What does a Certified Professional Coder do?

A health information professional who enables hospitals, doctors’ offices, outpatient centers, nursing homes, or group practices to be paid for health services is known as a Certified Professional CoderTM. Certified Professional CodersTM read medical records and assign codes to procedures so that the information can be submitted to insurance companies, Medicare, or Medicaid. The specific codes must be entered correctly, because coding errors could result in a reduction in the amount paid to medical providers for the health care services they provide.

As a Certified Professional CoderTM, you’ll be dealing with both procedural and diagnostic coding. A Certified Professional CoderTM, for example, uses codes to code the treatments that doctors provide. There are codes in the health care common procedure coding system (HCPCS) that refer to products or services that doctors may provide to their patients. Diagnostic codes are codes that refer to specific diagnoses that a doctor may give to a patient. For example, if a patient presents with arm pain and the doctor diagnoses the issue, there is a specific diagnostic code for arm pain.

A person must typically complete high school and college to prepare for a career as a Certified Professional CoderTM. Although an associate’s degree is possible, those who want to become a Certified Professional CoderTM should pursue a bachelor’s degree in medical coding from an accredited college medical coding program. To obtain appropriate certification after completing a college degree, one must pass the Certified Professional CoderTM (CPC) exam, which is the entry-level exam to become a Certified Professional CoderTM.

Coders frequently specialize once they begin working. A coder might specialize in emergency medicine, oncology, or cardiology, for example. Some specialties may be in higher demand than others at any given time. As a result, depending on the coding specialty they choose, some coders may be paid more than others.

Because they work with numbers and codes, coders are naturally detail-oriented people. They are also persistent because they may need to contact a medical provider to obtain additional information about a treatment the provider provided so that the appropriate code can be assigned. They might also need to contact the insurance company about a specific claim.

After several years of coding experience, many programmers move on to other careers. Coders may choose to work as health information directors or coding supervisors, for example. A coder, on the other hand, might decide to return to school to become a nurse, allowing them to work as a nurse-coder and potentially earn more money for their coding services.