Orthopedic Coding Alert

Our second annual salary survey shows that experience, education and certification can help you earn more

If you-ve ever wondered which orthopedic coding professionals bring in the most income, we-ve got the answers. The results of our second annual salary survey reveal some interesting information that could help kick your coding career into high gear.

Our Coders- Salary Survey found that the average salary among our 416 orthopedic respondents is in the $35,000-$45,000 range. Spine surgery, hand surgery and sports medicine coders earned slightly higher salaries than general orthopedic coders. Coders at ambulatory care or hospital facilities brought in more money than office-based and home-based coders.

Fact: 41 percent of hospital-based orthopedic coders tell us that their employers required certification before the hospital would hire them. On the other hand, only 29 percent of physician office-based coders say that their employers required certification.

Certifications Offer a Boost

For the second year in a row, our survey shows that certified coders have earning power, with the average coder who holds either a CHBME or CMBA certification earning more than $70,000.

Respondents who held an RHIT or RHIA certification average salaries in the $50,000-$65,000 range, while those who held a CPC or CPC-H earned an average of $35,000 to $45,000. Uncertified orthopedic coders averaged $30,000 to $35,000.
 
Education Pays

Our survey shows that coders with a high-school diploma average a salary in the $35,000-45,000 range, but with every additional degree, the salaries rise. On average, bachelor's degree holders earn upward of $50,000, while those with master's or doctorate level degrees earn over $70,000.

Our results also speak to the importance of staying on the job. Those with less than one year of experience average less than $25,000 annually, but coders with 11 or more years coding earn more than $70,000.

And which titles carry the most financial weight? Our study shows that consultants, administrators, CEOs, CFOs, COOs and vice presidents earn the most, whereas coders with the title of -collection professional- earned less than $25,000 on average.

Often, the term -collection professional- refers to staff members who send out statements or perform filing work, and perhaps don't have in-depth coding skills as a certified coder might, so the salary reflects that, says Annette Grady, CPC, CPC-H, CPC-P, OS, an officer on the American Academy of Professional Coder's (AAPC-s) National Advisory Board.

If you-re thinking about a move in the near future, note that the highest-paid orthopedic coders that we surveyed live in California, followed by Texas and Illinois.

Your Least-Favorite Payer? It's Not Medicare

For the second year in a row, respondents to our survey indicated that Medicaid -- not Medicare --  was their least-favorite payer.

There are several reasons to explain why Medicaid would be less favored than Medicare, says Suzan Hvizdash, BS, CPC, CPC-EMS, CPC-EDS, physician education specialist for the department of surgery at UPMC Presbyterian-Shadyside in Pittsburgh.

-Most of it comes from the general availability of reliable information and people,- she says. -Most Medicare carriers have dedicated departments to answer provider questions; often Medicaid carriers don-t.-

In addition, Hvizdash says, Medicaid's reimbursement is unacceptably low, and they often do not use the same codes that the rest of the coding community uses.

-They may still use the CPT codes from 2004,- she says. -They may not accept all the HCPCS codes. They may even have their own set of codes needing to be used for certain circumstances. I know that the Pennsylvania MA doesn't recognize any of the unlisted-procedure codes. They expect the service to fall within the identified service codes, and when they don-t, that opens up a Pandora's box of issues.-

Software Still Comes in Second Place

Only 65 percent of our respondents say they use coding software, with the favorite being Encoder Pro. Instead, most orthopedic coders tell us they rely heavily on their coding manuals and books.

Unfortunately, even though coders tell us they mainly rely on coding manuals over software, many coders are not replacing their coding guides annually. Five percent of respondents tell us that they replace their coding manuals just every other year, while 6 percent say they replace their manuals less often than that. 

-I am not surprised by this,- says Susan Vogelberger, CPC, CPC-H, CMBS, CCP, owner and president of Healthcare Consulting & Coding Education LLC in Boardman, Ohio. -The percentage is actually lower than I would have projected.-

Updated manuals are important: -It is imperative that new code books, including the HCPCS Level II, be purchased annually because it directly affects the accounts receivable,- Vogelberger says. -Insurers deny claims when the codes are invalid. In addition, ICD-9 codes are used to collect data that will improve healthcare in the future, and if claims are not coded correctly and to the highest level of specificity, then valuable data is lost. The cost of the books is well worth the increase in revenue.- 

Probably because coders rely so heavily on their manuals, most of the coders we surveyed don't think  software will replace human coders. Only 6 percent of our orthopedic respondents think that coding software could do their jobs for them.

Physicians Are Increasing E/M Responsibilities

A full 57 percent of our orthopedic respondents said their physicians do their own E/M coding.

-Through auditing, I have found this to be true, but unfortunately some physicians are not well informed on the subject and don't realize that there are constant changes in this industry that they need to keep up on,- Vogelberger says.  

-Hopefully they employ someone who is watching out for them. Some physicians think they are playing it safe by undercoding, which is just as subjectable to penalties as upcoding. They are also missing out on revenue by undercoding. On the flip side, when they upcode they are also collecting revenue that they are not entitled to.- 

Review the charts in the following article to see how your education, location, years on the job, hours worked, and certification fared in our survey.