Medical coding is the crux of the healthcare industry. Medical coders translate complex medical information into standardized codes essential for billing, insurance claims, and maintaining accurate patient records. While coders may not interact directly with patients, their work ensures that doctors, insurance providers, and health systems can communicate efficiently and accurately every day.

With around 15,000 job openings for medical coders projected each year on average, medical coding is not just a stable career path—it’s an increasingly relevant one.

But before diving into the field, look before you leap. Aspiring coders need to be well-versed in a wide array of medical topics. Here’s what medical coders need to know before launching a career.

What is medical coding?

Medical coding is converting medical reports and clinical data into standardized codes. These codes come from physician notes, lab results, diagnoses, and treatment plans. Once transcribed and translated into the correct coding format, the information can be used to bill insurance providers, maintain patient records, and facilitate accurate data sharing between healthcare facilities.

Accurate coding does more than streamline administrative tasks. It ensures that healthcare providers are paid appropriately for their services and that patient data remains protected. Standardized medical codes make transferring important documents, like invoices and treatment histories, between hospitals, clinics, and insurance agencies easier.

To become a successful medical coder, individuals typically study key subjects like:

• Concepts in Human Biology
• CPT®-4 Coding
• ICD-10-CM Coding
• Medical Office Management

These topics form the foundation of medical coding knowledge and help students understand the scope and importance of the work they’ll be doing.

What do medical coders need to know?

Medical coding isn’t just about typing numbers into a computer. It requires an intimate understanding of medical language, software systems, and organizational standards. To make it in this occupation, coders must be detail-oriented, highly organized, and capable of working within rigid guidelines and healthcare regulations.

Among the most important tools in a medical coder’s toolbox are two standardized coding systems, the International Classification of Diseases and the Current Procedural Terminology.

International Classification of Diseases

The International Classification of Diseases (ICD) is a global system used to code and classify diagnoses, symptoms, and health conditions. Managed by the World Health Organization (WHO), the ICD helps healthcare professionals track health statistics, identify public health trends, and ensure accurate reporting.

Medical coders use ICD codes to turn clinical diagnoses into alphanumeric sequences that can be universally understood and stored in health records. These codes are foundational to health documentation and are key to any coder’s education.

Current Procedural Terminology

While ICD codes classify diagnoses, Current Procedural Terminology (CPT) codes record the procedures and services healthcare professionals provide. Developed by the American Medical Association (AMA), CPT coding allows coders to describe everything from routine physical exams to complex surgical procedures in a standardized way.

By turning complex medical services into short, standardized entries, CPT codes bridge medical knowledge and administrative requirements. These codes help ensure that providers are compensated correctly and services are properly documented.

Start your medical coding journey at Goodwin!

How to become a medical coder

The journey to becoming a medical coder can fly by pretty quickly. In fact, some programs allow students to earn a certificate or diploma in as little as 12 to 18 months.

With flexible scheduling and online formats available at some schools, it’s an accessible path for many. Medical coding programs teach students not only how to use ICD and CPT codes but also how to understand the broader healthcare environment.

Coursework in medical coding programs typically includes:

• Medical terminology: Teaches students the language of medicine, including prefixes, suffixes, root words, and abbreviations, so they can understand and accurately code physician documentation and patient diagnoses
• Health insurance systems: Students learn how different health insurance models work, including private insurance, Medicare, and Medicaid, and how to apply proper codes for claims submission and reimbursement processing
• Laws and regulations in healthcare: Introduces students to critical healthcare laws such as HIPAA, teaching them how to handle sensitive patient information, avoid legal violations, and maintain ethical standards in coding
• Coding software and billing platforms: Covers hands-on training with industry-standard software tools used for entering codes, managing billing cycles, generating reports, and ensuring accurate medical recordkeeping in real-world settings

Medical coders also benefit from having soft skills that make them great collaborators and efficient workers. Traits like time management, attention to detail, communication, and the ability to work independently are all necessary.

Medical coding program requirements

While admission requirements vary between schools, most medical coding programs have similar prerequisites. In general, applicants must:

• Be at least 18 years old
• Have a high school diploma or GED
• Pass a background check

After acceptance into and completion of a medical coding program, graduates will be able to:

• Understand basic medical billing and coding concepts (ICD/CPT)
• Pass the Certified Professional Coder (CPC) exam

The CPC exam, administered by the AAPC (American Academy of Professional Coders), is a standard industry certification that confirms a candidate’s readiness to begin working in the field. Passing this test is often a necessary step to securing a full-time position.

Starting your career in medical coding

Once you’ve completed your training and passed your certification exam, you’ll be ready to rock and roll. Medical coders are needed in a variety of settings, including hospitals, private practices, insurance companies, and billing service providers. Thanks to the universal need for accurate health documentation, there’s a high demand for well-trained coders across the healthcare industry.

Hopefully, we’ve answered your question, “What do medical coders need to know?” So if you’re looking to jumpstart your career in healthcare but prefer to work behind the scenes, Goodwin University’s Medical Billing and Coding program might be the perfect fit.

Learn more about medical coding programs at Goodwin University to see if healthcare is a good career choice for you.