Medical Coding Specialist Job Description and Salary

Medical coding and medical billing are often used interchangeably, but they are not the same. While medical billing is more of a data entry or clerical job, medical coding is much more technical. Becoming proficient in coding and obtaining a certificate is not as costly as a medical billing program, has a wide variety of job opportunities, and the salary can be more than double of a medical biller's salary.

The American Academy of Professional Coders (AAPC) reports that its members made an average of $43,100.00 annually in the year 2008. In 2009, the average salary was $44,750.00.

Although most post-secondary schools will charge tens of thousands of dollars for a program it will often refer to as a medical billing and coding specialist program or medical billing and coding program, these programs do not provide students with a sufficient amount of knowledge in coding to pass the CPC (certified professional coder) exam and only offers a diploma. These medical billing/coding programs are designed to provide students with enough knowledge to begin a career in medical billing only and do not include the extensive coding coursework that is needed in order to prepare students for the CPC exam.

AAPC provides a complete coding course, covering medical terminology, anatomy, a preparation/study course and includes the exam fee for a total cost of $1995.00. This fee includes the cost of membership but excludes the cost of books (CPT, ICD-9, and HCPCS). The program lasts 8 months and can be done from home. There is also a long list of available courses in classroom settings around the country. Both learning environments will provide a student with enough knowledge to pass the national exam and receive a CPC credential.

AAPC provides just the preparation/study course and exam for $1395.00, excluding the cost of books. This would be appropriate for people who have experience in a medical setting with knowledge of medical terminology and anatomy and only takes four months to complete.

The above courses are bundled courses. If you are unable to afford the bundled courses (everything paid for at once), AAPC does offer individual courses, though it does end up being more costly in the end.

On every medical claim form there are nationally recognized codes that depict: diagnoses; services/procedures; supplies. A certified medical coder reads through medical records and appropriately assigns codes for each category. Although it may sound simple, it is extremely technical. It involves understanding of medical procedures including surgeries and diagnostic procedures, applying the correct diagnosis for each procedure in order to ensure payment and, above all, every code assigned must be found in the medical record.

A certified professional coder has complete understanding of coding and reimbursement regulations, is able to recognize in what order services should be billed out on a claim form in order to maximize payment, is able to identify bundled procedures and services which reduces a provider’s A/R and is able to identify the need for higher payment from an insurance company based upon documentation in medical records by using two-digit modifiers that explicitly explain why more payment should be issued from an insurance company.

In addition to working in a medical setting and performing abstract coding including per diem positions in a hospital setting, certified coders are also able to find employment with an insurance company as a claims auditor.

Many providers/physicians look to a certified professional coder to train both doctors and staff in proper medical documentation, coding, and reimbursement issues.

Additionally, a certified coder can choose to become certified in a specialty for specialists like cardiologists, orthopedic surgeons, urologists, etc.

Whether you are looking to begin a career in the medical field or looking to expand your knowledge and your pay in the medical field, becoming a certified professional coder costs far less than medical billing programs and provides a wide variety of professional, sought-after job opportunities.