Medical coding more key than ever

LISBON – When most go to the doctor their main concerns are diagnosing their health issue and getting better.

Then at some point, the medical bill may become a concern. Will their insurance cover the treatment? How much will be owed out of pocket?

It may have not occurred to the patient how the hospital or doctor communicates with the insurance company to make certain they get paid for the proper diagnosis, treatments and supplies used.

Deborah Kay Arter, a medical coder at Salem Community Hospital and instructor at the Columbiana County Career and Technical Center, knows exactly how it is done. She recently went over the process with CTC board members, talking about her two semester program, which prepares students for a career as a certified medical coder.

Arter said the importance of passing the exam to become a certified coder can mean $5 more per hour over non-certified coders. Of those who take the national certification test 76 percent do not pass, she said. At the Career Center last time, 100 percent passed.

Arter teaches her students about the different types of health insurance programs and how to properly bill both insurance companies and patients for the health expenses. She pulled out the books of codes, more than 14,000 in the current book of international classified diseases, another 8,800 codes for procedures and final book containing codes for supplies and injectable drugs.

The book with 14,000 codes for diagnosis is about to undergo a major revamp. The new code book for 2014 will have more than 78,000 codes. Arter said when the new changes go through, she predicts the bills will not get paid for a while.

“Canada tried this and nothing got paid,” Arter said.

She predicts the changes which will be brought about by Obamacare will affect the job of coders greatly. According to Arter, hospitals and doctors already write off large amounts of bills which they are unable to collect on. In her opinion, a 2 percent drop in what Medicare will pay will force hospital staffs to be unable to employ about 15 people.

Although codes are changing, certified coders are required to obtain annual continuing education. She offers continuing education at the CTC, allowing her students to return to a place they feel comfortable and meet with their former classmates while obtaining information on the latest changes.

Not only do codes help make the difference about whether a doctor or hospital receives the right amount of money for their services, codes are used for statistical purposes. Arter points out that it is only through coding that statistics become known about how many football-related injuries happen nationally each year or how many cases of cancer have been diagnosed for those living in the East Liverpool area.