Become a Coder

What is medical coding?

Medical coding is the process of applying codes to represent clinical information. Providers can use codes to describe the following:

  • Diagnostic information that is related to a patient’s condition
  • Procedures
  • Services and supplies

At this time, the United States uses these primary coding systems for billing purposes:

In general, codes are used for billing, insurance claims, patient records, and healthcare research, with the goal of describing:

  • Why the patient received a service (generally using codes from ICD-10-CM)
  • What services the patient received (generally using codes from ICD-10-PCS, CPT, or HCPCS Level II)

Medical coding as a profession

Although clinical knowledge can be extremely helpful to a coder, the medical coding profession does not involve the practice of medicine. Rather, it is the application of coding rules to a set of clinical facts.

Coding has become a recognized profession in its own right. Two national organizations certify individuals as having coding expertise:

Both organizations generally require some practical coding experience and successful completion of an examination before an individual can become certified. Credentialing is a necessity in the coding profession. Not only does the government recommend that only credentialed coders be permitted to provide coding for Medicare patients, but credentialing also validates the coder’s skills and knowledge to the world.

The AAPC offers a variety of coding certifications in addition to an apprentice credential (CPC-A) for an individual with limited coding experience and specialty coding certifications:

  • Certified Professional Coder (CPC): Awarded to individuals in physician office settings who have demonstrated competence in diagnosis coding and HCPCS/CPT procedure coding.
  • Certified Outpatient Coding (COC): Awarded to individuals who have demonstrated proficiency in assigning accurate medical codes for diagnoses, procedures, and services performed in the outpatient setting.
  • Certified Inpatient Coder (CIC): Validates expert level knowledge and experience in abstracting information from the medical record for ICD-10-CM and ICD-10-PCS as well as specialized payment knowledge in MS-DRGs and Inpatient Prospective Payment Systems (IPPS). This is intended for those working in hospitals (acute care facilities), skilled nursing facilities, critical access hospitals, teaching hospitals, inpatient rehab facilities, and long-term care hospitals.
  • Certified Risk Adjustment Coder (CRC): Demonstrates expertise in the complexity of diseases associated with chronic conditions and comorbidities, mastery of ICD-10-CM guidelines and risk adjustment guidelines, and ability to ensure clinical documentation accurately portrays the patient’s health status and all clinically documented diagnoses are properly reported.

AAPC also offers specialty coding certifications in the following fields:

  • Ambulatory Surgery Center
  • Anesthesia and Pain Management
  • Cardiology
  • Cardiovascular and Thoracic
  • Dermatology
  • Emergency Department
  • Evaluation and Management
  • Family Practice
  • Gastroenterology
  • General Surgery
  • Hematology and Oncology
  • Interventional Radiology Cardiovascular
  • Obstetrics Gynecology
  • Ophthalmology
  • Orthopaedic
  • Pediatrics
  • Rheumatology
  • Urology

On the other hand, AHIMA has three coding certifications:

  • Certified Coding Associate (CCA): Awarded to early-career coders who have demonstrated a basic understanding of clinical classification systems, reimbursement methodologies, patient health information, and compliance.
  • Certified Coding Specialist (CCS): Awarded to individuals who have demonstrated competence in coding hospital inpatient and outpatient services
  • Certified Coding Specialist-Physician-based (CCS-P): Awarded to individuals who have demonstrated competence in coding physician services.

AHIMA also offers two credentials that require a degree from a program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM):

  • Registered Health Information Administrator (RHIA): Awarded to an expert in managing patient health information and medical records, administering computer information systems, collecting and analyzing patient data, and using classifications systems and medical terminologies. RHIAs often manage people and operation units, participate in administrative committees, and prepare budgets.
  • Registered Health Information Technician (RHIT): Awarded to a health information technician who ensures the quality of medical records by verifying their completeness, accuracy, and proper entry into computer systems. An RHIT often specializes in coding diagnoses and procedures in patient records for reimbursement and research.

Earning potential for medical coders

According to the U.S. Bureau of Labor Statistics, medical coders—listed as medical records specialists—earned an average pay of $25.81 per hour in 2023 ($53,690 per year). The lowest 10% earned less than $35,080 per year while the highest 10% earned more than $77,810.

Other factors, such as education, setting, and the type of coding performed, play a role in the overall increase in coder salaries. Higher education often leads to higher salaries, with distinctions between coders whose highest education is “some college” compared to those who earned a degree. However, the typical entry-level education is a postsecondary certification for coding. Additionally, those who worked in general medical and surgical hospitals or outpatient care facilities often earned more than those who worked in physician offices or skilled nursing facilities.

As for the job outlook, employment of medical records specialists is projected to grow 9% from 2023 to 2033, much faster than the average of 4% for all other occupations. This is due to an increasing share of the population entering older age groups requiring medical care, although the increase in AI-powered solutions that make medical coding more efficient could affect the demand for such jobs.

 

Last updated 1/29/25