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What is a Medical Coder?

Sorting through the regulations and coding guidance for anesthesia can be a nightmare for providers, but it doesn’t have to be.  With the right billing team, you can rest easy knowing that your medical billing is being done accurately and ethically.

Medical coders are vital members of that team. They have the extensive training, knowledge base and expertise to review medical records and assign codes for diagnoses and procedures performed by physicians and other qualified healthcare providers.  Medical coders work to insure accurate and compliant billing and maximize reimbursement.

For every diagnosis and procedure, there is a corresponding code or code-set.  Coders are not only familiar with the code-sets, but also with medical and procedural terminology, anatomy, physiology, and the major payer’s policies and guidelines.

A coding certification enables a coder to proficiently code a wide a range of services, including E/M, anesthesia, surgery, radiology, pathology, and medicine, while specialty credentials qualify coders for in-depth knowledge of a particular specialty.  Additionally, only hiring certified coders helps providers insure that the billing team can achieve the highest standard of charge capture and compliance.

For professional coders there are two reputable, credentialing organizations;  The American Academy of Professional Coders (AAPC), which offers a Certified Professional Coder (CPC) certification, and American Health Information Management Association (AHIMA), which offers Certified Coding Associate (CCA) certification.  Both require candidates to demonstrate proficiency by passing a certification exam. Once certified, the coder must maintain his or her credentials by completing continuing education training throughout the year.  In addition to these basic credentials, coders can also obtain credentials with a variety of medical specialties, practice management and teaching focuses.

PPM Partners Coding Department is staffed with full time, certified coders and auditors to meet this important need in the anesthesia billing community.  The medical billing arena becomes more complex each day, but a billing team staffed with highly qualified coders can help navigate the red tape and bring in the reimbursement, while preserving your peace of mind!  

By: Gina M. Dillon, CPC, CANPC

Coding Department Assistant Manager

On Monday, August 13, 2018

Categories: Compliance & Coding News

The information presented herein reflects general information that is current as of the date it was first published. Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.

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