Frequently Asked Questions in Medical Coding Interview
⇒ How should I prepare for a medical coding interview?
Medical coders are generally hired by healthcare organizations, such as hospitals, clinics and Insurance companies for managing patient information and billings. Therefore, as an aspiring medical coder, you should be well familiar with the most commonly used coding systems, such as ICD, CPT, DSM, and HCPCS to be able to carry out your job well.
⇒ Why are you choosing a medical coding career?
Since medical coders need to be well-versed with anatomy, physiology and medical terminologies to be able to carry out their role involving entering, verifying, and updating coding and billing information, they need to have a certain level of interest in the medical field.
⇒ What is medical coding?
Medical coding is a process that involves the analysis of a patient’s clinical statements to translate them into standard universal alphanumeric codes as per the classification system. These translated documents are used by insurance companies in processing and reimbursing claims. Additionally, healthcare organizations, research organizations, and the government may also use this data for research.
⇒ What are the types of medical coding?
The three main types of medical coding are HCPCS and its 3 levels, ICD-10, and CPT. Medical coders have varying amounts of experience and knowledge in the three coding systems based on which one is predominantly used in the healthcare organization
⇒ What are the skills that a medical coder should possess?
Some of the major skills that a medical coder must possess are as follows-
- In-depth knowledge and understanding of medical terminologies, physiology, and anatomy. Common on different types of diseases and injuries, and the medical procedures that are highly useful for treating the respective diseases and injuries.
- A medical coder should be able to read and understand patient charts as well as medical and surgical reports
- Since coding conventions are central to the job of medical coders, they are expected to have a good understanding of the classification and coding conventions that are in use. Some common coding conventions include ICD-10 (International Classification of diseases), DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), and CDC (Centres for Disease Control and prevention).
- They should also possess the skills to use computer-based and paper-based data management systems.
- Good communication Skills to confer with doctors, Surgens, ettc
- 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
⇒ What are some common phrases used in clinical coding?
Certain phrases and jargon are used on a day-to-day basis and form an important part of a medical coder’s job, which are as given below- Abstraction – Determining a patient’s ailments with the help of the patient’s records, reports such as radiology and laboratory reports, and their operation notes among other documents. Assignment – Appropriate codes are determined for every procedure, and these codes are entered into the system. Review – The codes assigned are cross-checked for accuracy as to if they explain the condition of the patient and the treatment used. Review is crucial as it helps ensure all the documents are error-free before the data is submitted
⇒ What are ICD codes?
ICD stands for International Classification of Diseases, which was established by the World Health Organization (WHO). ICD codes were created to describe diseases, illnesses, injuries, and deaths. These codes have 5-7 characters, a combination of alphanumeric codes. They always begin with an alphabet. There are currently two components to ICD, which are ICD -10 CM (clinical modification codes for diagnostic coding), and ICD-10 PCS (procedure coding system for inpatient procedures performed). Version 10 is the 10th revision of the original ICD provided by the World Health Organization
⇒ What are HCPCS codes?
There are three levels in HCPCS or Healthcare Common Procedure Coding system, which are as follows- The American Medical Association manages Level I, which are a 5-digit number. These codes include CPT codes that help determine medical services and procedures that a physician or a licensed healthcare practitioner has ordered. Level II comprises 4-character alphanumeric codes with four numbers and an alphabet, which is used for identifying services, pharmacies, and products not used in CPT. Level III codes gave 5 alphanumeric characters, which begin with W, X, Y, and Z. When Level I and II are unavailable for diagnosis and specifying certain activities, we use Level III.
⇒ When are HCPCS modifiers used?
HCPCS modifiers are generally useful for providing extra information about the procedures and services that are used for a patient. These codes are added for specifying the area of the body, the number of procedures performed in a single visit, and the reason for discontinuation of the treatment.
⇒ What are DRG codes?
DRG is the acronym for Diagnostic Related Groups, which is used for classifying hospital cases into 500 set groups. DRG codes find their application only in inpatient claims spanning from the admission of the patient to their discharge. It is highly crucial to get these codes right and accurate as many insurance companies only consider the DRG codes when paying
⇒ What is the difference between ICD and CPT coding?
The International Classification of Diseases established by WHO is a globally recognized coding system used for describing and diagnosing different types of medical conditions. On the other hand, the Current Procedural terminology is a coding system used specifically for reporting medical procedures and services such as surgeries, diagnoses, laboratory reports, as well as radiology reports
⇒ What is the difference between ICD9 and ICD10?
ICD9 has 5 characters while ICD10 covers 7 characters. ICD10 has laterality that ICD9 lacks
⇒ How is medical coding used in the practical world?
Medical coding is useful in various situations, and it specifically has a financial aspect. Medical coding greatly helps insurance companies to understand how to pay medical claims, and it is also useful in the billing process. In addition to its financial applications, it is also a big part of studies and research pertaining to diseases and treatments. The medical coding data helps analyse the pattern of diseases in society, which helps governments understand how to come up with programs that combat these diseases
⇒ What is a “J” code in medical billing?
The ‘J’ code in medical billing is a part of the HCPCS code set which denotes medications administered non-orally and for chemotherapy drugs. The J code is generally a part of the HCPCS Level II Codes.
⇒ What are the common billing errors in medical coding, and how do you prevent them?
One of the common billing errors is not including an adequate level of information required by the insurance companies for processing a claim. Yet another error in terms of medical coding that is commonly found is entering the wrong costs or codes. Therefore, it is extremely crucial to review the codes and the documents before finalizing them
⇒ What are the methods for organizing bill payments?
Different offices make use of a different methods to organize bill payments, such as digital bill paying portals and paper systems. Therefore, medical coders should be proficient in handling both types of bill payment organizing systems.
⇒ What types of specialities in medical coding do you know?
- E/M ED
- Surgery etc.
⇒ Guidelines and tips for medical coders?
- Code only what is documented
- Report codes in the right order
- Follow NCCI and MUI guidelines
- Use appropriate modifiers
⇒ What is Medicare and Medicaid?
Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage to some people with limited income and resources.
⇒ What is RCM?
Revenue cycle management (RCM) is the financial process, utilizing medical billing software that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance. When the patient visits to the hospital they will provide insurance details to the doctor and in return doctor will provide treatment to the patient and submit all the claim details to the insurance company and payers will process the payment to the doctors
⇒ What is AAPC and CPC?
The aim of AAPC(American Academy of professional coders) is to provide education and certification to coders working in physician-based settings. AAPC CPC (Certified professional coder) certification is more suitable for professional coding.
⇒ What is HIPPA?
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.
The Health Insurance Portability and Accountability Act (HIPAA) lays out three rules for protecting patient health information, namely:
The Privacy Rule.
The Security Rule.
The Breach Notification Rule.
⇒ What is ABN?
An Advance Beneficiary Notice (ABN), also known as a waiver of liability, is a notice a provider should give you before you receive a service if, based on Medicare coverage rules, your provider has reason to believe Medicare will not pay for the service. You may receive an ABN if you have Original Medicare, but not if you have a Medicare Advantage Plan
⇒ What are the 12 systems of the body?
They are Integumentary System, Skeletal System, Muscular System, Nervous System, Endocrine System, Cardiovascular System, Lymphatic System, Respiratory System, Digestive System, Urinary System, and Reproductive System (Female and Male).
⇒ What is Modifier in medical coding?
A medical coding modifier is two characters (letters or numbers) appended to a CPT® or HCPCS Level II code. The modifier provides additional information about the medical procedure, service, or supply involved without changing the meaning of the code.