paranoid about possible malpractice, you haven't been around coders. The whole coding business is nothing but Medicare rules and regulations. Fraud is the big issue and people get huge fines and prison sentences for trying to code so that a doc can collect more money than he should get. Because collection of money is at the end of those codes, the incentive for some doctors or facilities to push coders to ignore coding principles can be very tempting.

You can go onto the AHIMA website (http://www.ahima.org/) and find certified coding schools near you and inquire about their tuition. I believe that AHIMA is also offering online coding training again so you could train from home via your own computer. My community college has already switched half the classes in their coding program to online anyway. They only require the students to be present for coding labs now and the rest of classes are done online.

classicdame, MSN, EdD · Dec 11, 2008

As for coding treating wallets - the opposite is true. It is YOUR wallet that will suffer if the correct code is not entered. The incorrect code can cost the provider many thousands of dollars, which then affects how the provider will pay salaries, buy equipment, etc. Coders are worth their weight in gold!

Daytonite, BSN, RN · Dec 11, 2008

'tis true. the er docs i worked for paid the employees a bonus twice a year based on what they earned, so we had an incentive to code correctly and efficiently. we got about a $500 check each june and december.

what was hair pulling though was the constant coding changes that came to us from the various insurance companies. they were usually discovered via denials. they would start denying payments of this or that service. we would have to adjust our coding in order for the bills to get through in a timely manner. re-coding and re-submitting takes up time and costs the company more money.

recently i had one of my own eobs come back to me with a denial for the doctor's fee for one of my recent surgeries by medicare. i was on the phone with the doctor's office immediately and found out from their biller that medicare has only recently been denying payment for that type of surgery, no prior notice to the doctors, and they are re-submitting these claims. it's an exciting world and not at all boring.

classicdame, MSN, EdD · Dec 11, 2008

Years ago, before Medicare rules changed, I owned an insurance agency whose sole purpose was to coordinate benefits between insurance companies so that the insured maximized benefits. I had one situation where the MD office coded for a foley cath (urinary) when the patient actually received a heart cath. A BIG difference in price. The family was elated to get that huge check back after paying off Dad's medical bills.