In this insightful edition of the DocScopy segment on MedBound Times, Dr. Nirainila Joseph interviews Dr. Nithyadharshini Devakumar, a dentist who has transitioned into a successful career in medical coding. Dr. Nithyadharshini graduated with BDS degree from Tamil Nadu Government Dental College and Hospital in Chennai, India.
In this interview, she shares her motivations for switching career paths, the essential skills and certifications required for medical coding, and the significant impact of medical coders on patient care and healthcare systems. Nithyadharshini also discusses her future aspirations, offering valuable advice for others considering a similar transition. This discussion sheds light on the dynamic career opportunities in healthcare beyond traditional clinical roles.
Dr. Nirainila Joseph: Please introduce yourself to our readers.
Dr. Nithyadharshini Devakumar: This is Nithyadharshini Devakumar, a dentist who graduated from Tamil Nadu Government Dental College. I am currently working as a medical coder in Optum Health and Technology.
Dr. Nirainila Joseph: Medical coding has become a hot topic in the job market. Can you explain what medical coding is in simple terms for someone who has never heard of it before? Are there different types of medical coding, and what do they represent?
Dr. Nithyadharshini Devakumar: Medical coding is the transformation of healthcare diagnoses, procedures, medical services, and equipment into universal medical alphanumeric codes. These standardized codes are used by private or government sectors (US) to derive medical information for public health purposes and by insurance companies for reimbursement to the payers. There are many types of coding related to hospital setup such as E&M, inpatient coding, risk adjustment coding, specialty coding and much more and each of them serves its uniqueness and advantages.
Dr. Nirainila Joseph: Can you describe your journey from being a dentist to working as a medical coder? What motivated you to transition from clinical practice to medical coding?
Dr. Nithyadharshini Devakumar: I was working in a private clinic as a Junior dentist after my graduation. The worst part is that I needed to work all days a week with a low salary which kept stressing me out. Then when COVID hit, the clinic closed and I had nowhere to go for a job. During that time, I looked for a remote job that I could pursue with my medical knowledge.
There came this MEDICAL CODING which is an underestimated job in everyone's understanding as far as I know. This job helped me to work during COVID times and I eventually felt comfortable in this job. The main advantages over dentistry (if you don't own your clinic) are better pay, good work-family balance, and mandatory weekends off. I chose medical coding as my core since I got everything I needed.
Dr. Nirainila Joseph: I believe many new dentists share the same feelings about their careers, making your insights especially valuable. It's eye-opening to hear how medical coding provided you with job stability during such challenging times. How has your background in dentistry influenced your approach to medical coding and understanding of chronic medical conditions?
Dr. Nithyadharshini Devakumar: As I am already bagged with enough medical knowledge, it helps me to crack the code effectively as I know what those medical conditions are and how they affect the patient's health. Even though you can trace the code using guidelines, knowing the actual medical condition fastens the process in a much more effective way.
Dr. Nirainila Joseph: Your answer highlights how your dental degree has given you a helping hand in medical coding. Now, can you explain your current role as a medical coder and what your day-to-day responsibilities entail?
Dr. Nithyadharshini Devakumar: I am currently working as a medical coder in Risk adjustment coding (HCC coding). Risk-adjustment coding is an end-to-end coding system that is used by payers to forecast medical costs by the patient, specifically patients with complex medical conditions and multiple chronic conditions. We code the medical health records of an individual in a very confidential manner using standardized International Classification of Diseases (ICD) guidelines and HCC tools.
Dr. Nirainila Joseph: What tools and software do you use for medical coding and how do you stay proficient in using them?
Dr. Nithyadharshini Devakumar: We use HCC tools, Salesforce, Optum 360, ICD guidelines, CPT codes, and HCPS for risk adjustment, depending on the type of coding or the company we are based in. To maintain proficiency in coding, we need to be certified professional coders (CPC certified), which requires passing and continuously renewing our certification through continued education to stay updated with current trends. Depending on the coding company, various other certifications (AAPC, AHIMA, CIC, etc.,) can also be pursued.
Dr. Nirainila Joseph: To stay ahead in careers, you need to be up to date. How do you keep yourself updated with the latest coding guidelines and regulations in medical insurance?
Dr. Nithyadharshini Devakumar: The standardized dictionary we use for medical coding is the ICD guidelines which is important because it provides a common language for recording, reporting, and monitoring diseases. The ICD guidelines are revised each year in October by the World Health Organisation (WHO) and currently ICD 11 version is in use.
Dr. Nirainila Joseph: From your experience, what skills do you believe are essential for someone working in medical coding and risk adjustment? Looking back, are there any skills you honed in dentistry that you find most valuable in your coding work?
Dr. Nithyadharshini Devakumar: You can enter the field of medical coding with any science-related background and a basic understanding and knowledge of human anatomy. All we should do is stay updated with the current guidelines to step up the ladder in coding. Only my medical knowledge gained in dentistry has helped me here.
Dr. Nirainila Joseph: What are some of the common challenges you face in your role, and how do you overcome them?
Dr. Nithyadharshini Devakumar: The challenge in coding is to trace the accurate codes based on medical records which might be difficult because we should analyze the trueness of the medical conditions of that patient (all symptoms of that condition and supporting documents). As a dentist, I easily overcame this hurdle using my medical skills in coding.
Dr. Nirainila Joseph: Being a dentist and a medical coder, why do you think medical coding important in the healthcare industry?
Dr. Nithyadharshini Devakumar: Yes! Here it comes. Not everyone is stuffed with medical knowledge especially insurance companies or non-medical professionals but this medical coding helps to translate medical conditions into universal language (alphanumeric codes) which can be understood by insurance companies for claiming purposes and for various medical research or studies.
Dr. Nirainila Joseph: How do you see the field of medical coding evolving in the next few years? Are there any emerging technologies that you believe will create new opportunities or challenges for medical coders?
Dr. Nithyadharshini Devakumar: The healthcare industry is constantly changing especially in the US where medical coding is used by insurance companies. Since there are declining reimbursements and the rising cost of hospital care due to the increase in the cost of supplies post-COVID, medical coders are now becoming lifelines for processing complex reimbursement processes. Therefore experienced medical coders are always in demand.
As AI evolution increases, this might become challenging to coders but since we should analyze and make decisions based on medical records, the human brain is much more needed than AI or machine learning.
Dr. Nirainila Joseph: That encapsulates the fundamental importance of medical coding in healthcare. How does your role as a medical coder contribute to patient care specifically?
Dr. Nithyadharshini Devakumar: As a medical coder, we ensure that patients receive accurate diagnoses and treatments for which they get their reimbursement accurately. This work again helped me to indirectly provide health care to patients in need.
Dr. Nirainila Joseph: It's nice to know that through medical coding, you're still contributing to patient care indirectly. Could you explain how medical coders contribute to the evolving healthcare landscape?
Dr. Nithyadharshini Devakumar:
With the aging population and chronic health conditions getting high in the US, coding helps to deliver accurate medical diagnoses and the quality of cost they get for their treatment.
Since healthcare mode has changed after COVID, with telehealth or home health care making reimbursement complicated. Thus coders help to maintain standard guidelines to provide proper care to patients both in terms of health and cost needs there.
Dr. Nirainila Joseph: On a personal note, what have been the most significant differences between your career in dentistry and your current role in medical coding? What aspects of your work as a medical coder do you find most rewarding compared to your previous role as a dentist?
Dr. Nithyadharshini Devakumar: As I said earlier, the main thing switching from dentistry to medical coding is the work-life balance which I could find easily in the latter, where I could work remotely and 8 hours a day with weekends off. Dentistry was stressing me out as some skills needed were not a cakewalk for me and skills in which I excelled like theoretical knowledge helped me get a good position in medical coding. Another thing working in a private dental clinic does not provide PF or insurance, which we need to protect our family. But I could avail these benefits in corporate companies.
Dr. Nirainila Joseph: Even though you've shifted your career base to medical coding now, how do you maintain your connection to the dental field? Also do you see yourself returning to clinical practice in the future?
Dr. Nithyadharshini Devakumar: As I have completely moved to medical coding, I get connected with dentistry through my clinician friends and Google updates. To answer your second question, I don't find myself returning to dentistry as I am good with what I need for my work satisfaction in medical coding.
Dr. Nirainila Joseph: Considering your own experience transitioning from dentistry to medical coding, what advice would you give to other healthcare professionals who might be considering a similar career shift?
Dr. Nithyadharshini Devakumar: Medical coders must be accurate, responsive, and organized to address each claim and leave no condition undiagnosed. They must prepare for the future changes expected in the industry, such as ICD-11 implementation and the origin of new diseases and possible epidemics.
Dr. Nirainila Joseph: What resources or training programs do you recommend for those interested in pursuing a career in medical coding?
Dr. Nithyadharshini Devakumar: Medical coders can get help from thousands of online resources that will help them prepare for a successful career. CPC certification from AAPC and CCS certifications from AHIMA would be excellent places to begin your certification journey.
Dr. Nirainila Joseph: That was insightful! Can you elaborate on the current job opportunities available in medical coding?
Dr. Nithyadharshini Devakumar: There is increased demand for medical coders after COVID as the need for healthcare has increased many folds and affected millions of patients. This has opened huge job opportunities for medical coders. Many corporate companies like Optum, Episource, AGS Health, Cotiviti, Corro Health, and many small-scale companies offer job opportunities each year for their revenue cycle management.
Dr. Nirainila Joseph: You mentioned the significant demand for medical coders in the US previously. How does the job market for medical coders in India differ, if at all, from other developed economies?
Dr. Nithyadharshini Devakumar: Medical coding is one of the fastest growing outsourced business in India becoming the second largest pool of medical coders after the US with outsourcing companies like Optum, Ajuba, Cognizant, etc, providing inhouse training for medical coders meeting the skills to excel in this job.
Dr. Nirainila Joseph: Given the rapid growth of medical coding in India, what changes would you like to see in the industry to support the growth and development of medical coders?
Dr. Nithyadharshini Devakumar: There is steady growth and job stability in this sector but we can expect more opportunities when medical insurance becomes mandatory in India too with healthcare providers and insurance companies needing more number of skilled medical coders and billers.
Dr. Nirainila Joseph: Thank you very much, Dr. Nithyadharshini, for sharing your insightful perspective on medical coding. Your experience transitioning from dentistry and your tips to excel in medical coding would be extremely valuable to our audience. To conclude our conversation, I am be interested to learn, what professional milestones do you hope to achieve in the next few years?
Dr. Nithyadharshini Devakumar: I hope to become a training specialist in medical coding which I would love to do the most. After finishing the required certification, I aim to eventually step up the ladder as Team Lead (TL) and Manager with my improved skills and admin management in the upcoming years.
MedBound Times expresses sincere gratitude to Dr. Nithyadharshini Devakumar for sharing her valuable insights on our platform.