Paul Mannet

(Return To Page One of Medical Coding Careers Article)

Certificate Levels
Both The American Academy of Professional Coders (AAPC) and The American Health Information Management Association (AHIMA) are reputable organizations, though some say that AAPC is more oriented to physician-office coding and AHIMA is more hospital or “in-patient” focused.

Tests for the following three certificates are administered by AHIMA. If you meet the requirements for a certificate, you can apply to take a test in your area at AHIMA’s website.

Certified Coding Associate (CCA)
If you have recently completed a coding degree, the CCA certification gives you the first credential you need to work in a medical environment. It’s an entry-level certification you can use to start building your career on. To be eligible for the CCA test, you need a high school diploma. It’s recommended, but not required, that you have at least six month’s experience working in a medical office or a certificate from a coding program. Virtually all coding certifications require you to have a good understanding of the Health Information Portability and Accounting Act (HIPAA), the federal law that protects patient rights and guarantees that their medical records will be kept confidential.

Certified Coding Specialist (CCS)
This is a more advanced certification, which proves you can operate the current state-of-the-art coding systems – the ICD-9-CM and the surgery system of the CPT (Current Procedural Terminology). This credential can get you a higher-paying job, but it requires that you understand a good deal about pharmacology and medical terminology. Eligibility requirements include experience in a hospital-based coding environment and course study in physiology and pharmacology, along with other medical specialties.

Certified Coding Specialist-Physician-based (CCS-P)
Provides you with certification to work on physician’s offices, clinics and other treatment environments. For this, you need to be familiar not just with ICD-9-CM and CPT, but also the Level 2 coding systems known as HCPCS (Healthcare Common Procedure Coding System). Eligibility requirements include experience in a physician-based coding environment using codes in surgery anesthesiology and other specialties, and some course study in anatomy, physiology and other medical specialties.

AAPC’s certifications are slightly different. They offer:

Certified Professional Coder (CPC)
This is for coders working in physician’s offices, either private or hospital-based, home health agencies or with auditors of insurance claims.

Certified Professional Coder – Hospital (CPC-H)
For coding in hospital outpatient billing, ambulatory surgical centers and other outpatient centers.

Certified Professional Coder – Payer (CPC-P)
A new certification created in 2009, primarily for claims managers at insurance companies and auditors.

Certified Interventional Radiology Cardiovascular Coder (CIRCC)
An advanced certification for coders working in radiology and cardiovascular charging and coding.

For information on testing and qualifications for AAPC’s certifications, visit their website.

Online Medical Coding Degrees
Medical coding is definitely an area where you can benefit from an online degree. Typical courses involved in an online coding degree include human anatomy, medical terminology, computer fundamentals, procedural terminology, CP coding, ICD-9-CM coding and pathology.

A key skill you need to be a medical coder in any hospital or physician’s office is an understanding of a federal law known as the Health Information Portability and Accounting Act or “HIPAA.” Designed to protect the rights of patients and insure that their medical records are kept confidential, the HIPAA governs how a medical provider must respond when a patient asks for his or her medical records, and how any request for patient information from an insurance company must be handled.

The past few decades have seen an explosion in the complexity of medical care, medical record keeping and information needs of insurance companies. The HIPAA covers any medical information that a doctor, nurse or therapist places in a patient’s file, including billing information, history and diagnostic notes and even conversations between medical specialists about the patient.

Avoiding Problems
To comply with HIPAA, you’ll need to know the unique identification codes for medical procedures, the tech safeguards for privacy, electronic signature rules and more. Failing to follow HIPAA rules can damage your career and even result in sanctions against the doctor or clinic you are working for, so it’s important to learn them completely. Patients who feel their privacy rights are violated can file a complaint through the U S Department of Health and Human Services.

A few key points you will study about HIPAA in virtually any medical coding degree program:

• Patient information that’s protected by HIPAA include patient’s name, diagnosis, medications prescribed and procedures done.
• Medical providers must give patients their medical records within 30 days of a patient asking for them.
• Life insurance companies, lending banks and other companies can only be given a patient’s medical information if the patient signs an authorization form giving permission to have the data released.
• Physicians, hospitals and other care providers can only share patients’ information while they are actually treating them.
• Patients have a right to ask that all communications with a doctor or hospital are confidential. In many cases that means the patient can ask a doctor to call them to discuss diagnosis and treatment at home rather than at work where part of a conversation may be overheard.
• A privacy notice must be given to all patients by healthcare providers telling them how their health information may be used, and the patients must sign it.

Working From Home
From the standpoint of your own work situation, it’s also good to be very up to date on HIPAA, because it governs how much of your coding work you can do from your home. Many medical coders enjoy an ability to do some or all of their work from home on a computer. But in order to do so, you must understand the very strict rules that exist about taking any protected health information on a patient out of a doctor’s office to code it in from another location.

More on getting the right degree and certification to become a medical coder here.

Virtually every hospital, doctors’ office, clinic and other health facility across the U.S. has a need to hire good medical assistants. And labor statistics indicate that demand for medical assistants is growing fast, and will continue to expand more than most other job categories for years to come (in fact, the government says that this will be the third fastest-growing profession in the U.S. from now through 2014). The job description can vary, with assistants in small clinics or physician’s offices doing both record keeping and direct patient care, while those in much larger practices tend to specialize either in clinical work or medical administrative assistant duties behind the front desk.

Job Options: More Focus On Degrees
This is a job path where having the associate degree for medical assistants is much more important than it was just 10 years ago. There are really two tiers of medical assistant jobs – the lower paying ones in general practice facilities, and the higher salary jobs that exist in more specialized practices. Doctors and administrators in specialty fields have become much more picky about hiring medical assistants with degrees – the Associate of Science Degree for Medical Assistants is the best known one. They can afford to do this because there’s currently an oversupply of job applicants with only “on the job” training as medical assistants, but fewer people who have a degree. Even medical assistants who have a great deal of hands-on experience in busy specialties like Family Medicine, Podiatry and Urgent Care now complain that they can’t get the best jobs if they don’t have the Associates Degree.

An Associate of Science Degree in Medical Assisting will prepare you to take one of two national certification tests, the CMA (Certified Medical Assistant) or the RMA (Registered Medical Assistant). More below on who gives these exams and how you can take one.

Basics of the Associate of Science in Medical Assisting Degree
Medical assistants can work in the administrative side of a practice or more directly with patients. Most AS degrees in medical assisting prepare you for both clinical and administrative work, with training in patient communications, billing, processing insurance claims and scheduling appointments, as well as functions that you might perform under the supervision of a doctor or other practitioner, like taking vital signs, doing electrocardiograms, giving injections and, in some cases, even assisting in minor in-office surgical procedures.

Medical assistant schools typically require 60 credits in their AS degree programs. The training generally takes two years, though some full-time students can complete them on a more accelerated schedule. These degrees are offered by a wide variety of schools from community colleges to major universities, and there are many options to get your AS medical assistant degree either entirely or partly online. If you have long-range plans to move up in the medical professions, it’s good to be aware that some of the courses you take in a degree program of this type may be transferrable to a bachelor degree program later on, but many of them will not.

Here’s a sampling of typical courses in an AS Medical Assisting degree program, which will generally mix topics that are directly career-related with general education subjects:

• Clinical Procedures
• Medical Terminology
• Anatomy, Radiography
• Medical Office Management
• Lab Procedures
• Behavioral/Social Science
• Psychology
• Communications
• Computers
• English Composition
• American Literature
• Intro & Intermediate Algebra
• College Mathematics
• Statistics
• Intro & Advanced Biology

Earnings
The national median salary for medical assistants in 2010 was about $28,000, with more experienced assistants earning over $40,000 per year (Source: U.S. Bureau of Labor Statistics). Primary care physicians (family practitioners, internists) treat a large volume of patients, but are not able to pay top dollar to their assistants. The higher paying medical assistant positions are working for doctors in allergy, dermatology, otolaryngology or other highly-compensated specialties. Private medical practices generally pay more than hospitals.

Getting Certified
When you have completed your degree, you’ll want to get your certification as a medical assistant before you go job hunting. Here are the two most widely recognized tests for a credential:
Certified Medical Assistant (CMA)
You must complete and accredited medical assistant degree program before taking this test, which is administered by the Certifying Board of the American Association of Medical Assistants. You are required to complete an approved “externship” before taking the test, which is administered at centers across the US three times each year. For information on how to apply for the test, visit AAMA’s site here. Keep in mind that you must renew this credential every five years.
Registered Medical Assistant
The RMA certification is offered by the American Medical Technologists (AMT), and it’s done via a computer test that’s done frequently throughout the US and Canada. For more information, visit AMT’s site here. After you are certified, you must show documentation to AMT every three years that you have taken continuing education credits to keep your knowledge current. Finally, it’s worth keeping in mind that once you have your associate’s degree as a medical assistant, you can always go back to college later on and complete a bachelor’s degree in just two more years that can lead you into nursing or other areas of health care.