It would then become incumbent on the experienced coder to be able to read through the injuries and determine the accurate code to use. Another issue Kramer, Barancik, and Thode, Jr. (1990) found was that certain areas of the body lacked a code when injured to a very specific area of the body. The training and education one needs to be a successful medical coder, and in particular a remote medical coder, is extensive. If we examine Figure 1 below, we can understand why this is so:

AAT (alpha-1 antitrypsin) deficiency 273.4

AAV (disease) (illness) (infection) - see Human immunodeficiency virus (disease) (illness) (infection)

Abactio - see Abortion, induced

Abactus venter - see Abortion, induced

Abarognosis 781.99

Abasia (-astasia) 307.9

[7 subitems]

Abderhalden-Kaufmann-Lignac syndrome (cystinosis) 270.0

Abdomen, abdominal - see also condition

Kramer, Barancik, and Thode, Jr. (1990) found

Abdominalgia 789.0

[1 subitems]

Abduction contracture, hip or other joint - see Contraction, joint

Abercrombie's syndrome (amyloid degeneration) 277.39

Aberrant (congenital) - see also Malposition, congenital [26 subitems]

Aberratio

[2 subitems]

Aberration - see also Anomaly

[3 subitems]

Abetalipoproteinemia 272.5

Abionarce 780.79

Abiotrophy 799.89

Figure 1-Example of medical coding chart

Who amongst the untrained can make sense of this medical gobbledygook? Obviously, it would require a great deal of instruction and education to be able to decipher which symptoms applied to which condition. An even greater level of skill would be required should one work remotely, where one would be unlikely to have help in ascertaining the correct medical code.

JM Taylor (2010) recommends extensive, supervised on-site training, followed by annual continuing education, as the healthcare industry does not remain static but is overwhelmingly dynamic. The American Health Information Management Association goes a step further to suggest mandatory certification (2011). This credentialing would, at minimum, prove the coder had the sufficient medical knowledge to pass a rigorous examination. Once earned, the continuing education requirement would ensure the coder was kept abreast of new medical advances and technologies.

The American Health Information Management Association (2011) assures certification involves not only the medical knowledge requirements,...

Beyond that, management suggests using testing and certification as criterion for qualified applicants. A proven track-records, long-term employment history, and background checks should be conducted. Remote coders would thereafter need to comply with continuous review and educational requirements as a quality control check. Joining and participating in medical coding organizations is also encouraged.
Management feels that, drawing from its data collection, these stringent requirements would ensure that only the highest-caliber medical coders be allowed to work remotely, not to mention the only ones who would likely be successful and competent. All of these extra factors lead directly into the hospital's bottom line: its revenue (and, consequently, the remote medical coder's revenue). And that is what makes or breaks a healthcare facility, not to mention the career of a remote medical coder.

References

American Health Information Management Association (AHIMA). (2011). Quality healthcare through quality information. Retrieved from http://www.ahima.org/Default.aspx/.

Kramer, Caroline F., Jerome I. Barancik, and Henry C. Thode, Jr. (1990). Improving the sensitivity and specificity of the abbreviated injury scale coding system. Public Health Reports, Vol. 105, No. 4, pp. 334-40.

Rodecker, Kristy. (2010). Medical billing and coding. Retrieved from http://www.medicalbillingandmedicalcoding.com/.

Taylor, JM. (2008). [Emergency Department] Management. Experienced coders help ED create excellence. The Monthly Update On Emergency Department Management, Vol. 20, No. 11, pp. 123-5.

Figures

1.) ICD-9. (2009). International statistical classification of diseases and related health problems. Example of a medical coding chart. Retrieved from http://icd9cm.chrisendres.com/index.php?action=alphaletter&letter=Aa.