Nursing home
My first job out of college was at a nursing home as the HIM Manager. I coded as well as everything else under the sun (except billing and I was only there 9 months). As I understand it, coding does not affect the reimbursement for nursing home patients because they are paid per diem. It helps to use correct code assignment however, because the doctor and staff needs to be aware of the patients problems and also because when meds are ordered, it is important to show medical necessity for the med. Insurance does not cover usually cover nursing home stays unless they have Medicaid or another private payer that offers LTC benefits. Not Part A
We also had skilled nursing facilties and they are paid based on RUG (Resource Utilization Groups) based on the MDS (Minimum Data Set) resident assessments. SNF's complete their MDS assessments according to schedule (5th, 14th, 30th, 60th, and 90th days). This is based on the patient as a whole but it is equally important to correctly code the patients chart. Part A
Now, Long Term Acute Care hospitals utilize DRG's but I am not up to speed on this process and they are a whole different animal.
Since nursing homes do not have large budgets (usually) they use nurses or CNA's to do their coding and manage their HIM dept. However, if you can find a large nursing home/SNF they may look for coders. Hopefully I did not just give any misinformation.
