Assignment for this week:Â “Opportunity Knocks”, “e-Him Professionals Wanted”, and “Inpatient Coding as a Career”. Based on the information you read, write a post that includes the following information for each article you read: What was new informatio

“Inpatient Coding As a Career”

Inpatient Coding as a Career

Written by Bonnie Moore, BA, RHIT

The ICD 10 CM and PCS transition that occurred October 1, 2015 had a significant impact on the inpatient coding field. This coding system

change was probably the most difficult for inpatient coders due to the use of the new PCS coding system for inpatient procedure coding for hospitals. In PCS coding the coder now had to “build” the code instead of finding the completed code.

Then there was the difficulty in PCS coding of translating physician documentation into the more detailed, different, and standardized

terminology used in PCS coding. Matching root operations to the physicians’ documentation became more difficult and required more training and education in anatomy and physiology and medical terminology. To sum it up: inpatient coding became more difficult and too longer to code.

Most hospitals have now set higher credentialing standards and experience standards for inpatient coders since the change to ICD 10. There are now higher education requirements in regard to pathophysiology, medical terminology, and anatomy and physiology in order to become successful as an inpatient coder. Most hospitals now require a coding credential of some type and many ask for an RHIT. The usual requirement to be hired as an inpatient coder is 2 years of coding experience. If you want to remote code for a hospital as an inpatient coder, it is usually required that you work 6-12 months on site before working from home. There is a contract you will have to sign that you will work set hours and your home office will meet certain criteria. If you do not keep up production or quality standards equal to what you did on site, you are brought back on site or put on a probation period.

If you want to work for a remote outside coding company that hires their coders out to hospitals for temporary work, you usually need a minimum of 3 years of coding experience and an RHIT and very good references. Once you are trained, they have accuracy and production standards that need to be met.

Most inpatient coders begin coding ancillary services, physician coding, ER coding, observation coding, or outpatient surgical coding before moving to inpatient coding. The Coding Supervisor or Manager may begin cross training them in inpatient coding to “test the waters” and see if they like this type of coding or prefer inpatient. If they prove to have the skill to inpatient code, they may be then moved to a full time inpatient coding position.

Sometimes a coder will do both inpatient and outpatient coding. Many outpatient coders do not like inpatient coding and many inpatient coders do not like outpatient coding. They coding guidelines are different for each system. You need to find what type of coding you like best and then become an expert in your area of coding.

If you would like to pursue inpatient coding in a hospital or remote coding company as a career, here are my suggestions:

· Stay brushed up on medical terminology, anatomy and physiology, and pathophysiology after completing those courses in school.

· Keep practicing and building your ICD 10 CM and PCS coding skills to prepare for a coding test to get an inpatient job. Even after taking your coding courses.

· Make sure you have a minimum of a CCA national coding credential (if you are in the Rasmussen MBCC program you will get your exam prep book in your Medical Coding Practicum Course.

· Or earn your RHIT credential which requires graduating with an AA degree from an accredited AHIMA/CAHIIM college. Then you can sit for the RHIT national credential exam. Depending on the hospital or the outside coding company, an RHIT credential may be the required credential.

· Stay current on coding changes that occur each year on October lst for all ICD 10 codes.

· Get an entry level coding job and work your way up to your ultimate goal as an inpatient coder.

· Get about 2 years of experience and good work references and start applying for inpatient coding positions.

· Make sure you network in your area and keep looking at the job postings at hospitals.

· If your goal is to work for an outside coding company eventually, make sure you have good references, keep your credentials current, be a member of either AHIMA or AAPC as a professional organization and stay current with trends in the field.

· Research well any outside coding company before accepting a position. Some of them are very good and reputable and some are not as good.

As you can see, inpatient coding is not an entry level position. It is the most complicated and difficult area of coding. It requires skill development, good work ethic, ability to focus for long periods of time, and good computer skills.

I have been an inpatient coder for 9 years both for hospitals and for outside coding companies. I absolutely love my job. It’s not easy, I work hard, and I work hard to stay skilled and current in my field. But I have to say, I have enjoyed being an inpatient more and more each year. As I have become more skilled and more knowledgeable in inpatient coding, my job satisfaction level has increased each year. I highly recommend this field if you are willing to make it a process and a goal for your career.