RN coder, what type of things I need to know and things I need to watch out?

most states have language similar to pa's practice act

21.11. general functions.

© the registered nurse may not engage in areas of highly specialized practice without adequate knowledge of and skills in the practice areas involved

http://www.pacode.com/secure/data/049/chapter21/chap21toc.html#21.1.

i don't understand why nurses accept a position if they don't understand basic requirements of a position or have the necessary skills needed to perform work listed on job description.

an staff firmly believe that nurses should carry individual professional liability insurance to protect oneself from legal issues arrising from patient care lawsuit and/or being called before a board of nursing.

medical coding professionals ensure that medical records and data are accurate and timely, coded to the highest degree of specificity and can financially make or break an institution, especially snf or home health agency.

about medical coding & medical records: ahima

[color=#2200cc]medical records and health information technicians

coding is different for medical office practices, hospitals, snf and home health--each is a niche market. what setting is your job, so more info can be offered...

I went into medical coding when I could no longer do the physical aspects of clinical nursing. I have taken two coding courses, one at a vocational school and one at a community college. If there is professional insurance for coders I have never heard of it. Coders don't get sued by individuals for malpractice if they make a mistake; they get fined by government agencies (like Medicare) because they have violated laws. There is no insurance you can buy to get you out of those kind of jams. Your protection against that is not to violate the law. In both my coding courses it was drummed into us that we follow all coding guidelines or agencies like Medicare will slap you on the back of your hand for committing fraud.

Beside learning how to actually code a disease or medical procedure into its numerical code, coding requires you to be aware of the current insurance rules regarding payment of claims. These change daily at the whim of each payer and they also follow the coding guidelines. Coding is part of the accounts payable function. Providers (doctors, hospitals, etc.) can only be paid when they submit bills for their services that have been converted into these codes, so that is why coding is so important.

I thought the most difficult coding course was procedural coding (CPT coding). It requires knowledge of anatomy and physiology as well as the procedure that the provider is doing. In some cases, you have to know the procedure because there are multiple codes that you must apply rather than just one code for the procedure. Case in point is coding for cardiac heart caths. You must read the notes in the code books at the beginning of each section of the code books and follow the coding instructions. Hospital coding is different from physician office coding and requires knowledge of how DRGs work and what a principle diagnosis is.

My advice is to take a coding course that is AHIMA accredited. A good company will strive to hire certified coders only. With certified coders they reduce the chance of coding fraud. The first job is generally the hardest to get. Most employers do not advertise. Many will have you take a coding exam before they even interview you to see if you can code and the questions will include several common coding pitfalls. It is not uncommon for companies to require 95% or better coding accuracy of its coders. We were audited monthly and our supervisor knew if any of our charts came back from the computer room (mismatched diagnosis and procedure codes) or an insurance company (denials) because of incorrect coding.

When someone is up to no good they are going to look for a patsy to blame it on if they get caught. Not too long ago I interviewed for a coding job. They only wanted RNs for these coding positions. I took a portfolio I had put together of what I have done in my career as a coder for this physician specialty (it requires knowledge of the procedures these doctors perform in order to code correctly for them). During my interview I was asked a lot of specific questions about how I would code this or that and I responded. However, the interviewer made it very clear that they wanted to take an RN with no coding experience and train them in their coding procedures. When she said that it was like a red flag. That is something you say to impress someone who doesn't understand how the laws drive this field. I had worked for a huge company and knew exactly what she meant by their coding procedures. It had to do with how they were going to code charts in order to get the maximum payment from insurance companies just shy of staying within the federal laws. However, they were looking for a unwitting, unsuspecting participant and that wasn't going to be me since I had as much training as the person who would probably be orienting and training me to the job if I got hired and they couldn't have that.

Hello, I am new to this site, this is my first post. I actually ran accross this googling a coding subject for one of my assignments for school. I am in my last week of Medical Billing and Coding Certification schooling. From all that I have learned in the last 10 months of school is that coding is very detailed and you need to be precise when submitting a claim. If you code wrong it take longer for reimbursment and you could possibly get in serious trouble. I know I still have'nt got it 100% but with practice it gets easier. You could purchase the CPT and ICD-9 books over the internet and I suggest you do if the new job dosent supply them for you. They are books you must have there's no way around it. Also the codes are updated annually so make sure you get the newest editions. I would also suggest buying used College course books off of Amazon (They are very expensive new). They will teach you everything you need to know and each book will have practice tests and answers chapter by chapter. I also suggest, if you have never worked in a medical setting to learn medical terminology. This is pretty important, medical language can be confusing. I was planning on selling my books after graduation anyways so if your interested let me know. Here is a website to order the ICD-9, CPT and HCPCS coding books. WWW.ELSEVIERHEALTH.COM I hope this has been helpful. Good luck with your new job there hard to come by in this economy. To get a coding job is great resume experience, not every company requires a certification but most do so kudo's to you!

Ha! Ha! Ha! We had a corner in our coding lab at the college that I used to call Coding Jail. We talked about incorrect coding and fraud a lot. Our instructors were tough. Every one was an HRIA and certified coder as well. No one ever got into the high 90s on a test. CPT class was very difficult. The highest grade I ever got was an 88 and all I ever did was study for that class. We had NCLEX style questions on our advanced ICD-9 class tests and some of them were hard. I purchase my code books from the AMA including the DRG manual. The AMA also has many other supplemental books to assist with coding. We were also taught to use the 3M encoder because almost all the hospital coders use an encoder and do not code from manuals. The encoder takes some getting used to.