Clinical coders operate at six identifiable levels, which can be described as beginner, trainee coder, entry, competent, accredited and advanced levels. In this article these levels are elaborated within the theoretical perspectives of Simon's four-stage and Wilson and Walsh's six-stage models of systematic decision making. The article then examines briefly the importance of understanding how clinical coders make decisions, because of both the coder's crucial role in determining hospital funding, and the reliance of research upon access to accurate data. Finally, future avenues for study in this area are suggested.
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