What Does an Outpatient Medical Coder Do?

An outpatient coder must know how to code multiple areas, if not all areas, related to the services performed at an outpatient hospital or a hospital owned facility that is classified as outpatient. The types of coding this type of coder must know are CPT procedures, ICD-9 diagnosis codes, and HCPCS supply and service coding. A coder must know medical terminology and anatomy.

Daily Activities

• An outpatient coder determines the appropriate coding from either a paper chart record or an electronic chart record. They review all notes prior to determining the correct codes.

Computer Software Used

• Most facilities have a specific type of computer software the coder uses to determine the Ambulatory Payment Classification (APC) used by government payors and many third-party insurance carriers.

Ability to Override

• Medical coders must have a good understanding of when the data does not explain "the whole picture." They have the ability to override the computer code outcome for more appropriate choices of codes or APC.

Accurate Evaluation

• A coder must be able to accurately evaluate when more information is needed from the physician or ordering medical provider.

Confidentiality

• Confidentiality is the law. Coders must not discuss any medical case outside the office with any other employee, family member or friend.