Medical coding and billing is the process of translating the information from patient records — such as treatments, procedures, and diagnoses — into the standardized numeric codes used to bill patients and third-party payers like insurance companies and Medicare.

In the world of medical coding, there are two fairly distinct groups of coders:

1. Outpatient Coders perform coding for clinics, physicians offices, and hospital emergency rooms.
2. Inpatient Coders perform coding in major hospitals.

As a general rule, a procedure or healthcare event that requires a hospital admittance and overnight stay is considered an inpatient event. Procedures that are performed on a same day basis where the patient is not admitted to the hospital for an overnight stay are considered outpatient events.

Physicians and hospitals are performing more and more of their procedures on an outpatient basis, creating a larger number of positions for outpatient coders and quicker entry into this side of the coding field. There is a significant difference in the skill set required to apply codes to complex inpatient operative reports, and this skill set difference has placed inpatient coders in high demand, providing them greater opportunity to earn higher salaries and advance to management.

At Career Step, our emphasis is on preparing you to become one of the highest quality coding and billing specialists, in either inpatient or outpatient coding. The Career Step Outpatient Medical Coding and Billing curriculum prepares you for entry-level certification and entry-level employment in outpatient coding, while the Career Step Inpatient and Outpatient Medical Coding and Billing curriculum prepares you for entry-level certification and entry-level employment in inpatient coding.

Both inpatient and outpatient medical coders play a vital role in the growing healthcare industry, translating medical records into standardized numeric codes used to bill patients and third-party payers, such as Medicare and insurance companies. Most inpatient coders work in hospital setting coding inpatient procedures, and most outpatient coders work in physicians’ offices, clinics, and other outpatient facilities.

Medical coding is divided into two separate but related fields: inpatient and outpatient. The professionals who work in each of these fields are paid at different levels because of the differences in the skill sets required.

Based on 2008 data, the U.S. Department of Labor reports that medical records and health information technicians (including both inpatient and outpatient coders and other related professions) have an average annual salary of $32,960.

Inpatient coders:

According to a 2008 salary study conducted by the American Health Information Management Association (AHIMA), CCA (entry-level credential) certified coders earn $36,900 annually, while coders who have earned the CCS credential (the Career Step program prepares students for the CCS exam) make an average of $57,900 annually. The study also reports that nearly 3 out of 4 coders surveyed received a salary increase in the previous 12 months.

Outpatient coders:

According to a 2008 salary study conducted by the American Academy of Professional Coders (AAPC), entry-level outpatient coders earn $30,600 annually, while coders who have earned the CPC credential make an average of $43,100 annually (the Career Step program prepares students for the CPC exam).

Both of the Career Step medical coding programs can be completed in 640 hours, or 4 months of full-time study. Enrollment includes 4 months of access to the curriculum and online learning tools, and by enrolling today you can use this complimentary 8 month extension voucher and have a full year to complete the program! Additional extensions are also available for purchase, should you need more time.

Outpatient coders are primarily certified by the American Academy of Professional Coders (AAPC). According to a 2008 AAPC survey, only about half of outpatient coders are certified, but this percentage is increasing every year. Career Step’s program prepares students for the CPC exam, which is one of the most common outpatient certifications.

Inpatient coders are primarily certified by the American Health Information Management Association (AHIMA), and, with very few exceptions, employers require certification. Career Step’s program prepares students for the CCA exam. Graduates may also sit for the CCS exam (AHIMA recommends on-the-job coding experience before taking this exam).

The Career Step medical coding programs will help students prepare to take many key industry certification exams. Both programs prepare students for the CCA and CPC. Graduates of the Inpatient program may also sit for AHIMA's CCS certification exam (AHIMA recommends on-the-job coding experience before taking this exam).

Entry-level medical coding certification exams are offered throughout the year by two national organizations:

1. AHIMA - American Health Information Management Association
2. AAPC - American Academy of Professional Coders

The Career Step medical coding programs will help students prepare to take many key industry certification exams. Both programs prepare students for AHIMA's CCA exam and the AAPC's CPC exam. Graduates of the Inpatient program may also sit for AHIMA's CCS certification exam (AHIMA recommends on-the-job coding experience before taking this exam).

As a medical coding and billing specialist, you will most likely work in a professional setting and closely interact with other healthcare professionals. Typically, coders work in pleasant and comfortable offices, with a full or part time schedule. There are work opportunities for outpatient coders in physician practices, hospitals, government facilities, ambulatory surgical centers, billing companies, and a variety of other healthcare facilities.

There are also limited opportunities to work from home and enjoy: no commute, no daycare costs, increased flexibility, and spending work breaks with the ones you love most. There appears to be a trend toward outsourcing of coding and billing work to third-party vendors. As this trend catches on, it is possible that more coding and billing work will be done in homes and that coding will evolve to become more of a home-based career — much like medical transcription is today. However, at this point it is important to point out that this is not the norm and that most coding and billing is still accomplished in a hospital and clinic setting.

A nationwide shortage of medical coders has increased the demand on employers to fill these positions. The U.S. Department of Labor estimates that there will be 30,000 new coding related jobs before 2016, and a study conducted by the American Health Information Management Association (AHIMA) in 2006 reported that over half of coding employers had open coding positions in the previous year. Entrants into the medical coding field can expect a promising career outlook.

The Department of Labor's Occupational Outlook Handbook states:

"Employment of medical records and health information technicians is expected to increase — faster than the average for all occupations — because of rapid growth in the number of medical tests, treatments, and procedures that will be increasingly scrutinized by health insurance companies, regulators, courts, and consumers... Technicians with a strong background in medical coding will be in particularly high demand."

You must possess a high school diploma or GED. There are no specific skills and experience that are considered prerequisites for entry into the Career Step training program. A desire to succeed and a commitment to learning are the most important qualifications. No previous coding or billing experience is required.

Yes. Both of the Career Step medical coding training programs are self-paced online programs of study that can be completed entirely in the comfort of your own home.

The process of medical coding is a highly regulated and tightly supervised activity. Medical coding is also subject to frequent and rigorous audits to ensure accuracy in billing, as there are literally billions of dollars on the line. It is a much more scrutinized activity than medical transcription.

As a consequence, the requirements for certification are greater for individuals in the medical coding and billing field compared with many other career fields. Whereas medical transcription requires spelling and advanced literacy skills, coding is more analytical and objective.

Medical transcription is predominately performed by individuals working from home. At this point, most medical coding is still performed in hospitals and clinics.

While there are a few companies who hire home-based medical coding and billing professionals, most medical coding and billing work is performed onsite at hospitals and clinics. There appears to be a trend toward outsourcing of coding and billing work to third-party vendors. As this trend catches on, it is possible that more coding and billing work will be done in homes and that coding will evolve to become more of a home-based career — much like medical transcription is today. However, at this point it is important to point out that this is not the norm and that most coding and billing is still accomplished in a hospital and clinic setting.

The course has been put together in such a way that following the suggested order optimizes your chances for success. You are welcome to work through the program according to your own strategy, but you will be responsible for all of the material covered in the course, so be sure not to miss any units.

The Career Step online training program is designed to build each new idea or skill on previous ones, which ensures that you move on to the next level only when you fully understand each concept. You may have had previous experience with various sections of material taught in the course, and in this case, we recommend that you skip directly to the test for that particular section. If you do not score well above an 85%, please go back and review the material.

You may take each unit test or complete each exercise as many times as you need to until you are confident in your performance, in fact, we encourage it! Many students like to review each test before taking the final exam. Please note that your score will be recorded each time you take a test. The grade book will hold a maximum of two test scores: your oldest score and your best score. You should pay attention to the best score as indication of how well you have learned the material in that section.

If someone you referred enrolls in the Career Step course, you will receive $50 from Career Step! This gift will be applied to your account if you have an outstanding balance, or will be sent to you if you do not have a balance. The person you referred must let us know at the time of enrollment that you were the source of course information. It usually takes about 45 days after the person's enrollment for your gift to be sent.