Coding Specialist

What is a Coding Specialist?

A medical coding (or clinical coding) specialist is an individual who reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. The medical coding specialist is responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form. The translation process requires interaction with the healthcare provider to ensure that the terms have been translated correctly. The coded information that is a product of the coding process is then utilized for reimbursement purposes, in the assessment of clinical care, to support medical research activity and to support the identification of healthcare concerns critical to the public at large.

The medical coding specialist must have a thorough understanding of the content of the medical record in order to be able to locate information to support or provide specificity for coding. Certified medical coders are trained in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded. Simply locating diagnostic and procedural phrases in the coding manuals or with encoder software without applying knowledge of disease processes and procedural techniques leads to coding errors. The medical coding specialist works as part of a team to achieve the best quality patient care.

For more information:

• Susan Scalzi , BS, CNCS