If you think of careers in the healthcare field, two common roles probably come to mind: doctor and nurse.
For most of us, those jobs have been staples ever since we got our first toy doctor's kits or attended kindergarten career day. But here’s what many people don’t realize: The healthcare field offers a vast range of non-clinical career opportunities.
One often overlooked administrative option is medical coding. If you’re asking yourself, “What is a medical coder?” or "What does a medical coder do?" you’ve come to the right place.
From the role medical coders play to the required skills and the history of the field, here's everything to know about what medical coding is—and why it's vital to the greater healthcare landscape.
What is the definition of medical coding?
Medical coding is the transformation of healthcare diagnoses, procedures, medical services and equipment into universal medical alphanumeric codes, according to the American Academy of Professional Coders® (AAPC).1
Put simply, this refers to the process of translating important medical information into simple codes for the purpose of documenting medical records and informing accurate medical billing.
What does a medical coder do?
Medical coders translate healthcare providers' reports into useful, uniform medical codes. For example, if you see a nurse practitioner (NP) at your local clinic, the NP will document your visit, basic health information (blood pressure, medications, etc…) as well as any concerns or new diagnosis you have.
Those notes will go to a medical coder who will translate everything into the codes insurance companies and healthcare providers around the country use.
Medical coders ensure all information is coded appropriately for consistency and accuracy.
This work is important so insurance companies or government providers can understand what was done in order to process the bill. Common language is too inexact to give the insurance company the accurate details it needs, so sets of specific codes have been established to define medical procedures. It’s the role of the medical coder to pass along this information in a way that is useful and efficient.
Every day, a medical coding professional abstracts information from a patient's medical record documentation—including everything from physician's notes to lab results and more—assigns each procedure and diagnosis an appropriate code and then uses those codes to create a claim that's paid by insurance carriers.
Medical coders can show up in more environments than you’d think. If that interests you, check out Where Do Medical Coders Work? 7 Settings That Might Surprise You.
Where did medical coding come from?
Technically, medical coding has been around since the 18th century. The bills of mortality posted in London each week were a way for doctors to track mortality figures and causes of death, and to give the public early notice of disease outbreaks and epidemics. They would note infected spaces to avoid, and correlations between the statistics on the bills eventually helped doctors to determine the causes of various epidemics.
Functioning as a combination of commercial news service, public health measures and scientific publications, the bills were one of the earliest documented forms of medical coding data—though it certainly looks different now.
Why is medical coding important?
Whenever you have a doctor’s appointment, your healthcare provider documents which procedures took place and what was diagnosed.
Using their knowledge of thousands of medical codes, payment policies and government regulations, medical coders take medical records and code them in a standardized system for billing and insurance purposes. Without them, the providers wouldn’t know what to charge for each procedure, and insurance companies wouldn’t be able to cover patient care properly.
In addition to informing reimbursement, medical coding data is also used to improve healthcare as a whole. Data from medical codes can be used to determine utilization, manage risk, identify resource use, build actuarial tables and support public health and actions, according to the AAPC.1
What are the main types of medical codes?
There are two primary types of medical codes: International Classification of Diseases (ICD) and the Current Procedural Terminology (CPT®). While there are certainly distinctions between these classification systems, their purpose is similar—to allow for uniform documentation between medical facilities.
ICD alone has been translated into 43 languages, according to the World Health Organization (WHO). Having these standard systems allows for a more seamless transfer of medical records, streamlined billing and more efficient research and analysis to track health trends.2
Though IDC is the most commonly used code—especially in countries outside the United States—there are other code sets that each serve different needs. To delve deeper into the importance of medical documentation and understand what's included in a medical record, check out our article on " What’s In a Medical Record?"
What are the strengths of medical coders?
The code sets that a medical coder uses can inform payers of a whole host of medical information: The patient's diagnosis, the medical necessity for treatments, services or supplies provided to the patient, as well as any unusual circumstances or medical conditions that impacted those treatments.
This means that in addition being familiar with the different types of codes listed above, medical coders need to have a working knowledge of the information they're interpreting.
Here are some overall strengths medical coders should have by the time they start working.
- Great attention to detail
- Adherence to regulations
- Patience!
What are some qualities that successful medical coders share?
There is no prototype when it comes to medical coders!
You’ll find people of all ages, identities and experiences. But good medical coders do share some common characteristics that help them on the job. One critical trait is a strong ethical standard, given that the patient data they work with is highly confidential.
Medical coders tend to be curious and imaginative, and they must also have a keen eye for detail—one minuscule mistake in a code could lead to much larger issues. They must be able to remain focused, even though their work can tend to be repetitive, and they'll benefit from a sharp memory for medical terminology and medical coding guidelines.
Additionally, it helps to be efficient and even-keeled, as their work is often tied to meeting production- and accuracy-based goals.
What are some important medical billing and coding skills?
Given the sophistication of medical codes, there are a handful of technical skills medical coders need to succeed in the field—but transferable skills are important as well. The Burning Glass Institute used real-time job analysis software to examine over 25,000 medical coding job postings and identified some of the most important medical coding skills that employers are seeking.³
Top technical skills for medical coders:3
- Medical coding
- Customer billing
- ICD-10
- CPT® coding
- Health information technology
- HCPCS coding
- Anatomy and physiology
- Clinical documentation
- Inpatient coding
- Health Insurance Portability and Accountability Act (HIPAA) compliance
Top transferable skills for medical coders:3
- Communication
- Research
- Computer literacy
- Microsoft Office®
- Teamwork/collaboration
- Organization
- Multi-tasking
- Analytical skills
- Problem solving
- Time management
If you can relate to some of those transferable skills, you may be a natural fit for a career as a medical coder. And don’t be intimidated by the list of technical skills—those are precisely the skills you’ll acquire with a formal medical coding education.
What are career options in medical coding?
Pursuing a career in medical coding can open the door to a range of opportunities. Here are just a few of the roles you can pursue with a Medical Billing and Coding Certificate from the Rasmussen University medical coding program.
Medical biller and medical coder
The most straightforward career choice, the certificate will allow you to become a medical biller and coder—translating medical records into standardized codes to inform billing processes.
Patient services representative/navigator
This is a more patient-facing role that still requires plenty of administrative know-how. Patient navigators help guide patients through the healthcare system, providing them with the resources they need throughout their treatment journeys.
Patient registrar
Patient registrars sit at the front desk of a healthcare facility. They're responsible for greeting patients, answering general questions and collecting sign-in information. They'll enter this information into record-keeping systems to update the patient’s medical charts, and may help with other pre-appointment tasks. Afterwards, they'll review physician notes, schedule follow-up procedures and release medical records as needed.
More careers with further education
In addition to pursuing any of these potential career paths after gaining your medical coding certification, you could continue to advance into the Health Information Technician Associate’s degree program—opening up even more non-clinical healthcare career paths.
So, how difficult is this career?
You now have a basic understanding of what medical coding is, what a medical coder does and the important role these professionals play in the healthcare industry. The short path to entry can make this an appealing option for those wanting to get a start in the medical field.
Now you might be wondering, is medical coding hard? Is this field difficult to understand or break into? Is the work challenging? Get those questions answered by hearing from professionals in the field!
Related Articles:
- Is Medical Coding Hard? Health Information Pros Share Their Experience
- Breaking Down the Medical Coder Job Description
- Where Have All the Medical Transcription Jobs Gone?
Most coding positions are not considered "entry level"; a combination of education and work experience is typically required to attain a coding position. Similarly, coders, especially those who are new to the field, should not expect to find a position where they can work from home. Most coding positions require onsite work.
American Academy of Professional Coders® is a registered trademark of American Academy Holdings, LLC
AAPC® is a registered trademark of American Academy Holdings, LLC
CPT® is a registered trademark of American Medical Association
Microsoft Office® is a registered trademark of Microsoft Corporation
1American Association of Professional Coders (AAPC), What is Medical Coding? [accessed December 2023] https://www.aapc.com/resources/what-is-medical-coding
2World Health Organization, Importance of ICD, [accessed December 2023] https://www.who.int/standards/classifications/frequently-asked-questions/importance-of-icd
3The Burning Glass Institute (analysis of 25,637 medical coder job postings, Nov. 1, 2020 – Oct. 31, 2021). https://www.burningglassinstitute.org/ [accessed October 2021].
EDITOR’S NOTE: This article was originally published in January 2017. It has since been updated to include information relevant to 2024.
