The document highlights the importance of medical coding education for physicians, noting the lack of coding training in U.S. medical schools despite its relevance to patient care and health outcomes. It discusses various coding systems like ICD, CPT, and HCPCS, emphasizing the complexity and necessity of accurate coding. The integration of coding into medical curricula is proposed to enhance physician training and improve understanding of documentation and its impact on health services.

1. Introduction
Physicians must be adequately
prepared in working with many facets
of disablement and functioning. This is
especially critical considering such
knowledge and clinical skills can
improve the likelihood of positive
health outcomes for patients.
A crucial knowledge and skill area for
physicians that has been increasingly
discussed is the complex area of
medical coding. This includes medical
or health coding systems such as the
ICD (International Classification of
Diseases), CPT (Current Procedure
Terminology), and HCPCS (Healthcare
Common Procedure Coding Systems).
Coding is an important aspect of a
physician’s daily work responsibility.
Furthermore, coding is complex and
ever changing. For example, ICD-10
contains nearly 5 times as many
diagnostic codes as the preceding
version, ICD-9. However, coding is not
required in physician training in the
United States. And it is not integrated
in all medical school curriculum.
To address this gap in medical training
and allow physicians to develop an
understanding of coding systems,
multiple medical schools have decided
to include coding in the medical school
curriculum.
As already mentioned, ICD coding has
been included in association with these
medical educational programs; but,
there is no known inclusion of the ICF
within U.S. based medical curriculum
at this time.
Integration of ICD and ICF Coding
in U.S. Medical School Curricula
2ND INTERNATIONAL ICF EDUCATION SYMPOSIUM
Patricia Welch Saleeby, PhD, MSSA
Southern Illinois University - Carbondale, School of Social Work, USA
Importance of Coding
Medical coding is the translation of the
medical/health profession. Coders take
medical documentation (reports and
assessments) from physicians and
translate the information into a set of
codes, which comprise a critical
component of the medical claim.
Generally, there are key aspects of
such documentation – the condition of
the patient, the diagnosis by the
physician, the prescription and
whatever procedures the physician or
healthcare provider performed with the
patient.
ICD, International Classification of Diseases
Developed in 1940s by the World
Health Organization, the current
version is the ICD-10 which contains
14,000 diagnostic codes that describe
the causes of injury, illness, and death.
The ICD codes represent the patient’s
condition and the physician’s diagnosis.
The CM that follows ICD-10 represents
Clinical Modification, or set of revisions
established by the National Center for
Health Statistics and the Centers for
Medicare and Medicaid. CM represents
over 68,000 codes that increases the
scope for coders, allowing for greater
specificity and flexibility.
CPT, Current Procedure Terminology
Developed by the American Medical
Association, CPT codes are divided into
three components. Used most often,
the first includes six major medical
fields – Evaluation and Management,
Anesthesia, Surgery, Radiology,
Pathology and Laboratory, and
Medicine. The second includes
performance measurement and
sometimes, laboratory or radiology
test results. The third component
included emerging medical technology.
HCPCS, Healthcare Common Procedure
Coding Systems
Developed by the Centers for Medicare
and Medicaid based on CPT codes,
HCPCS codes represent the services,
procedures, and equipment not
covered by CPT codes (ambulance
transport, durable medical equipment,
prosthetics, certain medicines). There
are two levels – Level I is identical to
the CPT codes. Level II is divided into
17 sections, each specific to a medical
area like Rehabilitative Services.
Acknowledgements or Notes
Overview of Coding Medical School Curriculum
For additional information, please
contact Dr. Patricia Saleeby at:
saleebyp@siu.edu
Generally, U.S. based medical schools
teach and train using either a
traditional or system-based curriculum.
The typical medical school model
focuses on a combination of lectures
and problem-based learning modules.
Problem-based learning generally
consists of a group of medical students
who work together to address and
resolve a patient case. Students
explore the assigned patient case and
ultimately, diagnose this patient.
Systems-based learning means that
classes are divided up by bodily
system. One month may focus on the
cardiovascular system and another
month on the respiratory system.
Regardless of the model utilized in a
given medical educational institution,
instruction on coding represents an
innovative learning mechanism that
would supplement physician training.
The method for inclusion or integration
has not been uniform. Some schools
have provide stand-alone courses.
Others have decided to replace the
entire 3rd-year curriculum with an
intensive course on diagnostic and
evaluation and management coding.
30 June 2017
Cape Town
South Africa
Implications
Currently, medical coders assume the
sole responsibility for this important
task. But it would certainly benefit
doctors to know about coding.
“If medical students took a coding
class while they were learning and
practicing medical procedures, perhaps
they would be able to see the vital
connection between caring for their
patients and coding for their services.”
Barbara Fontaine, CPC
With recognition of coding importance
it is likely that future studies will
address issues related to coding and
health. For example, analyses to
determine correlations between patient
health outcomes and coding patterns
among health care providers across
settings (hospitals, private practice,
public clinics).
Accurate coding facilitates uniform
documentation between service
providers, facilities, and systems. The
majority of physicians really do not
understand coding and so they need to
acquire this valuable knowledge and
skill. If physicians do not know how to
code, they cannot document in an
effective manner. And documentation is
key to effective service delivery and
payment systems through U.S.-based
insurance payers. Additionally,
documentation is monitored carefully
by both insurance companies as well as
governmental agencies.