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Category Archives: Medical Coder Certification

Medical Coder Certification

How to Become a Certified Medical Coder? | harvardsjd.org …

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Certified medical coders or medical coding specialists are part of the healthcare information technician team and perform the important task of converting written text on medical reports into a series of universally understandable and recognized numeric codes.

The emphasis is on the term “universally understandable and recognized.” Because they use a universal classification system to assign numeric codes to the diagnostic tests, treatments, and other clinical procedures that are performed on patients, health insurance carriers are able to interpret the documents medical coders prepare and disburse payments accordingly.

These documents are also important for doctors and other primary healthcare practitioners to communicate with each other; understand the stage of treatment a patient is in; leave instructions for support staff; and take necessary follow-up action.

If what you have read so far sounds even a little bit interesting to you, here’s a step-by-step guide on how to become a certified medical coder:

1. Learn about the profession: It’s good to assemble as much information as possible about the profession you are interested in so you can make an educated decision. Find out details like the nature of work, entry requirements, job opportunities, benefits and compensation, advancement opportunities etc. that certified medical coders enjoy. Spend lots of time on the Internet to assimilate any and all information that might be useful for you. No one will grudge you the long hours in front of a computer if it’s the question of your future.

2. Start preparing in high school: If you are still in high school or just about to start, it may be a good idea to prepare for postsecondary education in medical coding by taking courses in math, biology, chemistry, health science, nutrition, etc.

3. Choose a medical coding training program: This is the step where you’ll have to take a call between a college degree and a vocational training program in medical coding. There are pros and cons of both the options. For example, a vocational training program may be more flexible, affordable and shorter in duration. Going to college, on the other hand, can be expensive but leads to a very important piece of document called a degree at the end of two (or four) years.

4. Complete your coursework: Whichever route you choose to become a certified medical coder, make sure you are happy with your decision and then fling yourself with gusto in to the coursework. A medical coding program typically includes coursework in medical terminology, physiology, anatomy, healthcare reimbursement system, medical record types, coding and classification system, etc. Ideally, your training program should also include some hands-on practical experience in medical coding.

5. Get medical coding certification: This is the culmination point of your journey to becoming a certified medical coder. Different organizations have different requirements for granting certification. The American Health Information Management Association (AHIMA) grants certifications like the Certified Coding Associate (CCA) and Certified Coding Specialist (CCS). Medical coding certifications granted by the American Academy of Professional Coders (AAPC) include Certified Professional Coder (CPC), Certified Professional Coder – Outpatient Hospital (CPC-H), etc. Find out details about the prerequisites for the certification you want to obtain; pick a suitable date to sit for the examination; pass the exam and you have become a certified medical coder ready to conquer the world of medical coding!


Top 5 Reasons to Become a CPC (Certified Professional Coder)

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A CPC (Certified Professional Coder) is a medical billing and coding specialist, familiar with the systems that healthcare providers (hospitals and practices) and payers (insurance companies, Medicare and Medicaid) use to communicate with one another. Here are the top 5 reasons CPC is a good career choice.

1. They’re hirable.

Because of the lack of qualified coders, a CPC (Certified Professional Coder) finds a job easily. It is estimated that 18% of billing and coding positions go unfilled – that’s a big gap, and as a CPC, you will fill that gap. CPCs have the luxury of “shopping around” for jobs, so you’re likely to find one with a short commute and a pleasant work environment.

2. They get benefits.

In 2010, when the economy was still barely puttering along, CPCs did well. According to a survey done by the American Academy of Professional Coders  (AAPC), more than 95% of coders were employed full time. 91% of all coders received health insurance from their employers, and 78% also received dental insurance. Better yet, 89% received paid sick leave. CPCs are necessary and skilled employees – employers want to keep them around. So, they treat their CPCs well.

3. A Certified Professional Coder (CPC) can choose his or her work environment.

As a CPC, you can specialize by becoming a CPC-H or CPC-P. A CPC-H is certified by the AAPC to work in hospitals, working for the providers of medical treatment. A CPC-P works for payers – insurance companies or organizations like Medicare and Medicaid. If you specialize, you become more attractive to employers in your field, and you’ll be able to choose where you work.

4. CPCs can also work from home.

After a few years working in a hospital or insurance company office, many CPCs are allowed to work part- or full-time from home (or a café, or anywhere else). You will have greater flexibility in terms of your hours. A work-from-home position is ideal for single parents or people whose spouses travel often for work: you can come along and earn a salary no matter where you are.

5. CPC positions are stable.

Finally, becoming a CPC (Certified Professional Coder) is one of the best ways to ensure job security and financial independence. Once you have been hired and trained according to your new employer’s requirements, you are likely to enjoy a long career with a stable future. CPC positions are stable for two main reasons:

(1) CPCs are always needed.
The billing and coding system isn’t going anywhere: if anything, it’s becoming even more necessary as insurance systems become more complex. As a CPC, your skill set will remain necessary for many, many years – or as long as healthcare is structured and organized the way it is now.

(2) The healthcare industry is growing.
As the population ages and healthcare becomes more accessible, healthcare facilities of all kinds are expanding and opening in new places. For CPCs, that’s good news. The healthcare industry cannot function without coders – they’re needed in pharmacies, clinics, and nursing homes along with hospitals and insurance companies. The bigger healthcare gets, the more important each skilled, responsible CPC (Certified Professional Coder) will be.

Certification – Medical Billing and Coding PRO

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It is estimated that more than 87,000 professionals in health care industry in United States hold medical billing and coding certification approved by AAPC. They are employed in clinics, hospitals, physician offices, and outpatient facilities. These professionals are employed as medical auditors, billers, compliance officers, coding executives and practice management team members. These coders and billers process, submit and follow up on insurance claims to ensure receipt of payments for services offered by healthcare providers. A similar process is used by insurance companies. Medical billers not required by law to be certified in their line of work. The exams offered by various boards are RHIA Exam, and CMRS Exam. Certification schools provide a theoretical ground for students who enter the medical billing and coding field.

Good career

There is a surge of demand for the medical billing and coding professionals. If you want to work in health information field and have the following skills, then medical billing and coding career is right for you-

  • You enjoy working in allied medical field
  • You are detail-oriented
  • You can recall and remember without difficulty
  • You are technically skilled to use computer easily
  • You enjoy learning and you do not mind being trained to pursue and allied medical career
  • You like a routine job

Kind of work

The size of the medical facility you work for may affect your responsibilities and duties in medical coding and medical billing. The volume of data handled in large hospitals is much higher and more detailed compared to smaller clinics. You will realize that medical coders and billers are professionals who specialize in certain areas of health information. At smaller facilities, these professionals work in all areas. Though they specialists usually work in different health care facilities and hospitals, they have minimum interaction with patients. This career is good for those who do not enjoy customer and patient interactions but are good at vendor management. They focus on mostly operational, administrative work along with managing paperwork, database and information that is needed to keep records organized.

 

Medical Billing Certification

The healthcare business requires certified billers who can handle all aspects of revenue cycle. Without them, The Certified Professional Biller (CPB) has to take a rigorous exam and experience. The person has to know how to follow government regulations to submit claims, resolve claim denials, follow-up on statuses, post payments, submit appeals, handle adjustments and manage collections. Medical billing certification is vital to run the financial processes that ensure revenue generation and achieve success in professional claims process services.

Medical Coding certification

The medical billing and coding certifications are recognized in United States by physicians, employers, government organizations and societies. The Center for Medicare and Medicaid (CMS) recognizes this certification. The Bureau of Labor Statistics states that most employers prefer certified professionals as they have the basic knowledge of medical terms and billing codes. It is seen that certified coders earn more than 17% salary earned by non-credentialed coders. Hence AAPC approved certifications are necessary for those interested in engaging in allied medical career

Medical Auditing Certification

To advance your career the Certified Professional Medical Auditor (CPMA®) credential ensures a job in medical auditing. It is necessary to be compliant and run a profitable physician practice. Whether it is private payer denials, RAC audits, or just mental peace, more physicians have to go through regular audits. There is high risk if a medical practice is not compliant with coding and documentation norms. As Certified Professional Medical Auditor, you will use your knowledge and skills in billing, documentation and coding to improve revenue cycle of the business you work for. The skills include-

  • Knowledge of fraud, abuse, medical documentation, and penalties for coding and documentation violations of governmental guidelines
  • Coding Concepts
  • Statistical Sampling Methodologies and scope of coding
  • Abstraction Ability and skills in auditing Medical Records
  • Analysis of Coding Risk and Quality Assurance
  • Communication of findings and results
  • The Medical Record

 

Medical Compliance certification

Healthcare compliance certification deals with ever-growing requirements of adhering to government regulations, policies, laws and rules. Medical practices require someone who has the ability to organize, manage, develop and direct various functions of the compliance department. The Patient Protection and Affordable Care Act (PPACA) of 2010 approve the compliance programs that have become mandatory for enrollment in the Federal healthcare programs.

As individuals, holding the AAPC’s Certified Professional Compliance Officer enables you to demonstrate an understanding of basic requirements to implement, monitor and develop a healthcare compliance program for your facility. Based on governmental regulatory guidelines there is need for audits, internal compliance reviews, staff education and training and risk assessments. There is a rise in the number of medicare / medicaid fraud and abuse. Hence there is an impending requirement for mandatory compliance of physician practice programs,

CPCOs will have demonstrated knowledge of:

  • The Compliance Guidance for Individual and Small Group Physician Practices,
  • Effectiveness of Compliance program
  • False claims act for key healthcare abuse and frauds
  • Other laws and regulations including EMTALA, HIPAA, and CLIA
  • Self-disclosure protocols and handling investigations
  • Corporate Integrity Agreements (CIAs) and Certificate of Compliance Agreements (CCAs) requirement
  • Current investigative activities (ZPICs, MFCUs, RACs)
  • Handle conflicts of interest and gifts/gratuities,

The CPCO Certification Exam

  • 5 hours and 40 minutes to take the test
  • 150 multiple choice questions
  • $325.00
  • 1 free retake within one year of first attempt
  • Open reference (approved references)

The CPCO certification exam thoroughly covers-

  • Healthcare Compliance Program
  • Compliance program guidelines for physicians and group practices
  • Fraud and abuse laws
  • Other laws and regulations
  • Investigations and audits

Practical Manager Certification Exam

This exam needs to have detailed requirements and responsibilities for managing compliance regulations, health information, revenue cycle, human resources and general operative processes that challenge practice management The Certified Physician Practice Manager (CPPM) qualification is taken by those who have strong healthcare experience. They are prepared to enhance their occupations in management of physician practice this certification also helps existing practice managers as it increases knowledge and validates their experience.




4 Ways ICD-10 Changed Nursing Advanced Certification / College …

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By Eric Hoover

Over the next year, several changes large and small will update the current ICD guidelines. These will affect the way advanced nursing certification courses are taught, and those working in the medical field will have to adjust to the ever-evolving landscape of medical coding.

As a refresher, the International Classification of Diseases (also known as ICD) is a common framework and language used to compile, report, and compare health information from pregnancy to death from illness worldwide. The World Health Organization (WHO) periodically revises ICD coding to reflect current medical understanding of disease. Medical professionals should now be using the ICD-10 coding, which changed drastically from ICD-9. Officially, the start date for ICD-10 is October 1, 2014 for all HIPAA entities.

1. Changing for more robust coding.

Those entering the medical field after achieving their nursing advanced certification will have to learn a whole new set of codes and procedures, as the ones used for reporting under ICD-9 are now obsolete in the United States. This occurred because the old system did not have enough capacity to incorporate new codes. All other countries are currently using ICD-10, which helps track major global epidemics. Those in the nursing field will have to adapt to ICD-10.

2. Learning new codes and new diagnosis.

Nursing students will have a little bit of a jumpstart over those who are currently in the field when it comes to learning new diagnosis codes under ICD-10. They will also have to understand more in-depth knowledge of a disease, in order to help with patient treatment and support, as well as for assisting physicians.

3. Nurses and Billing Specialists should update software.

There’s a good chance the software you know how to use will need to be updated, perhaps completely overhauled. Speak to a supervisor (or professor, if you are still in school for nursing certifications or degrees) about how this new system will differ, as the ICD-10 codes are up to seven alphanumeric characters. More extensive coding training for those in billing will be required.

4. The more you know.

Nurses and healthcare professionals will have to understand up to 68,000 codes as part of ICD-10. New terminology will also have to be memorized and made consistent throughout the code set. Since the codes combine diagnoses, symptoms, and treatment, fewer codes will need to be reported to describe a condition, but the information still needs to be on record for caregivers and medical professionals to reference.

These drastic changes in the way medical coding is tracked should not turn anyone off if they are currently pursuing a nursing certification. In fact, now is the time to hit the books and learn how this updated system will change your duties before they go into full effect next year. These types of rapid advancements must be expected in a field as important as medicine. Learning to grow along with coworkers or fellow students will help you advance in a flourishing career.
This post was provided by Eric Hoover on behalf of Drexel University Online. Eric is a content strategist and blogger with a background in advertising and education journalism. He has also written ad copy for agencies throughout Vermont, New York City and Philadelphia.

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Should I Major In Medical Coding? – Career QA

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Answer to “Should I Major In Medical Coding?”

should i major in medical coding

Medical coding is a big deal right now precisely for the reasons you indicated. The entry barriers are not as high as those required for becoming a doctor, nurse, or other medical practitioner, but the job is still in high demand because it is in the medical field. Medical coders, unlike other medical staff members I just mentioned, do not work directly with patients or administer treatments. But they do need to have a knowledge of physiology so that they can translate the business of a hospital or clinic into medical codes. These codes are used to streamline and simplify communications and make them objective. That way it is easier to send out medical bills, distribute supplies and personnel, and so on.

As to whether or not you should get a degree in the field, I would say that in the long run, the answer is yes. Whether or not you should get one immediately depends on the details of your situation. You say you do not have much time or money to spend on a degree right now. That may make a certificate a better option for the time being, and at the very least I highly recommend you go to school to get that. Certifications are required by more and more employers, and they can increase your salary.

A degree, whether it be an associate’s or bachelor’s degree, can also increase your income significantly. The difference between the wage for a medical coder just starting out with nothing more than a certificate and that of a coder starting out with a bachelor’s degree can be the difference between a salary that barely can pay the bills for one person and one which can comfortably support a small family.

This is why I highly suggest you pursue a degree in the field, whether now or later. If you start out with a certificate, you can begin getting work experience and setting aside money so you can go back to school later. You also may find an employer who is willing to help finance further education. Once you get a higher degree you have a much better shot at making a really good salary as a medical coder. You can find detailed information on this topic if you visit the website for the American Association of Professional Coders (AAPC).








Medical Billing and Coding Schools- Schooling in Florida's Career …

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All the medical institutions are highly dependent on the medical billing and coding professionals who are certified from the accredited schools with great skills and impressive qualifications. To join in an accredited school you must aware that courses offered by the institution and training programs must be live based and practical. One of the best schools which are offering the desired programs in your interested course medical billing and coding is Florida’s Career College.

Under all the eight campuses of college, Florida’s career college is offering course programs for medical billing and coding which are available at diploma level with the duration of 12 months around. Human Anatomy, Pharmacology, human disease types and medical terminology are the topics in their course program with minimum basic skills required to certify in medical billing and coding specialist. It also additionally offers some of the courses like CPT Coding, Computers in Health Care, Medical Office Procedures, Legal Aspects of Health Care, Medical Reimbursement, Pharmacology, Pathophysiology, Accounting and Health Information Management etc.

Students should have excellent skills in Math or English, Algebra, Communications, Psychology or Sociology to complete the additional programs. Placement in this college requires students to complete a criminal background check, protection to get into a health facility. Some of the education programs offer virtual externship which is completed online like other courses. To get certificate from the reputed schools is more worthy than getting a non-valuable certificate from the unauthorized school.

However, when preferring a school for your education, it is necessary to consider a school that has good fame, quality training facilities, experienced faculty and a school that assures the quality certificate. It is also essential to settle for an institution that offers low tuition fees. It is your choice to choose a school that offers high quality education at a reasonable cost.

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Medical coding more key than ever – The Morning Journal

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LISBON – When most go to the doctor their main concerns are diagnosing their health issue and getting better.

Then at some point, the medical bill may become a concern. Will their insurance cover the treatment? How much will be owed out of pocket?

It may have not occurred to the patient how the hospital or doctor communicates with the insurance company to make certain they get paid for the proper diagnosis, treatments and supplies used.



Deborah Kay Arter, a medical coder at Salem Community Hospital and instructor at the Columbiana County Career and Technical Center, knows exactly how it is done. She recently went over the process with CTC board members, talking about her two semester program, which prepares students for a career as a certified medical coder.

Arter said the importance of passing the exam to become a certified coder can mean $5 more per hour over non-certified coders. Of those who take the national certification test 76 percent do not pass, she said. At the Career Center last time, 100 percent passed.

Arter teaches her students about the different types of health insurance programs and how to properly bill both insurance companies and patients for the health expenses. She pulled out the books of codes, more than 14,000 in the current book of international classified diseases, another 8,800 codes for procedures and final book containing codes for supplies and injectable drugs.

The book with 14,000 codes for diagnosis is about to undergo a major revamp. The new code book for 2014 will have more than 78,000 codes. Arter said when the new changes go through, she predicts the bills will not get paid for a while.

“Canada tried this and nothing got paid,” Arter said.

She predicts the changes which will be brought about by Obamacare will affect the job of coders greatly. According to Arter, hospitals and doctors already write off large amounts of bills which they are unable to collect on. In her opinion, a 2 percent drop in what Medicare will pay will force hospital staffs to be unable to employ about 15 people.

Although codes are changing, certified coders are required to obtain annual continuing education. She offers continuing education at the CTC, allowing her students to return to a place they feel comfortable and meet with their former classmates while obtaining information on the latest changes.

Not only do codes help make the difference about whether a doctor or hospital receives the right amount of money for their services, codes are used for statistical purposes. Arter points out that it is only through coding that statistics become known about how many football-related injuries happen nationally each year or how many cases of cancer have been diagnosed for those living in the East Liverpool area.




www.bellaviaggia.com | Medical Billing and Coding Schools …

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There are various medical billing and coding schools which offer many courses to be a professional in the field. Medical coding and billing are two fields that suit those who are interested in health care industry but don’t actually want to deal with healing the patients. In order to get a certified mark in these fields, you have to take medical billing and coding courses in reputed schools. Among these schools, one of the best is National College, providing several medical billing and coding programs to students, who are interested in this profession.

To understand the ethical and professional responsibilities, National College is provides you with the skills and knowledge essential to perform the functions of a medical biller and coder. Upon graduation from this college, the students will be placed to work as either medical coder or medical biller. They can bind both career paths as some employers want one individual who is efficient of accomplishing both activities.

Individuals those who complete the program from this college, are eligible to take certification exam as a Certified Professional Coder or Certified Professional Coder-Hospital, from American Academy of Professional Coders, and certified medical biller through the American Association of Medical Billers.

As a student in the Medical Billing and Coding program, you will learn following programs:

  • How to handle health insurance claims, including paperwork and legal issues.
  • Computer Billing applications and administration procedures from the client side.
  • To retrieve data from medical documents and to translate the codes into required medical information.
  • Accurately code medical conditions and services.
  • CPT and ICD-9-CM medical coding techniques and terminology.

Certification from accredited college is conforming to an ultimate standard of perfection for those who are looking for having a brilliant career in this field.