"IPDRG Coder"

Job Summary:

The IPDRG Coder is responsible for reviewing inpatient medical records and assigning accurate ICD-10-CM and ICD-10-PCS codes. The coder determines the appropriate MS-DRG/APR-DRG classification, ensures compliance with coding guidelines, and supports accurate reimbursement and quality reporting.

Key Responsibilities

• Review inpatient medical records, including discharge summaries, operative reports, physician notes, and diagnostic reports.
• Assign accurate ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes.
• Determine principal diagnosis, secondary diagnoses, and procedures based on clinical documentation.
• Assign appropriate MS-DRG/APR-DRG classifications and understand the impact of CC/MCC conditions on reimbursement.
• Validate Present on Admission (POA) indicators and ensure proper DRG grouping.
• Identify documentation deficiencies and initiate physician queries when clarification is required.
• Ensure compliance with official coding guidelines, CMS regulations, UHDDS standards, and client-specific requirements.
• Use coding tools such as 3M Encoder, TruCode, Optum Encoder, and hospital EMR systems.
• Collaborate with Quality Analysts, CDI teams, auditors, and healthcare providers to improve coding accuracy.
• Meet productivity and quality benchmarks while maintaining high coding accuracy.

Required Qualifications

• Bachelor's degree in Life Sciences, Nursing, Pharmacy, Allied Health, or related healthcare field.
• Certification such as CPC, CIC, CCS, RHIT, or RHIA preferred.
• Strong knowledge of ICD-10-CM, ICD-10-PCS, MS-DRG, APR-DRG, POA, CC/MCC concepts.
• Understanding of medical terminology, anatomy, physiology, and pathophysiology.
• Experience with inpatient coding and DRG assignment methodologies.

Resume-Friendly Job Description

Reviewed inpatient medical records and assigned ICD-10-CM/PCS codes, determined MS-DRG/APR-DRG classifications, validated POA and CC/MCC conditions, ensured coding compliance with CMS and coding guidelines, performed physician queries for documentation clarification, and maintained productivity and quality standards for accurate reimbursement.

Key Skills

• ICD-10-CM
• ICD-10-PCS
• MS-DRG / APR-DRG
• Medical Terminology
• Anatomy & Physiology
• DRG Validation
• Physician Query Process
• Clinical Documentation Review
• 3M Encoder / TruCode / Optum
• Quality Assurance & Compliance