Generalist Coders – A Fallacy

There is no such thing as a coder who knows it all. If your coder claims to be able to code every specialty, and you let them, you might want to get your checkbook ready to pay back some recoupments.  There are over 70,000 ICD-10 codes and 10,000 CPT codes. The wealth of knowledge is simply too vast for one person to be able to accurately code multiple specialties and maintain an acceptable level of accuracy.  Just as doctors specialize because there is simply too much to know about the human body and the selective area of focus they pursue, coders need to take the same considerations into place while specializing.  Coding isn’t solely the application of various codes, it requires the coder to possess an in-depth knowledge of anatomy, physiology, and procedures.

A patient needing a knee replacement wouldn’t go to a urologist nor would a patient with a bladder issue go to an orthopedist.  Yes, the urologist learned about knees and orthopedics in medical school and as such would have a rudimentary understanding of the specialty.  However, they haven’t had the higher level training and deliberate repetitive practice to become an expert in the field of orthopedic surgery.

Similarly, a coder has to learn a little bit of every specialty in order to pass their certification exam.  However, in order to truly master a coding specialty they need to immerse themselves in that field.  There isn’t time for one person to do deep dives across a multitude of specialties while keeping abreast of all the changes and updates on top of maintaining a knowledge of all the specific rules and guidelines that each payor has in place.  If I’m a provider I would want someone who has the same level of specialization that I have coding my cases, not someone jumping from specialty to specialty with surface level knowledge of each field.

Asking a coder who is unfamiliar with a specialty to start coding in that discipline because they are an expert elsewhere is asking for compliance and revenue troubles down the line. It might require a bit more effort to have coding specialists in each field, but down the line you’ll be thankful that you did.

More Coding jobs in Coding Jobs

Translate »