certified medical records coder Interview Questions and Answers

1. What is the difference between ICD-10 and ICD-9 coding systems?

   • Answer: ICD-10 is a more detailed and comprehensive diagnostic coding system compared to ICD-9. It uses alphanumeric codes (letters and numbers) with more specific codes for diseases and injuries, allowing for better tracking of disease trends and improved data analysis. ICD-9 used primarily numeric codes and was less granular.

2. Explain the importance of medical coding accuracy.

   • Answer: Accurate medical coding is crucial for accurate reimbursement from insurance companies, proper disease tracking and public health monitoring, research, and maintaining the integrity of the healthcare system. Inaccuracies can lead to financial losses for healthcare providers, misrepresentation of disease prevalence, and hindering effective healthcare planning.

3. What are the different types of medical coding systems?

   • Answer: Common medical coding systems include ICD (International Classification of Diseases) for diagnoses, CPT (Current Procedural Terminology) for medical procedures, HCPCS (Healthcare Common Procedure Coding System) for procedures and supplies, and others like SNOMED CT (Systematized Nomenclature of Medicine - Clinical Terms) which provides a comprehensive clinical terminology.

4. Describe your experience with CPT coding.

   • Answer: [Candidate should detail their experience with CPT coding, including specific procedures they've coded, any challenging cases they've encountered, and how they resolved them. Example: "I have extensive experience coding CPT codes for surgical procedures, particularly in orthopedics. I am proficient in understanding modifiers and their application, and I've successfully navigated complex cases involving multiple procedures and bundled services."]

5. What are some common challenges you face as a medical coder?

   • Answer: Common challenges include incomplete or unclear medical documentation, staying updated with coding changes and guidelines, managing high volumes of charts within deadlines, dealing with complex cases requiring in-depth knowledge, and ensuring compliance with regulatory requirements.

6. How do you stay up-to-date with changes in medical coding?

   • Answer: I stay current through continuous professional development, subscribing to industry publications (e.g., AAPC, AHIMA journals), attending webinars and conferences, and actively participating in professional organizations.

7. Explain the concept of medical coding compliance.

   • Answer: Medical coding compliance refers to adhering to all applicable laws, regulations, and guidelines related to medical coding practices. This includes following proper coding conventions, using accurate codes, and maintaining meticulous documentation to prevent fraud and abuse.

8. What are some common coding errors?

   • Answer: Common errors include using outdated codes, incorrect sequencing of codes, missing necessary codes, upcoding (assigning a higher-paying code than appropriate), downcoding (assigning a lower-paying code than appropriate), and failing to use appropriate modifiers.

9. How do you handle ambiguous or incomplete medical documentation?

   • Answer: When faced with ambiguous documentation, I first attempt to clarify the information with the physician or other relevant personnel. If clarification is impossible, I document my attempts to obtain the necessary information and code to the best of my ability based on the available details, using caution and flagging the record as potentially incomplete.

10. What is your experience with Electronic Health Records (EHR) systems?

    • Answer: [Candidate should describe their familiarity with specific EHR systems and their experience extracting information from them for coding purposes. Example: "I have extensive experience using Epic and Cerner EHR systems. I am proficient in navigating these systems to locate relevant documentation for accurate coding." ]

11. Describe your experience with auditing medical records.

    • Answer: [Candidate should describe their experience with auditing, including identifying coding errors, suggesting corrections, and contributing to improving coding accuracy and compliance. Example: "I have conducted internal audits to identify areas for improvement in coding accuracy and compliance. This involved reviewing a sample of charts, identifying discrepancies, and providing feedback to coders."]

12. How do you handle conflicting information in a medical record?

    • Answer: When conflicting information exists, I attempt to resolve the discrepancy by reviewing the entire record to determine the most accurate representation of the patient's condition and treatment. If unable to resolve, I consult with a supervisor or the physician to clarify the information.

13. What is the role of modifiers in medical coding?

    • Answer: Modifiers provide additional information about a procedure or service, clarifying circumstances such as the location of service, the type of anesthesia used, or the reason for a procedure. They are essential for accurate reimbursement.

14. Explain the concept of unbundling and bundling in medical coding.

    • Answer: Unbundling is the improper practice of billing separately for individual components of a service that should be bundled into a single code. Bundling is the appropriate practice of grouping multiple procedures or services into a single code when they are performed together as a single comprehensive procedure.

15. What are your strengths as a medical coder?

    • Answer: [Candidate should list their key strengths, such as attention to detail, accuracy, knowledge of coding guidelines, ability to work independently and as part of a team, problem-solving skills, and time management skills.]

16. What are your weaknesses as a medical coder?

    • Answer: [Candidate should provide a genuine weakness and explain how they are working to improve it. Example: "I sometimes struggle with time management when faced with a high volume of charts. To address this, I am actively working on implementing better prioritization techniques and utilizing time management tools."]

17. Why are you interested in this position?

    • Answer: [Candidate should articulate their genuine interest in the position and company. Example: "I am interested in this position because of [company's] reputation for excellence and its commitment to accuracy in medical coding. I am eager to contribute my skills and experience to a team dedicated to providing high-quality medical coding services."]

18. What are your salary expectations?

    • Answer: [Candidate should provide a salary range based on research and their experience. Example: "Based on my research and experience, I am seeking a salary in the range of $[lower bound] to $[upper bound]".]

19. What is your preferred work environment?

    • Answer: [Candidate should describe their ideal work environment, emphasizing factors like teamwork, collaboration, opportunities for professional growth, and a supportive atmosphere.]

20. Describe a time you had to deal with a difficult coworker.

    • Answer: [Candidate should describe a situation and how they handled it professionally, focusing on their ability to maintain positive working relationships.]

21. Describe a time you made a mistake. How did you handle it?

    • Answer: [Candidate should describe a specific situation, focusing on taking responsibility, learning from the mistake, and implementing corrective actions to prevent future errors.]

22. How do you prioritize tasks when you have multiple deadlines?

    • Answer: [Candidate should describe their approach to prioritization, perhaps mentioning techniques like using a task management system, prioritizing tasks based on urgency and importance, and effective time management strategies.]

23. What is your experience with different types of healthcare settings? (e.g., hospitals, clinics, physician offices)

    • Answer: [Candidate should describe their experience across various healthcare settings, highlighting relevant experience in coding specific to those settings.]

24. What is your understanding of HIPAA regulations and their relevance to medical coding?

    • Answer: HIPAA (Health Insurance Portability and Accountability Act) is a US law protecting patient health information. In medical coding, it requires coders to maintain patient confidentiality and follow strict guidelines for handling and securing Protected Health Information (PHI).

25. How do you handle pressure and stress in a fast-paced environment?

    • Answer: [Candidate should describe their coping mechanisms for handling stress, such as prioritizing tasks, time management techniques, taking breaks, and maintaining a positive attitude.]

26. Are you comfortable working independently and as part of a team?

    • Answer: Yes, I am comfortable working both independently and collaboratively as part of a team. I can work efficiently on my own and I thrive in collaborative environments where I can share knowledge and learn from others.

27. What software and tools are you proficient in using?

    • Answer: [Candidate should list relevant software and tools, such as specific coding software, EHR systems, spreadsheet software, and any other relevant tools.]

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