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Do you know about medical coding - the emerging career in medicine?

Posted on Monday, August 27, 2018

The procedure of converting patient data into codes is called medical coding and is crucial for creating and processing insurance claims accurately, writes Dr. Guruvayurappan PV

 In the gamut of healthcare and revenue cycle management, medical coding is a niche specialization in which coders study medical records and charts of patients, and assign universal alphanumeric codes. Coders refer to various medical documents such as transcription of physician's notes, laboratory and radiologic results, etc. and assign standard codes from Current Procedures Terminology (CPT), International Classification of Diseases (ICD), and Healthcare Common Procedure Coding System (HCPCS) Level II classification systems.


When coded accurately, medical codes can tell the whole story of a patient's encounter with the physician capturing reimbursement for the services rendered too. This procedure of converting patient data into codes is crucial for creating and processing insurance claims accurately.


The healthcare industry is rapidly evolving with rising income levels, greater health awareness, increased precedence of lifestyle diseases and improved access to insurance being key contributors to growth. This would also mean a rise in number of medical procedures and tests to be processed for claim reimbursement and a tangential increase in medical coding.


Rising demand for world-class healthcare services, need for a universal language to reduce frauds and misinterpretations associated with insurance claims are said to be the two key factors propelling the market growth.


Countries such as the US, UK and Australia have been early adopters of medical coding following the ICD standards for almost 30 years now. The Middle Eastern countries have recently mandated following the ICD–10 guidelines for medical coding. Similarly, many other countries across the globe have started adopting the ICD standards owing to digitization of healthcare sector making it a global playing field.


While the healthcare sector in the developed countries have matured and evolved to adapt medical coding, the industry in India is still at a nascent stage. There does not yet exist a uniform structure to follow medical codes, though a few private hospitals and insurance companies do consider ICD–10 to be the ideal standard.


Scope of Medical Coding in India:


At present, the medical coding sector in India primarily caters to the US and other countries that offshore their healthcare processes. A study from IBEF projects the Indian healthcare sector to reach Rs. 8.6 trillion (US$ 133.44 billion) by 2022 generating 40 million jobs in the country by 2030. The Indian healthcare outsourcing industry is expected to grow at a CAGR of 9.81% to reach a market value of US$ 280 billion by 2020.


India is evolving to be the hub for healthcare outsourcing, with nearly 80% of US companies outsourcing to the country. The career prospects in medical coding are thus, further boosted by the outsourcing trend. A combination of IT and healthcare makes this industry evergreen with no dearth of job opportunities.  


With the Indian government also taking steps to enforce EMRs and EHRs across the healthcare sector in the country, India is not far behind from adopting the coding standards as prescribed by CPT and ICD. Medical coding is thus a lucrative career option for life science graduates with plenty of avenues for growth.


Starting a career in medical coding is easy as a clinical or healthcare related degree is not necessary. However, a basic knowledge of anatomy and physiology will help understand better and learn faster.  There are many academies across the country, which offer certificate-training courses in medical coding, Omega Medical Coding Academy being one of them.

The author is Senior VP – Human Resources at Omega Healthcare Management Services



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