In recent years, there has been a huge increase in demand for people who can code medical records. This is because healthcare is changing and accurate coding is becoming more important. As healthcare companies try to stay in compliance, make the most money, and run their businesses more efficiently, medical coders play a big part in their success. To find and hire skilled medical coders, HR professionals and CXOs who are involved in the hiring process need to know about the changing trends in this field.
Recent research shows that the need for medical coders has been steadily growing, and it is expected to continue growing at a rate of X% per year for the next five years. This rising need shows how important it is to know how the medical coding field works and to ask the right interview questions to find qualified people who can help the company succeed.
Landing a job as a medical coding specialist can be competitive You’re up against other qualified candidates who also want to launch or advance their career in this booming healthcare field That’s why it’s essential to thoroughly prepare for the interview to stand out from the crowd.
In this comprehensive guide, we’ll explore some of the most common and critical medical coding interview questions you’re likely to encounter. We’ll provide example answers to help you craft thoughtful, professional responses that highlight your skills and experience.
Ready to ace that upcoming medical coding specialist interview? Let’s dive in.
What is Medical Coding and Why is it Important?
Medical coding is the process of translating clinical documentation from doctors, nurses, and other healthcare providers into universal medical code sets. These include:
- ICD codes – International Classification of Diseases codes used to classify diagnoses and procedures
- CPT codes – Current Procedural Terminology codes that represent medical services like lab tests, surgeries, and healthcare provider visits
- HCPCS codes – Healthcare Common Procedure Coding System codes used primarily for supplies and equipment
Accurate coding is crucial for
- Ensuring correct reimbursement from insurance companies
- Maintaining detailed patient records and medical histories
- Collecting healthcare data for analysis of disease patterns, treatment outcomes, etc.
- Complying with healthcare regulations and medical coding guidelines
Critical Skills for Medical Coding Specialists
Interviewer: What are the most important skills that a medical coding specialist should possess?
Solid medical coding requires an intricate blend of hard and soft skills. Here are some of the most critical ones:
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An eye for detail – Meticulousness and precision are absolute must-haves. Coding requires extreme attention to detail since minor errors can have major consequences.
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Medical terminology knowledge – Fluency in medical terms is crucial for accurately translating clinical documentation into codes.
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Analytical ability – Reviewing patient records, identifying relevant details, and determining the right codes requires strong analytical skills.
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IT proficiency – Using coding software and navigating electronic health record systems is a core task, so tech skills are vital.
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Organization – Juggling multiple coding tasks and projects demands top-notch organizational abilities.
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Teamwork – Collaborating with nurses, doctors, and fellow coders is integral. Strong teamwork skills make you a valued contributor.
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Communication skills – Frequent interactions with care providers mean communication skills are essential for clarifying documentation.
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Adaptability – The field evolves rapidly. You must be able to adapt to changes in coding guidelines and tech systems.
Key Medical Terminology for Coding Specialists
Interviewer: Can you share some examples of common medical terminology relevant for a coding specialist?
Here are some key terms and phrases coding specialists need to understand:
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Signs vs. symptoms – Signs are observable evidence like lab results or rashes while symptoms are subjective feelings reported by the patient.
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Morbidities vs. mortalities – Morbidities refer to diseases or conditions while mortalities indicate deaths.
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Acute vs. chronic – Acute conditions are short-term while chronic ones are long-lasting.
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Congenital vs. hereditary – Congenital means present at birth while hereditary indicates passing genetically from parents to children.
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Iatrogenic – Caused inadvertently by medical treatment or diagnostic procedures.
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Comorbidities – Co-existing diseases or conditions often indicated with secondary diagnosis codes.
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Present on Admission (POA) – Indicates a condition was present when the patient was admitted to the healthcare facility.
Fluency in terminology like this is imperative for medical coders to ensure accuracy.
Understanding ICD Codes
Interviewer: Could you please explain what ICD codes are and how they are used?
ICD codes, short for International Classification of Diseases codes, are a standardized system to classify medical diagnoses and procedures. There are two key types:
ICD-10-CM codes – Used to specify medical diagnoses like diabetes, asthma, and so on. The CM stands for Clinical Modification.
ICD-10-PCS codes – Denote procedures like surgeries, evaluations, and medical tests. PCS means Procedure Coding System.
Some key points about ICD codes:
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Maintained by the WHO and updated annually.
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Mandatory for Medicare/Medicaid reimbursement claims in the US.
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Indexed alphabetically with related diagnoses grouped by body system or condition.
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Used by coding specialists to translate diagnosis terminology in clinical notes into standardized codes.
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Enables easy retrieval of health data for analytics and research.
HCPCS Coding Essentials
Interviewer: Could you walk me through some basics of HCPCS coding?
Absolutely. HCPCS stands for Healthcare Common Procedure Coding System. It is a standardized code set maintained by CMS or the Centers for Medicare and Medicaid Services. HCPCS codes primarily represent:
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Medical services – Like ambulance transportation, durable medical equipment rentals, prosthetics, etc.
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Medical supplies – Such as surgical dressings, stents, implants, wheelchairs.
Here are some key facts about HCPCS:
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Uses 5-digit numeric codes along with optional 2-digit modifiers.
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Updated annually to add new codes and terminology.
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Consists of two levels – Level I contains CPT codes while Level II contains supplemental codes for specialized services, equipment, and supplies.
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Vital for billing to Medicare and generating healthcare data.
As a coding specialist, having a strong working knowledge of HCPCS codes is essential for capturing all healthcare services accurately.
When To Use HCPCS Modifiers
Interviewer: Could you explain when HCPCS modifiers would need to be used?
HCPCS modifiers are 2-digit codes added to the main 5-digit HCPCS code to indicate additional details about the healthcare service. Here are some common instances when modifiers help capture specifics:
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To specify left or right side of the body when coding procedures.
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When coding for bilateral procedures.
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To report multiple procedures performed during the same session.
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To identify discontinued or reduced services.
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To indicate distinct procedural services normally bundled together.
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To report devices furnished by external suppliers rather than the healthcare provider.
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To specify unusual clinical circumstances related to a service.
So in essence, HCPCS modifiers add an extra layer of nuance and precision when standard codes alone can’t fully convey the unique circumstances. They are vital for telling the complete procedural story.
Understanding DRGs in Coding
Interviewer: Could you please explain DRG or Diagnosis-Related Group codes?
Of course. DRG or Diagnosis-Related Group codes are a way of standardizing and grouping inpatient medical cases for the purposes of payment reimbursement. Here are some key facts:
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DRGs assign inpatient cases requiring hospitalization to groups based on diagnosis, procedures performed, complications, and other factors.
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This enables hospitals to get bundled payments that cover the entire patient stay instead of separate fees for each service.
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DRGs aim to incentivize cost-effective treatment since hospitals retain savings if patient care costs less than the lump payment.
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DRG codes require reviewing the entire medical record, from admission to discharge, to accurately reflect resource utilization.
As a coder, familiarity with DRG assignment rules is important for inpatient facility coding and determining appropriate reimbursement levels. The goal is to maximize reimbursement through accurate DRG coding while also ethically capturing the true patient story.
Audit Flags in Medical Coding
Interviewer: What types of things may raise red flags during a medical coding audit?
Several factors can draw auditors’ attention. Here are some noteworthy examples:
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Upcoding – Assigning codes for more complex conditions than justified by medical records.
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Unspecified codes – Overuse of vague diagnosis codes instead of more precise ones.
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Inconsistent coding – Contradictions between diagnosis codes and documented procedures.
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Cloned or copied notes – Identical descriptions for different patients and encounters. Lacks individualization.
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Overutilization – Billing for medically unnecessary treatments or excessive services.
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Fragmented billing – Splitting a single session into multiple bills.
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Diagnosis sequencing errors – Listing diagnosis codes in the wrong hierarchical order.
Being mindful of these red flags can help improve documentation and coding practices. It enables proactive self-auditing to identify potential issues early.
Handling Coding Errors
Interviewer: Could you walk me through your process for handling
5 sample answers to behavioral interview questions for the Medical Coder
- Tell me about a time when you had to deal with a very difficult coding situation. How did you approach it, and what was the outcome?.
Look for: the ability to solve problems, the skill to handle difficult coding situations, and a good result through smart coding techniques.
Answer Example: “In a previous job, I had to deal with a complicated coding situation involving a patient who had several long-term illnesses.” The documentation was incomplete, making it challenging to assign accurate codes. I proactively reached out to the physician and requested additional details to ensure accurate coding. After careful review and research, I applied the appropriate coding guidelines and assigned the necessary codes. The outcome was successful, with accurate coding that reflected the patient’s conditions and led to appropriate reimbursement. ”.
- Can you think of a time when you had a big problem with coding or a disagreement with a doctor or other healthcare professional? What did you do?
Look for: Communication skills, the ability to collaborate, and professionalism in resolving coding disagreements.
Example Answer: “I had trouble with coding when I didn’t agree with a doctor about how complicated a certain procedure was.” Instead of making things worse, I politely approached the doctor and showed him my research and supporting documents to back up my coding suggestion. We engaged in an open dialogue, discussed the coding guidelines, and ultimately reached a mutual understanding. The key was maintaining professionalism and effectively communicating my rationale, which resulted in a collaborative resolution. ”.
- Tell me about a time when you messed up while coding. How did you figure out you were wrong, and what did you do to fix it?
Look for: Accountability, attention to detail, and the ability to take corrective actions when mistakes occur.
Example Answer: “Once, I inadvertently assigned an incorrect diagnosis code due to misinterpreting the physician’s notes. Upon realization, I immediately notified my supervisor and initiated an internal audit to identify any potential similar errors. I contacted the healthcare provider to get more information about the paperwork, fixed the code, and made changes to the patient’s record. To stop mistakes from happening again, I made a list to make sure that codes were correct and set up a peer review system for difficult cases. ”.
- Give an example of a time when you had to finish a coding project quickly. How did you decide which tasks to do first and make sure they were done correctly when time was of the essence?
Look for: Time management skills, the ability to handle pressure, and maintain accuracy under tight deadlines.
Example Answer: “At my last job, I had to deal with a coding project that had to be finished faster than planned because of unplanned events.” To figure out what to do first, I looked at how important each case was, put the most important patient records at the top of the list, and set aside time for coding and checking. I maintained my attention to detail by leveraging coding templates and established processes. Even though I was pressed for time, I made sure everything was correct by doing regular self-checks and a final review before turning it in. I met the deadline and kept the quality of the code. ”.
- Why did you have to change the way you coded something because of changes in the rules or guidelines? How did you make sure the change went smoothly? What did you do to keep up with the changes?
Look for: Adaptability, willingness to learn, and proactive efforts to stay updated with coding guidelines and regulations.
“When switching from ICD-9 to ICD-10, I knew I would need to learn new things and make the change go smoothly.” To fully understand the new coding system, I went to training sessions, webinars, and read the coding manuals over and over again. I also engaged in discussions with colleagues, joined professional coding associations, and actively followed industry publications. This proactive approach helped me easily change how I coded to follow the new rules, which led to accurate and legal code. ”.
5 sample answers to personality interview questions for Medical Coder
- What do you do when you have a lot of work to do and little time to do it?
Look for: Time management skills, the ability to handle pressure, and maintain quality under demanding circumstances.
When I have a lot of work to do and little time to do it, I prioritize tasks by how important they are and how hard they are to do. I break down the work into smaller, manageable chunks and create a schedule or checklist to stay organized. I maintain open communication with my team or supervisor to ensure a clear understanding of expectations and deadlines. When this happens, I stay focused, make good use of my time, and use any resources or tools I can find to keep the quality of my coding work high. ”.
- Can you think of a time when you had to work with someone else or a team to complete a coding task? What steps did you take to help the team succeed?
Look for: Collaboration skills, teamwork, and the ability to work towards a shared objective.
Answer Example: “In my last job, I worked with a group of coders, doctors, and billing experts to set up a new way to code for a specialized service line.” I actively participated in team meetings, providing input and insights based on my coding expertise. I also made it easy for team members to talk to each other and answered any questions or concerns they had about coding rules and documentation requirements. We were able to successfully implement the new coding process because we worked together. This led to higher accuracy, easier billing, and more money for the organization. ”.
- How do you make sure that your coding work is accurate and pays attention to detail? Can you give an example of a time when your attention to detail made a big difference?
Look for: Strong attention to detail, commitment to accuracy, and the ability to provide specific examples.
Example Answer: “In medical coding, attention to detail is very important, and I have developed a methodical way to make sure accuracy.” I carefully review medical documentation, cross-reference information, and verify codes against coding guidelines and regulations. I also perform regular self-audits to catch any potential errors or discrepancies. One time my attention to detail paid off was when I found a mistake in the coding while doing a regular audit. By fixing the mistake right away, we avoided possible billing problems and made sure that the patient’s record correctly showed the services that were given. ”.
- How do you make sure that your coding skills and knowledge are always getting better? Can you give an example of how you actively looked for ways to grow?
Look for someone who is dedicated to their professional development, eager to learn, and eager to keep up with changes in the field.
Example Answer: “I believe in the importance of continuous improvement in the rapidly evolving field of medical coding. I actively take part in coding workshops, webinars, and online forums to stay up to date on coding guidelines and industry trends and to improve my skills and knowledge. Additionally, I am a member of professional coding associations and regularly read coding publications. As an example of looking for ways to grow, I got an advanced certification in a specific area of coding that was useful for the healthcare organization where I worked. This certification not only helped me learn more, but it also made it easier for me to code complicated cases in that specialty. ”.
- When things change or get hard in the healthcare industry, how do you keep a positive attitude and be able to adapt?
Look for: Positive mindset, adaptability, and resilience in response to industry changes and challenges.
Example Answer: “I understand that the healthcare industry is dynamic, and changes are inevitable. To maintain a positive attitude, I focus on embracing change as an opportunity for growth and professional development. I stay up to date on changes in the industry and am always looking for ways to understand why coding guidelines or regulations are changing. I also maintain open communication with colleagues and superiors, fostering a collaborative environment to navigate challenges together. By keeping an open mind, I can quickly change how I code to meet new needs and make sure I’m following the rules while still producing high-quality code. ”.
INTERVIEW TIPS AND ADVICE FOR NEW MEDICAL CODERS | MEDICAL CODING WITH BLEU
What questions should you ask a medical coding specialist?
Most interviews will include questions about your personality, qualifications, experience and how well you would fit the job. In this article, we review examples of various medical coding specialist interview questions and sample answers to some of the most common questions. What inspired you to pursue a career in medical coding?
How to write a medical coding interview?
Furthermore, if you’re an experienced medical coder, you should go through your resume and ensure that you can answer all the questions related to your experience, job role, and your responsibilities at your previous company well. Hiring managers also ask several medical coding interview questions that cover the behavioral aspect.
What does a medical coding specialist do?
Accuracy is a cornerstone in the medical coding profession. As a medical coding specialist, your work directly impacts the financial health of your organization and the care that patients receive. This question is designed to assess your attention to detail, your ability to identify errors, and your problem-solving skills to correct them.
What skills do medical coding professionals need?
The question is posed to gauge your technical skills and familiarity with electronic health record systems. Medical coding professionals play a significant role in maintaining patient records and ensuring their accuracy. Proficiency in EHR systems is necessary for efficient and accurate work.
