# Medical Coding



## GoatsRus (Jan 19, 2003)

Ok, so I signed up for medical coding class. Not my background by any means (MBA- Business, AS programming), but given the job markets and the general consensus that the medical field will be heating up, I'm taking a chance. I'm actually interested in medical subjects, but I'd never make a good nurse or phlembotist. Getting to the point where I'd like to work from home but would take a business position in a hospital.

Anyway, anyone do this for a living? What are your thoughts? The course is looking pretty scary, but I just started.


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## SashayXP (Apr 26, 2008)

Hello:
If you do not have a medical background with a good knowledge of medical terminology, lab procedures, drugs, equipment, etc. you are going to have a tough row on the medical coding. However, having said that...no one was born knowing any of this and if they learned it then certainly you can too. Do not be discouraged...there is a desperate shortage of CERTIFIED medical coders...that's the key to getting a job...you must be certified...and almost any hospital of any size anywhere has an opening for at least one coder and usually more than one opening. If you are taking medical coding in order to get a work at home job...well I hate to disappoint you but without any sort of medical background and a brand new coder besides...I suspect that that will not be possible for you. You need to work in house in a hospital for awhile so that they feel comfortable with your work and know that you know what you are doing..."awhile" meaning a year or two and not a couple of weeks, depending on the hospital and depending on the complexity of the charts that you are coding. However...beyond that in house training...then you can likely have several offers to work at home...most likely the hospital where you trained, working at home as a hospital employee with full benefits. I know this looks daunting, but please do hang in...there are tons of jobs and in a year or so you will be in a new career with a very good future. Congratulations for having the guts to start something new when you already have an MBA...don't let anyone discourage you or question WHY you have made this change with that level of education...because we do what we need to do to get where we want to go. You are a strong and gutsy person to make this change and you will be fine....after a tough few weeks/months when you really want to quit! If I can help, send me an email and I will be glad to do so.


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## SashayXP (Apr 26, 2008)

oh and that is PHLEBOTOMIST


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## GoatsRus (Jan 19, 2003)

Thanks SashayXP - I've started the course and it does look daunting. Thanks for your offer to help. I'm not retirement age yet, so I figure if I start now, get the certification and work a few years in a hospital/dr office, then I will be able to find something from home. I actually have a website that has nothing but work from home medical jobs.


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## Cassie (Dec 7, 2002)

Do you have to be an exceptionally fast typist like you do in transcription? 

One thing I've wondered about coding and transcription is if they could be lost to overseas workers. I figure anything that can be done at home via computer can be shipped abroad. Anyone think these careers are in danger of that?


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## Nevada (Sep 9, 2004)

GoatsRus said:


> Thanks SashayXP - I've started the course and it does look daunting. Thanks for your offer to help. I'm not retirement age yet, so I figure if I start now, get the certification and work a few years in a hospital/dr office, then I will be able to find something from home. I actually have a website that has nothing but work from home medical jobs.


I think medical coding is something worth pursuing, but I also think that there are related opportunities that could really make you stand out. Today, the opportunity seems to be in making yourself a medical practice software jock. Medical practice software is a single integrated software solution for appointments, medical records, billing, electronic prescriptions, insurance authorizations, and even more.

Medical practice software can be horribly expensive. New clinics are advised to budget between $10K & $25K for the medical practice software & server purchase and setup, then another $3K to $5K each year to maintain it. While medical practice software is expensive, it's nevertheless considered a necessity. Still, many clinics can't afford it.

The opportunity lies in an open source (free) medical practice software solution that is sweeping the industry, called OpenEMR. That software is a multi-user server environment that is served from a single computer to multiple users as if it were a web page (more precisely, a php page). I believe that OpenEMR will become the industry standard.

Clinics will soon be under enormous pressure from the government to become compliant with universally available medical records, and it appears that OpenEMR will be the leader in that. Therefore, I believe that persons who can install, implement, and maintain OpenEMR will become indispensable to clinics.

The three most common methods for installing OpenEMR are:


Dedicated Linux server in the office.
Dedicated Windows server in the office.
Hosted at a commercial web server, and accessed with a DSL connection.
Most commonly, OpenEMR is installed on a Linux server, which creates a dimension of complication that many (nearly all) medical clinics can't handle. The result is that it costs thousands to hire a consultant to install and maintain the server, but the fact remains that the software itself is free. The opportunity is in your overcoming the difficulty in installing, maintaining, and implementing OpenEMR by learning all about it. It's not rocket science. If I can do it, anyone can do it.

I've started my own niche business with OpenEMR, where I have authored an install CD that turns a Windows XP machine into an OpenEMR server. I've found that most clinics can handle maintaining a Windows XP machine. I have customers all over the world. 

Imagine letting local clinics know that you can setup & maintain a comprehensive medical practice software server for their clinic at a modest price. After all, their alternative to hiring you is spending tens of thousands on software that they don't really want to maintain anyway. Think about it...

I happen to know a lot about this. Trust me, this is a wide open opportunity in that you have virtually no competition, it doesn't require any formal education credentials, and the product is in high demand.


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## vicki in NW OH (May 10, 2002)

Cassie said:


> Do you have to be an exceptionally fast typist like you do in transcription?
> 
> One thing I've wondered about coding and transcription is if they could be lost to overseas workers. I figure anything that can be done at home via computer can be shipped abroad. Anyone think these careers are in danger of that?


Transcription is already outsourced overseas, especially to India. 

By the way, typing rate only has to be average for transcription. One uses word expansion programs to increase the speed of typing. I use Shorthand, but there are others.


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## Cassie (Dec 7, 2002)

I've heard my friend talk about 'macros' I guess that's the extension? But even if typing isn't a problem, I would still be leary of getting into the profession because of jobs leaving the country. I would be interested in whether it will happen to coding. I'm guessing it will.


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## seagullplayer (Nov 6, 2008)

Nevada said:


> I think medical coding is something worth pursuing, but I also think that there are related opportunities that could really make you stand out. Today, the opportunity seems to be in making yourself a medical practice software jock. Medical practice software is a single integrated software solution for appointments, medical records, billing, electronic prescriptions, insurance authorizations, and even more.
> 
> Medical practice software can be horribly expensive. New clinics are advised to budget between $10K & $25K for the medical practice software & server purchase and setup, then another $3K to $5K each year to maintain it. While medical practice software is expensive, it's nevertheless considered a necessity. Still, many clinics can't afford it.
> 
> ...


This sounds very interesting, where could I learn more?


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## foxtrapper (Dec 23, 2003)

I've known a lot of people who got into medical coding and transcription because it's such a lucrative and well paying field (cardboard flier says so). With the exception of one, none of them are in it any longer. And the one who stayed, he isn't rich.


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## GoatsRus (Jan 19, 2003)

coding is different from transcription. Because of strict medicare guidelines, I doubt that coding will go overseas. Besides, a lot of companies that tried the overseas route have brought back jobs because of poor customer relations and the fact that "India" is getting smarter and starting to charge almost what a US person would make.

Nevada - your information is intriguing. I actually have an AS in programming from many years ago (think RPG, Cobol.....). I would still think that a medical background would help with any of the installations. I'm going to check out your link.


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## Nevada (Sep 9, 2004)

seagullplayer said:


> This sounds very interesting, where could I learn more?


To read about it you can go to the main page at oemr.org. The SourceForge.net project page is at sourceforge.net/projects/openemr/. The most active OpenEMR forum is at the SourceForge page.

I really believe in the product, so I've actually joined the software development team. That makes me feel as if I'm a part owner in the product and helps me stay current on capabilities and bug issues.

Probably the best way to get to know the product is to install it on your computer and work with it. It's platform independent (i.e., it will run on any operating system with a php capable web server and MySQL), since the application is basically just a web page with a MySQL backend. It is, however, a huge web page application. To give you an idea if how comprehensive it is, the application itself takes up almost 40 mb of hard drive space. That's a BIG web application!

Since OpenEMR is a such a comprehensive application, there is plenty of room for people who are knowledgeable in the operation of OpenEMR. In other words, you'll make yourself in demand simply by becoming familiar with OpenEMR.

Just so you have an idea of what the product looks like, I have an online demo you can play with. This demo gives you physician access (the demo logs you into the Ben Casey account), but you'll learn a lot more if you have your own installation with administrator access.

Username: demo
Password: pass

OpenEMR 3.0.1 Demo
_(Important note: I'm upgrading my hosting account to dedicated IP hosting. You may not be able to reach the demo for up to 24 hours while the new IP address propagates.)_

OpenEMR can maintain separate appointment calendars for any number of physicians in a clinic, but has only a single database for patients. What that means is that the physicians can see the patient records for all patients of that clinic. If separate patient records are required then you would need separate OpenEMR installations.

One thing that most clinics need help with is custom encounter forms. That's the form that the doctor works with each time he sees a patient. It has all of the normal services and procedures that he's likely to perform. That form will vary with the type of practice, and even with physician preference. If you can do enough php to create custom encounter forms for OpenEMR, you'll be in demand most everywhere.

By the way, OpenEMR's usefulness does not end with medical doctors. I also have customers who are vets, optometrists, and dentists. Basically, any practice that has patients, makes appointments, and does billing will need it.


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## Nevada (Sep 9, 2004)

The point I'm making is that electronic medical records are the biggest news in medicine today. Obama is committed to having patient records available universally. Privacy issues aside, this is going to revolutionize medicine in this country.

As it stands today, if you show-up in an emergency room that you haven't been to before they have no idea who are are. The only medical history available is from you, and if you're unconscious they have to rely on just what they can learn at the time. When you think about it, we're in the medical dark ages.

That's all going to change -- virtually overnight. Patient history will be available from a central database to medical professionals all over the country. It won't be long before an ER can punch in your name and see your history. They'll know your ongoing conditions, the meds you take, and even your immunization record.

But having a system like that is going to take a little doing. That's where electronic medical record software comes in, which is integrated into most medical practice software applications.

The old pen & ledger days are suddenly over, but that's all some clinics know. They're going to need help -- a lot of help. Anyone who is considering a medical back office career needs to look into medical practice software. This is new to the point where you can't even take a course in it yet, but it's going to become huge fast.

Electronic medical records is the biggest thing to hit medicine since penicillin. OpenEMR is the opportunity of a lifetime.


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## vicki in NW OH (May 10, 2002)

Some of the accounts at the company where I transcribe are on EMR. My clinics haven't been transitioned yet, but the MTs say that entering information is very fast.


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## Nevada (Sep 9, 2004)

vicki in NW OH said:


> My clinics haven't been transitioned yet, but the MTs say that entering information is very fast.


It won't be long, but when everyone starts using it the opportunity won't be over. There's going to be lots of ongoing work for maintaining the systems, and there will always be competition for less expensive and better software solutions.


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## mthome (May 8, 2009)

My own clinic doctors have been using EMR for several years but they still dictate for acute care.


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## GoatsRus (Jan 19, 2003)

Just an update on this medical coding...I really like it ! My first test I got a 97%, but it was on general terminology and acronymn and not actual coding. My 1st real coding test I'll be taking this week. Anyone have suggestions on how to get into this business without going to $8 hr job. I know it's too early to even be perusing the jobs, but I keep seeing that employers want at least 2 years and this class will count as 1 yr. I'm wondering if I can do something from home on weekends - ie.... contractor work. That will at least get me started. Any suggestions ? I just can't quit my day job yet !


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## ladytoysdream (Dec 13, 2008)

I completed a medical coding class last year. Got a certificate. 
I started to look for work in the field but everything I looked at wanted 
the person to be certified. In order to be certified, one needs to take a state test and pass it ...it costs just over $ 100 and a good part of a day to take. 

I have not took the state test. It only gets offered a few times a year. 
I would need to study and refresh myself before I even think about taking it. There was another course offered at the same time, I took the coding class but they ended up canceling it, due to not enough interest. It was the class for the medical terminology. I think it would have helped me a lot. Maybe if they offer it this fall again, I might consider taking it. It sure would have helped a lot with all those BIG medical words. Kind of hard to find the correct medical code to bill for, if you don't know what the procedure was the doctor put the patient through.


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