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Medical coding for beginner


Medical coders are responsible for translating physician reports into useful medical codes or the universal codes used by insurance companies.
Coders translate all the information present in a patient medical file – diagnosis, treatment, to the supplies used. They include any unusual procedures done during a patient visit or treatment.
Medical coders must code all the relevant information. After a patient is treated or examined by doctors, the insurance company will require exact data to process the claim. Medical coders pass the information to the insurance companies methodically and precisely.
It is vital to be well prepared for a medical coder interview and exhibit your knowledge and aptitude for medical coding. We have compiled some common medical coder interview questions and answers in this article.

Right now, there are five major types of medical coding classification systems that are used by medical coding professionals — ICD-11, ICD-10-CM, ICD-10-PCS, CPT and HCPCS Level II.

Watch the video for more better understanding for CPT.

Part: 2.

This section covers frequently asked medical coder interview questions and answers. These questions will be useful for candidates applying for the position of a medical coder, clinical coder, clinical coder officer, diagnostic coder, or medical record technician. Both experienced and fresher medical coders will find this section useful.

1. What is medical coding?
Sample Answer: Medical coding or clinical coding is the profession of analyzing a patient clinical statement and translates them into standard codes specified in the classification system. Insurance companies use the translated document to process and reimburse their claims. Government, health care organizations, and research organizations use the data for studies and research.
2. What are skills do you think a medical coder must possess?
Sample Answer: The main skills a medical coder should possess are,
Good knowledge of medical terminology, anatomy, and physiology along with the prerequisite degree.
 An understanding of various diseases, injuries, and medical procedures performed to treat them.
  Ability to read and understand medical and surgical reports and patient charts.
  Familiarity with classification and coding conventions such as ICD-9, CDC, etc.
  Capable of using computer or paper-based data management system.
  Good communication skills to confer with doctors, surgeons, etc.
  Have good attention to detail and the ability to multi-task.
 Have integrity as the medical coder is privy to confidential medical files of patients and other sensitive data.
 Focused and driven

3. What are the different phrases used in clinical coding?
Sample Answer: There are three main phases of clinical coding,
   Abstraction – We determine a patient’s ailment by reading their record. How was it treated? Sample Answer We use medical notes, laboratory and radiology reports, operation notes, etc.
    Assignment – We find the appropriate code for each procedure and enter it into the system.
    Review – We cross-check if the assigned codes accurately explain what happened to the patient and the treatment carried out. Reviews are crucial. We reexamine before all documents before the data submitted.

4. What do you know about ICD codes?
Sample Answer: ICD code or International statistical classification of disease is a system of codes that was established by the WHO to describe the causes of injury, illness, and deaths. ICD codes are 5-7 character alphanumeric codes beginning with an alpha character. The ICD has two components:-
ICD-10 CM or Clinical modification code for diagnostic coding
ICD-10 PCS – Procedure coding system for inpatient procedure performed.

5. What are HCPS codes?

Sample Answer: HPCS or Healthcare Common Procedure Coding System has three levels,
Level 1 are 5 digit numbers maintained by the American Medical Association. The code comprises CPT codes to identify the medical services or procedures ordered by the physician or licensed medical professional.
Level II are 4 character alphanumeric codes comprising of one alphabet and four numbers in the code. We use these codes to identify the products, pharmacies, and services not used in CPT.
Level III codes are 5 character alphanumeric codes beginning with W, X, Y, or Z used when Level I and II are unavailable to specify a particular activity or diagnosis.

6. When are HPCS modifiers used?
Sample Answer: HPCS modifiers are used by coders when we want to provide extra information about a service or procedure performed on a patient. We use the codes to specify.
    Specify the area of the body
    If the doctors performed multiple procedures in the same visit.
    The reason for discontinuing treatment.
7. What are DRG codes?
Sample Answer: DRG codes stand for Diagnostic related groups. This system classifies hospital cases into 500 set groups. DRG codes are used only for inpatient claims from the time of admission to the time of discharge. Many insurance companies pay only according to these classifications, and the coder needs to get it right.

8. How is Medical Coding used in the practical world?
Sample Answer: Medical coding has several real-world applications. The code has a financial aspect and helps to collect data for the WHO and governments to run programs to tackle different medical conditions. We use medical coding in,
Insurance companies pay medical claims are paid based on the medical codes they receive. It helps in the billing process. Data aids in the analysis of disease patterns in society. Governments can formulate programs to combat the disease. The information can provide statistical data for national and regional health and death cases.

9. What are some guidelines and tips you will give to a new medical coder who comes to work under you?
Sample Answer: Some tips and guidelines to work on a medical code assignment are,  It is important to code everything that has been documented. The code needs to be consistent with the medical record provided by the physician. Remember not to add anything or miss out on any information.  Report the codes in the right order- The first code used explains the reason for the patient’s visit to the hospital. ollow the NCCI and MUE guidelines closely to prevent coding errors. Coding convention is modified periodically. As a coder, you need to keep yourself updated with the latest convention.
 Use modifiers only when necessary. Do not overuse or use incorrect modifiers.
10. What medical code sets are you familiar with and trained to use?
Sample Answer: I am familiar with the CPT and HPCS and have used these codes in the past. I am currently working on CPT.

Medical coder interview questions for fresher

A fresher are asked some basic questions to test their knowledge and determine how much training is required. You should be able to answer these questions without much thought.

1. Did you take an anatomy and physiology course in school?
Sample Answer: I took a course on anatomy and physiology when I was a student in college.

2. What coding certifications do you have?
Sample Answer: I have completed my Certified Professional Coder course (CPC) and plan to become a Certified Outpatient Coder (COC) soon.
3. What is the difference between ICD and CPT coding?
Sample Answer: The ICD is a globally recognized international coding system designed by the WHO for diagnosing and describing medical conditions. While, we use the CPT or Current Procedural Terminology coding for reporting medical services and procedures such as diagnostic, laboratory, radiology, and surgery. CPT describes the procedures and medical services done by the physician or medical practitioner.

4. What is A “J” code in medical billing?
Sample Answer: J code is a part of the HPCS Code set. The codes correspond to non-orally administered medication and chemotherapy drugs. J-Codes are usually used for HPCS Level II Code.
5. What is meant by epistaxis? and What is ICD-10 CM?
Sample Answer: Epistaxis is the loss of blood from the tissues that line the nose. The ICD10 is the 10th revision of the International Statistical classification and related health problems. The code provides a common code to report and monitor diseases.

6. What is the difference between ICD9 and ICD10?
Sample Answer: The main difference between ICD9 and ICD10 is that ICD-9 has 5 characters while ICD10 covers 7 characters. ICD 10 has laterality that ICD9 lacks.

7. What is your opinion about undertaking continuous training opportunities?
Sample Answer: The healthcare system is dynamic with new procedures, diseases, treatment coming. The trends in medicine keep changing. It is important to keep an important mind to these changes.

8. What is your 5-year plan?
Sample Answer: I plan to become a senior coder in the next 5 years. I also plan to complete my Certified Professional Coder-Payer (CPC-P) certification.

9. How many charts can you code per hour?
Sample Answer: I can code 2 charts per hour.

10. Why did you choose this career?
Sample Answer: A medical coder provides us with a great opportunity to work in health care without the physical demand of many health care professionals.
1. What are the common billing errors in medical coding, and how do you prevent them?
Sample Answer: The most common error is not including sufficient information for insurance companies to process the claim or accidentally entering wrong costs or codes. I usually double-check my entries against the patient file. I ask the physician for any clarification in case I notice missing details or confusing entries.

2. What method do you use to ensure you enter the data quickly and correctly?
Sample Answer: While entering medical data, I get into a rhythm of typing the numbers while reading the patient files while entering the initial data. I review my work before submitting, pointing at important patient data on the file, and highlighting the data with my mouse to ensure they match.

3. What medical specialties have you coded in the past?
Sample Answer: I have coded for the pediatric, gynecology, and neurology department. I enjoyed my stint in pediatric coding the most.

4. How do you prioritize your work when entering billing codes for the patient?
Sample Answer: Before starting my daily workload, I scan the patient files for urgent billing needs such as getting approval for a patient prescription medication to continue with the treatment. After that, I continue with the oldest file first to ensure the patient files are cleared, and there are no barriers to their treatment.

5. What are the methods for organizing bill payments?
Sample Answer: My current office uses a digital bill paying portal. We also maintain a backup paper system for patient files if there is a problem with the digital system.

6.How would you explain billing codes to a confused patient?

Sample Answer: I know hospitals can be stressful for the patient. I will approach the patient with empathy. I will review and confirm the procedures that were carried out. I would list the codes with the corresponding procedure. I would ask if the patient any other questions.

7.How would train physician and other staff on medical coding?
Sample Answer: When training a colleague, I will prepare flashcards with all of the codes they need to know. I will review simple case files and gives them feedback on things they missed or misinterpreted while praising them for the correct code.

8.What would you do if the patient file was unclear?
Sample Answer: I would get in touch with the concerned doctor to clear any ambiguity. I prefer gathering all relevant information about the patient file to prevent errors.

9.What would you do if the patient’s claim is denied?
Sample Answer: It is important to find out why the claim was rejected. I will approach the doctor or insurer directly and ask them to explain why the claim was rejected or was the rejection of an error. The patient will need to be notified about the rejection.

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