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Transitioning From Clinical to Administration

A shift is required

Transitioning into the coding field as a nurse has its perks, but it also comes with it’s downfalls. You see, a nurse is in a very unique position because they understand A&P, medical terminology, and the disease process from a clinical standpoint.

However, coders approach those same concepts but in a very different way, coders are making sure that everything has been done correctly and according to the billing guidelines. Whereas nurses may approach it from a treatment standpoint.

For example, a patient is seen in the provider’s office for lumbago, and the provider has decided to give them an ESI for the lumbago, he documents the procedure and from a coding standpoint we have everything that we need in the report in order for us to code it and bill it.

However, a nurse may come in and question why the provider performed an ESI so quickly without providing conservative treatment. All of this is good especially as it relates to prior authorization, however, from a coding standpoint it’s not really needed unless the claim has been denied or you know for sure that it will be denied, based off of the payers’ guidelines.

This is just one example of a small hurdle a nurse may face when transitioning into a coding role, however, it only takes a shift in the way the nurse approaches the medical record and he or she will be a coding superstar in no time.

I hope that this information was helpful, as always feel free to reach out to me for a coaching session, I am happy to assist in anyway that I can.

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