Are you interested in a career change? Do you want to stop working nights, weekends, and holidays? Making the transition from clinical nurse to RN medical coder may help balance your work and life.
Registered nurses (RN)s are vital to the healthcare system. They can lend their experience and knowledge to the billing process to help keep accurate records and prevent insurance fraud.
Discover how this job opportunity may fit your lifestyle.
How Long to Become:
ADN or BSN
Certified Professional Coder (CPC) or Certified Coding Associate (CCA)
What is an RN Coder?
An RN coder applies medical coding and reimbursement policies in the claims process. Nurse coders review patient charts and provide diagnosis codes based on International Classification of Diseases (ICD) or Current Procedural Terminology guidelines.
They also help create and carry out cost strategies that ensure healthcare providers' success. Nurse coders may work in hospitals, offices, clinics, or insurance companies. Some RN coders work remotely at home.
A nurse coder works closely with medical billing specialists to identify errors and achieve team goals. For example, RN coders may audit the work of other coders for accuracy. (This differs from a clinical documentation specialist, who reviews a patient chart for potential errors before being discharged.)
RNs' familiarity with medical terminology, anatomy, and physiology, and their clinical experience can aid the transition to nurse coding.
Nurse coders must review patient charts, procedure notes, medication reconciliations, and labs to assign the correct ICD and CP codes. Many of these codes have dual meanings and slight differentiations that may be easier to distinguish with clinical experience.
Nurses can add coding to their knowledge and skills in a matter of weeks by attending a medical coding bootcamp or webinar. Earning coder certification can lead to more job opportunities and higher salaries.
Steps to Becoming an RN Coder
The path to a billing and medical coder career does not always begin with a nursing degree. However, those who have a nursing degree are in high demand. They have the education and skills to read medical records and choose the right diagnostic codes for billing. Additional education and requirements can vary among states and employers.
Earn an ADN or BSN Degree From an Accredited Program
Students seeking a nursing degree have two entry-level options. Nurses who complete an associate degree in nursing (ADN) may begin working as a nurse in as little as two years. Nurses may also complete nursing prerequisites through a four-year bachelor of science in nursing (BSN) program. A BSN degree increases career and salary potential.
Pass the NCLEX Exam to Receive RN Licensure
The National Council Licensure Examination for RNs (NCLEX-RN) evaluates nursing competency. Nurses must pass the NCLEX to get their state license. Each state board of nursing maintains its own exam eligibility requirements.
Gain Experience in Clinical Nursing
RN coders with clinical experience are highly valued and sometimes better paid. Seek an entry-level clinical position after licensure before pursuing a coder position. Hospitals offer the best clinical experience. A clinic or physician’s practice can also provide experience.
Become a Certified Coder or Auditor
The American Academy of Professional Coders (AAPC) offers four medical coding certifications and additional ones in medical specialties. The Certified Professional Coding (CPC) Certification is the gold standard for RN coders. Nurse coders may also add outpatient, inpatient, or risk adjustment certifications.
Candidates need two years of experience as a medical coder for full CPC certification. Those without two years of experience are awarded an apprentice status until the two years are complete. Aspiring RN coders can sit for the CPC exam after paying the required fee and becoming an AAPC member.
Best Online Medical Coding Certificate Programs
RN Coder Education
Nurses can enter the nursing field with a two- or four-year degree. While either is acceptable, a four-year degree offers more flexibility, opportunities for advancement, and greater RN coder salary potential.
An associate degree in nursing is best for students who wish to start working as quickly as possible. This degree has a high clinical focus. It allows ADN nurses to work while completing a four-year degree if they choose. Although many employers accept an ADN, most prefer a BSN.
ADN applicants need a high school diploma or GED certificate. They must submit a personal essay and recent SAT scores. Applicants must have taken high school chemistry and biology. Some programs also require the Health Education Systems Incorporated test to evaluate learning style.
The ADN curriculum prepares students for a clinical role. Students take chemistry, microbiology, anatomy and physiology, and pharmacology. They also have to pass English, communications, behavioral health, and foundations in nursing. Students must complete clinical hours where they apply classroom knowledge in hospitals, rehabilitation centers, and nursing homes.
Time to Complete
Full-time students can complete an ADN program in two years.
Students learn how to perform basic clinical skills, such as how to make an occupied bed, take blood pressure and heart rate, give an injection, and insert a catheter.
Candidates may complete a bachelor of science in nursing degree as their first choice, or attend an RN-to-BSN program online or in person.
This degree covers everything in the ADN program with more emphasis on critical thinking, research, management, and communication skills. The additional education can offer advantages for an RN coder.
Although admission requirements for a BSN degree differ among programs, many require a minimum high school GPA of 3.2 and prerequisite classes in science, English, sociology, and psychology.
BSN students take classes in anatomy and physiology, human development, microbiology, pathophysiology, health assessment, pharmacology, leadership and management, and mental health. Compared to ADN learners, BSN students spend more time completing a clinical and often have more clinical hours upon graduating.
Time to Complete
A BSN program takes around eight semesters (four years). It can take longer if a student attends part time.
BSN students learn to assess a patient's physical and mental status, apply critical thinking, and develop strong communication and leadership skills.
RN Coder Licensure and Certification
RNs are highly sought after in the medical billing and coding profession.
Maintaining an RN license and earning coder certification demonstrates commitment. It also helps protect an employer's compliance with insurance companies and agencies like the Centers for Medicare & Medicaid Services.
An RN license requires at least an ADN and a passing score on the NCLEX-RN. Employers, particularly in the nurse coding field, may prefer applicants who hold BSNs. Both an ADN or BSN provides eligibility for the NCLEX-RN.
Licensed RNs with ADNs can enroll in RN-to-BSN bridge programs to earn their nursing bachelor's degrees sooner.
Becoming certified entails taking the CPC or CCA exam. Both CPC and CCA credential holders qualify for entry-level coding positions.
To get a nursing license, candidates must master NCLEX-type test questions and pass the NCLEX-RN. This proves a job candidate has the competency to practice as a new nurse. The NCLEX-RN covers subjects learned in nursing school.
Nurses graduating from an accredited program are eligible to take the exam. Before registering for the exam, graduates must get an authorization to test and pay the required fee.
Each state may have additional eligibility requirements, so it is important to check with the state's nursing regulatory body.
Certified Professional Coder (CPC)
The AAPC does not have any eligibility requirements to take the CPC exam, but applicants must be an AAPC member. Student membership is $140 and individual membership is $205.
The test is 150 multiple-choice questions and takes five hours and 40 minutes. Exam locations are across the U.S. Certification is not official until two years of medical coding experience are completed.
Certified Coding Associate (CCA)
Offered by the American Health Information Management Association (AHIMA), Certified Coding Associate (CCA) certification requires a high school diploma. The AHIMA recommends, but does not require, either six months of coding experience or coding program completion.
The computer-formatted exam consists of 90-115 questions to be completed in two hours. Joining the AHIMA is optional, but non-members pay a $299 exam fee, while members pay $199.
AHIMA annual membership costs $49 for students, $135 for professionals, and $199 for the premier level.
RN coders often seek additional certifications in specialty areas. For example, the Certified Risk Adjustment Coder Examination focuses on codes in risk adjustment. Risk adjustment is important in patient populations where there is a greater burden of disease.
A certified professional medical auditor can be critical for a healthcare system's revenue cycles. This certification allows nurse coders to audit medical documentation for fraud and abuse.
Working as an RN Coder
It's helpful to have at least two years of experience as an RN coder before taking the CPC examination. AAPC grants full certification to those who pass the exam and can submit proof of experience. Full certification improves job options and salary potential.
Hospitals, doctors' offices, and medical coding companies advertise on job boards and job fairs for RN coders. Potential nurse coders can raise their job appeal by completing a medical coding course before certification.
The average annual salary for an RN coder is $83,680, according to ZipRecruiter data as of November 2022. This falls below the average annual salary of RNs ($82,750) according to the U.S. Bureau of Labor Statistics (BLS).
Additional certifications can increase job prospects. RN coders can find employment in several different settings:
RN coders work collaboratively with healthcare professionals. They help maintain patient confidentiality, review charts, and assign the right diagnosis codes for insurance reimbursements.
In a private physician's office, the RN coder may be responsible for both medical billing and coding. They prepare accurate medical codes for Medicaid, Medicare, and private insurance companies. They must also follow up on reimbursement and communicate with patients about outstanding balances.
Nurse coders can work in claims processing for insurance companies. They are responsible for analyzing a claim's validity. They then compare the codes against the patient's insurance policy. If the claim requires more information, the RN coder contacts the provider for the missing details.
Frequently Asked Questions About Becoming an RN Coder
How long does it take to become an RN coder?
Candidates who hold a BSN degree may complete AAPC's online course in six months. This can help potential nurse coders get their first coding job. After two years of experience, candidates may take the CPC exam.
How do you gain experience as an RN coder?
After completing an online or in-person medical coding training program, aspiring nurse coders can gain experience through job shadowing and internships. AAPC membership has networking access to RN coders across the country. Networking is a great way to find internships, job openings, or volunteer positions.
Those who pass the CPC exam without two years of experience can take part in the apprentice program which can also be an advantage for job seekers.
What qualities are important for RN coders?
RN coders have a strong attention to detail and high communication skills. These skills can help nurse coders perform research for coding and billing systems and work with healthcare professionals. RN coders should be able to work independently as many companies are moving to remote work. This means a nurse coder must be able to adapt to new technology and challenges.
Which certifications are most important for RN coders?
The CPC certification is the standard one that demonstrates competency to employers. Additional certifications can boost employability and salary potential. These include outpatient, inpatient, and risk adjustment coding. AAPC also has certifications for specialty areas like dermatology, cardiology, gastroenterology, and orthopedic surgery.
Page last reviewed December 19, 2022
After completing an online or in-person medical coding training program, aspiring nurse coders can gain experience through job shadowing and internships.How can I improve my medical coding skills? ›
- Right use of technology.
- Hiring the right resources.
- Frequent Guidelines and Coding Updates.
- Conducting compliance audits.
- Accelerate your Documentation process.
- Adhere to EMR workflows.
- Outsource your coding team.
- Step 1: Test-Drive Your Career Choice With a Few Basic Questions.
- Step 2: Take a Medical Coding Training Course.
- Step 3: Study for the CPC Exam.
- Step 4: Pass the CPC Certification Exam.
- Step 5: Network at Your Local Chapter.
- Step 6: Get a job.
Medical billing and coding can be hard at times, but it is by no means impossible. Like many healthcare careers, becoming a medical biller and coder will take education and training. In other words, it will take hard work. You cannot become a great medical coder or biller overnight.Can I become a coder with no experience? ›
If you're wondering how to become a coder in three to six months and have no coding, web development or software engineering experience, you'll want to enroll in a coding bootcamp. Coding bootcamps are intensive programs that help students build foundational knowledge in core technologies.Is it hard to get a medical coding job without experience? ›
While it helps to have professional experience when applying for a job as a medical coder, many companies hire candidates with no experience at all. Make sure to review the qualifications on the job post before applying for a position as a medical coder to improve your chances of getting the job.How can I practice coding effectively? ›
- Practice online. ...
- Read code written by someone else. ...
- Try out different ways to do the same thing. ...
- Put your code through a debugger. ...
- Take an online course. ...
- Use open source software. ...
- Join a team.
Top hard skills for medical coders include proficiency in software such as Master Patient Index (MPI), data entry, customer service, CPC, Ahima, Hipaa, Icd-9-Cm, patient care, medical records, facility and physician orders.Does medical coding require a lot of math? ›
In reality, math is very minimal in medical coding. A tiny bit is required for the integumentary system and the musculoskeletal system, but for the most part, it's not really a required skill set.Do you have to memorize ICD 10 codes? ›
There Are Roughly 68,000 Diagnosis Codes in ICD-10
Fortunately, medical coders aren't required to memorize all 68,000 codes—that's what the ICD-10 is for.
Becoming certified as a medical coder can take as little as four months or as long as fifteen months. These courses prepare you for taking the tests needed for the following credentials: Certified Professional Coder issued by the American Academy of Professional Coders.Can medical coding be self taught? ›
Self-taught medical coding is easier for those already working in the health care field that has a good basis of medical terminology and other insurance concepts. It would be extremely difficult for someone who has absolutely no background in healthcare or any exposure to medical coding.What is the hardest part of medical coding? ›
One of the most difficult aspects of medical coding is knowing the thousands of codes from numerous code sets that are updated on a regular basis.How fast can you get a coding certificate? ›
How long does it take to get a certificate in medical billing and coding? A medical billing and coding certificate often takes 4-15 months to complete. However, completion times vary by program and whether learners enroll full time or part time.What is the easiest type of medical coding? ›
What is the easiest medical coding job? Outpatient coding is generally easier than other types, as clinics tend to see more patients with the same conditions and procedures.What is the easiest coding job to learn? ›
- Junior web developer. By far, this is the most common route our coding graduates go. ...
- Junior web designer. As you might have guessed, web designers design websites. ...
- Data analyst. Data analysts, of course, analyze data. ...
- Become a freelancer.
- Figure out why you want to learn to code.
- Choose which coding language you want to learn first.
- Take online courses.
- Watch video tutorials.
- Read books and ebooks.
- Use tools that make learning to code easier.
- Check out how other people code.
- Complete coding projects.
Average starting Salary for Coder in India is around ₹1.1 Lakhs per year (₹9.2k per month).Is it hard to pass CPC exam? ›
There's no doubt about it, the CPC® exam is tough. And with new changes to the test for 2022, every single answer counts more than ever before. A variety of sources show that ONLY about 50% of coders receive the necessary 70% score to pass the CPC® Exam on the first try.What type of medical coder makes the most money? ›
What specialty in medical coding pays the most? Certified professional compliance officers earn an average of $77,190 a year, followed by certified professional coder-instructor professionals, who make $73,620. Certified documentation expert-outpatient coders also make an average annual salary exceeding $70,000.
Scope of Medical Coding in Canada
The scope of Medical Coding Jobs in Canada is significantly low because of the different structures of the health insurance system.
- Review the header of the report.
- Review the CPT® codebook (start in the Index).
- Review the report/documentation.
- Make a preliminary code selection.
- Review the guidelines (for the preliminary codes).
- Review policies and eliminate the extras.
Practice solving coding challenges regularly to improve your speed and accuracy. It can also be helpful to study common coding interview questions and practice answering them out loud. Lastly, make sure you understand basic data structures and algorithms, as they are often tested in coding challenges.How many hours a day should I practice coding? ›
People assume that one needs to invest a tremendous amount of time to learn to code, and that's actually not the case. It is true that the more time you put in, the faster you'll learn, but if you're okay with a longer timeframe, an hour a day is plenty.What are 3 skills a coder might need to have? ›
- Language acquisition.
- Innovative thinking.
- Analytical skills.
- Attention to detail.
The golden rule of healthcare billing and coding departments is, “Do not code it or bill for it if it's not documented in the medical record.” Providers use clinical documentation to justify reimbursements to payers when a conflict with a claim arises.What are five skills that coders need? ›
- Problem-Solving. ...
- A Sharp Memory. ...
- Efficient Laziness. ...
- Self-Motivation and Independence. ...
A career as a medical biller and coder can be stressful. Sometimes, the stress can be too much to handle. Having to bear so much pressure can make even the strongest people crack. If you do not deal with your stress properly, it can take a toll on you mentally and physically.What math is best for coding? ›
Binary mathematics is the heart of the computer and an essential math field for computer programming. For all mathematical concepts, the binary number system uses only two digits, 0 and 1. It simplifies the coding process and is essential for low-level instructions used in hardware programming.Would I be good at medical coding? ›
Someone who is a good fit for medical coding is academically inclined, enjoys the science of medicine, is an independent worker, and is a lifelong learner.
This 1-hour course offers education for physicians, non-physician practitioners, health care providers, medical coders, billing and claim processing personnel, and other medical administrative staff who send claims for payment using ICD-10-CM codes.What is the easiest way to find ICD-10 codes? ›
- Step 1: Search the Alphabetical Index for a diagnostic term. ...
- Step 2: Check the Tabular List. ...
- Step 3: Read the code's instructions. ...
- Step 4: If it is an injury or trauma, add a seventh character. ...
- Step 5: If glaucoma, you may need to add a seventh character.
"It depends on which part of ICD-10 you're talking about," says Engel. "ICD-10 diagnosis coding is not difficult to learn. Honestly, it's no harder than ICD-9-CM is." ICD-10 PCS, however, is another story.Is 30 too old to learn coding? ›
Let's get this out of the way: no, you are not too old to program. There isn't an age limit on learning to code, and there never was. But all too often, insecurity and uncertainty compel older adults to put a ceiling on their achievement potential.Is it too late to learn coding 25? ›
Coding is a skill that can be learned at any age. Many people who learn to code later in life go on to have successful tech careers.Is clinical coding hard to learn? ›
Medical coding can be challenging, but it's not hard for people with the right attitude and temperament. Learning medical coding systems is similar to learning new languages. Some people find this very easy, while it takes others much longer to become fluent.How long should I self study coding? ›
Most coding bootcamps last 3-4 months and teach enough coding skills to qualify graduates for entry-level coding jobs. It typically takes 6-12 months to learn to code on your own.Can I pass the CPC exam without going to school? ›
In answer to your question, you could potentially pass the exams this way, but the best way to pass these exams without obtaining a two- or four-year degree is to take the AAPC's or AHIMA's online or classroom setting preparation courses.How can I learn to code for free? ›
- Udemy. ...
- Skillcrush's FREE Coding Camp. ...
- freeCodeCamp. ...
- Khan Academy. ...
- Web Fundamentals. ...
- w3schools. ...
The medical coding process requires extensive knowledge of medical terms and procedures, as well as an understanding of the laws surrounding patient privacy (HIPAA). Medical coders must also be able to use medical coding software to translate medical information into billing codes.
The CPT terminology is the most widely accepted medical nomenclature used across the country to report medical, surgical, radiology, laboratory, anesthesiology, genomic sequencing, evaluation and management (E/M) services under public and private health insurance programs.Is a medical coding certificate worth it? ›
With the right training and a little hard work, you can conquer the challenges of medical coding and billing and land a great job at a critical time in the field. Becoming a medical coder is worth the effort it takes when you enroll in the right program.Can I become a coder in 1 year? ›
How long does it take to become a coder? It doesn't necessitate years of preparation; if you make a proper plan and follow it, the process could take as few as six months.How much does a medical coder make an hour? ›
The median average medical billing and coding salary is $46,660 per year or $22.43 per hour according to the Bureau of Labor Statistics (BLS), but many things impact how much you can earn.What is the fastest way to medical billing and coding? ›
One of the fastest online medical billing and coding programs is offered by Ashworth College. This course is completed online in your time. You can take up to one year to finish your course. However, most students complete the program in about four months.What does an RN coder do? ›
What is an RN Coder? An RN coder applies medical coding and reimbursement policies in the claims process. Nurse coders review patient charts and provide diagnosis codes based on International Classification of Diseases (ICD) or Current Procedural Terminology guidelines.How hard is it to pass medical coding exam? ›
Passing Score– To pass the Certified Professional Coder exam, you need to achieve a passing rate of 70 percent or higher. That means you must answer at least 105 questions correctly. Total 150 questions are their in CPC test. Exam results are released online in the respective candidate AAPC account, as well as mailed.Is hospital coding hard? ›
Medical billing and coding can be hard at times, but it is by no means impossible. Like many healthcare careers, becoming a medical biller and coder will take education and training. In other words, it will take hard work. You cannot become a great medical coder or biller overnight.Can a coder code from a nurses documentation? ›
Tips for Writing Comprehensive Clinical Notes
Specify the patient's condition correctly to ensure correct coding. Codes can be assigned for documentation by physicians, nurse practitioners and physicians' assistants, but information in nurses' notes cannot be coded.
Making the transition from nurse to medical coder is more common and natural than you think. For some nurses, medical coding becomes a natural career progression that wasn't planned. The nurse sees there is a need to help patients through accurate coding and billing of medical claims, learns how, and fills in to help.
To become a medical coder with no experience, you need to have several qualifications. These include having a high school diploma or a GED certificate, good observational skills, and strong technical ability with basic software, such as spreadsheet and medical coding software.What is an RN coding auditor? ›
Your responsibilities include assessing medical records to decide whether there is a valid reason for treatment or denial of care and ensure that the quality of patient care abides by health care policies and standards. In some cases, an RN chart auditor speaks with healthcare providers to verify the information.What should a nurse do during a code? ›
PRIMARY NURSE – calls the code, provides chest compressions until relieved, gives information to Team Leader about the patient, reviews the chart – orders, advanced directives, last labs and vital signs, etc.What does a nurse do when a patient codes? ›
Managing a code blue as a nurse includes activating the code, sharing clinical information with the team, performing chest compressions, monitoring, and evaluating the code blue process. A code blue is activated whenever a patient or someone is found unconscious, not breathing or without a pulse.Do medical coders have to memorize? ›
First, it's important to know that medical coders don't actually have to memorize all of these codes. Instead, they utilize reference codebooks and software programs to ensure accurate coding assignments are made.What is a day in the life of an RN medical coder? ›
A typical day in the life of a medical coder involves translating information provided by a healthcare provider into medical code. These code are then sent to the medical biller and streamline the process of medical coverage. Below is a more detailed list of what they do. Review patient information.Which coding certification is best? ›
The Certified Professional Coder (CPC) certification offered by the American Academy of Professional Coders (AAPC) is the most popular medical billing and coding certification students pursue.Does medical coding require math? ›
Medical billing and coding specialists should have a basic understanding of how to do simple accounting math. This is necessary for keeping track of the cost of a service and balancing it against the amount that the care facility had to pay to provide it.Is the CPMA exam hard? ›
CPMA certification exam is a difficult, high-level examination and is not intended for individuals lacking training or experience. Certified coders should have CPMA training and/or experience in auditing physician services — and preferably be well versed in different types of audits, including E/M.How do you complete a coding audit? ›
- Step 1: Determine What Types of Records to Review.
- Step 2: Determine Volume of Records and Frequency to Review.
- Step 3: Analyze Results.
- Step 4: Corrective Action and Training.
- Step 5: Get a Fresh Set of Eyes. CMS and the OIG recommend regularly having your coding audited by an outside reviewer.
Certified Professional Coder (CPC ®) Certification
AAPC offers online and in-person proctored exams. Choose to take the exam at home in a quiet, private location or through your local chapter or a licensed instructor. Learn more about the online proctored exam and how to prepare for the current exam.