Medical Coding Interview Questions and Answers - 2

6. When are HCPCS Modifiers used?

HCPCS modifiers are used when you want to provide extra information about some service or procedure performed on the patient. Using these codes you can -

i) Specify the area of the body which went through the procedure

ii) If there were multiple procedures carried out in the same visit

iii) If a procedure was discontinued for some reason etc.

7. What are DRG Codes?

DRG stands for Diagnostic Related Group. This system classifies hospital cases into one of approximately 500 set groups. These are used to code only inpatient claims. Since many insurers pay only according to these classifications, it is very important to get them right.

Every DRG has a payment weight attached to it and is affected by factors like geographic location, cost of living, number of low income patients, if this particular case is costly etc.

8. How is Medical Coding used in the practical world?

Medical coding is done not just for fun. It is something critical to both the financial aspect of the business and provides figures to WHO and governments to run combat programs against various kind of medical conditions.

i) Medical claims are paid by the insurance companies based on medical codes received by them.

ii) They help in billing process.

iii) Analyzing disease patterns in a society becomes easier with these codes which helps the governments in running the combat programs etc.  

iv) They provide the statistics for national and regional health and death cases.

9. What are some of the guidelines and tips you would give to a new medical coder who comes to work under you?

Some of the tips and guidelines to work on a medical coding assignment are:

i) Code what is documented. Make sure that your code is consistent with the medical record provided by the physician. Don’t add anything from your side and also don’t miss out anything .

ii) Report codes in the right order – The first code has to be the specific reason for a patient’s visit to the hospital.

iii) Follow NCCI and MUE guidelines closely to prevent prevents arising out of coding errors.

iv) The coding conventions might change. To be relevant, it is important to stay updated.

v) Make use of appropriate modifiers whenever necessary but stay cautious of the overused or incorrectly used modifiers.