1. What is medical coding?
Answer:
Medical coding is the process of translating healthcare diagnoses, procedures, medical services, and equipment into universal alphanumeric codes. The codes come from medical record documentation such as doctor’s notes, laboratory and radiology results, etc. Medical coders use these codes to ensure accurate billing and tracking of patient care services.
2. What coding systems are you familiar with?
Answer:
I am familiar with coding systems like ICD-10 (International Classification of Diseases, 10th Revision), CPT (Current Procedural Terminology), and HCPCS (Healthcare Common Procedure Coding System). I have practical experience using these in both inpatient and outpatient settings.
3. What is the difference between ICD-9 and ICD-10?
Answer:
ICD-10 has more detailed and specific codes compared to ICD-9. ICD-9 used 3-5 characters, while ICD-10 uses 3-7 characters, allowing for greater precision in coding medical conditions and procedures. ICD-10 also introduced new chapters and expanded the number of codes for better specificity in tracking and reporting diseases.
4. How do you ensure coding accuracy?
Answer:
I ensure accuracy by staying up to date on coding guidelines, regularly reviewing updated materials, cross-referencing codes with patient documentation, and using coding software tools. Additionally, I follow compliance guidelines and collaborate with healthcare providers to clarify any unclear documentation.
5. Can you explain the difference between CPT, ICD, and HCPCS codes?
Answer:
- CPT (Current Procedural Terminology) codes are used for reporting medical, surgical, and diagnostic services.
- ICD (International Classification of Diseases) codes are used to classify and code diagnoses and symptoms.
- HCPCS (Healthcare Common Procedure Coding System) codes are used for billing Medicare and Medicaid patients and cover services, procedures, and equipment not covered by CPT.
6. What do you do if there is a discrepancy between the physician’s notes and the code?
Answer:
If there is a discrepancy, I would consult with the physician or healthcare provider to clarify the notes. Clear and accurate documentation is critical for proper coding, so it’s essential to address any inconsistencies before finalizing the code.
7. How do you stay updated on coding changes?
Answer:
I stay updated by regularly attending webinars, participating in professional organizations like AHIMA (American Health Information Management Association) or AAPC (American Academy of Professional Coders), and subscribing to industry publications and newsletters. I also review the latest updates to coding systems and regulatory changes to ensure compliance.
8. Can you describe a time when you found an error in coding and how you resolved it?
Answer:
In a previous role, I identified a miscode related to a surgical procedure, where a less invasive procedure had been documented, but a more invasive code was applied. I reviewed the documentation and discussed it with the surgeon, confirming that the original code was incorrect. I corrected the code and ensured the billing was updated accordingly, preventing a costly overcharge.
9. What would you do if you are unable to find the correct code for a procedure?
Answer:
If I am unable to locate the correct code, I would first refer to official coding guidelines, references, and coding software tools. If the issue remains unresolved, I would consult with a senior coder, supervisor, or healthcare provider to clarify the procedure and ensure the correct code is applied.
10. How do you prioritize your workload in a fast-paced environment?
Answer:
I prioritize my workload by focusing on urgent cases first, such as those that impact patient care or reimbursement timelines. I organize my tasks using project management tools or checklists and ensure open communication with my team. Additionally, I regularly reassess priorities throughout the day to stay flexible and adjust as new tasks arise.
11. How do you handle confidential patient information?
Answer:
I strictly adhere to HIPAA (Health Insurance Portability and Accountability Act) guidelines and organizational policies for handling confidential information. I ensure that all electronic records are securely stored, limit access to authorized personnel only, and never disclose patient information without proper authorization.
12. What do you think are the biggest challenges facing medical coders today?
Answer:
Some of the biggest challenges include keeping up with constant coding updates and regulatory changes, ensuring compliance with increasingly complex healthcare regulations, and maintaining accuracy despite high work volumes. There is also the challenge of adapting to new technologies and coding systems that continue to evolve.
13. Why did you choose a career in medical coding?
Answer:
I chose medical coding because I have a passion for both healthcare and technology. I enjoy the analytical and detail-oriented nature of the work, and it allows me to contribute to healthcare efficiency while ensuring compliance and accuracy in medical billing.
14. How do you deal with tight deadlines and high productivity expectations?
Answer:
I handle tight deadlines by planning ahead and setting clear goals for each day. I prioritize high-value tasks and manage my time effectively, avoiding distractions. In high-pressure situations, I remain calm and focus on completing one task at a time while maintaining coding accuracy.
15. Do you have any experience with electronic health record (EHR) systems?
Answer:
Yes, I have experience working with various EHR systems such as Epic, Cerner, and Meditech. I am familiar with navigating patient records, extracting necessary information, and using integrated coding modules within these systems.
