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Attending a Medical Billing and Coding School in Delaware can help achieve professional certification sooner

Coding is a challenging profession. Fortunately, Delaware has the resources necessary to help one succeed. There are multiple medical billing and coding schools and professional associations located within the state. Even more resources are available online.

While medical coding is not a licensed profession, it is, to an increasing degree, becoming a certified one. Prospective medical coders may want to consider certifications at the onset. There are two main third party certifying bodies, the American Health Information Management Association (AHIMA) and the AAPC; others are occasionally referenced in job postings but do not carry the level of widespread acceptance.

The education and certification process are, to some degree, linked. Having a discipline-specific education can mean achieving professional certification sooner. Perspective students will want to make sure that their education, at minimum, meets standards of the certifying body. Some programs include much more.

Select a Delaware Medical Billing and Coding Topic:

Earning AAPC Certification

The AAPC issues the highly respected Certified Professional Coder (CPC) certification. Certification is dependent on experience and examination. Candidates can test and, if successful receive an apprentice-level certification (CPC-A) before meeting experience requirements. Education can shorten the experience period. As little as 80 contact hours can be credited. (The AAPC does note that this is to be a program as opposed to continuing education.) Additional post-secondary education is valued but not mandated; the associate’s degree is noted as ‘recommended’.

The CPC examination requires candidates to apply ICD coding. It also includes concepts such as medical terminology, coding guidelines, and compliance and regulatory issues.

The AAPC offers related certifications that have similar experience requirements: Certified Professional Coder – Payer (CPC-P) and Certified Outpatient Coder (COC).

The organization also offers a number of certifications that do not have mandatory experience periods. However, these examinations actually require a greater level of expertise. Examinations such as the Certified Ambulatory Surgery Center Coder (CASCC), Certified Internal Medicine Coder (CIMC), and Certified Hematology and Oncology Coder (CHONC) are based largely on patient notes and are designed to simulate real-life coding in a specialty area; the candidate will also need to demonstrate knowledge that is specific to the discipline (for example, regulations). The AAPC does not recommend attempting any of these until one has at least two years of experience in the branch of coding being tested.

In order to take AAPC certification examinations, one must be a member of the AAPC. Examination information can often be obtained from local AAPC chapters. Candidates can search for upcoming exams on the AAPC website (https://www.aapc.com/certification/locate-examination.aspx). An early 2017 search reveals no Delaware tests but does provide information for a number of exams in Maryland and New Jersey.

The CPC certification examination carries a $350 fee. A candidate may retake the examination one time without repaying the fee. Some students have a reduced fee of $290.

The examination is open (code) book. The AAPC has identified which reference materials are allowed.

A professional who holds one certification is responsible for completing 36 continuing education hours every two years. With two credentials, the total requirement is 40 hours. The total requirement increases slightly with each certification (up to five). Some certifications carry specific continuing education requirements.

Earning AHIMA Certification

AHIMA offers the well-known Certified Coding Specialist (CCS) credential and a variant, the Certified Coding Specialist-Physician based (CCS-P). Experience is not mandatory, but it represents one qualification pathway. Individuals can also qualify by virtue of education. They will need intermediate/ advanced coursework in the two main coding systems: the ICD and the CPT. They will also need coursework in reimbursement methodology. This is in addition to foundational health sciences coursework. The following courses are mandatory: medical terminology, anatomy and physiology, pathophysiology, and pharmacology. These courses help medical coders make sense of patient charts, abstract information, and communicate with health professionals.

AHIMA also offers a lower level certification that does not have mandatory prerequisites: Certified Coding Associate (CCA). AHIMA does recommend that candidates have several discipline-specific courses (unless they have had six months of experience).

Students may instead pursue broader health information programs and then test for the Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) certification. AHIMA provides a number of career resources specifically for students of accredited programs.

The CCS examination fee ranges from $299 to $399, depending on membership status. AHIMA examinations are offered at Pearson VUE computerized testing centers. Delaware has two Pearson sites: Dover and Newark.

Other Certification Options

Employers occasionally reference other certifications as relevant. A recent certification referenced by a Delaware employer: the Radiology Certified Coder (RCC). The RCC certification is issued by the Radiology Certification Board. The RCB has recently announced two modality-specific assessments (https://rccb.org/about-rccb/in-the-news).

Medical Billing and Coding Educational Options

Delaware students may opt for certificate, diploma, or associate level medical billing and coding programs. Some programs are designed to articulate to others or be “stackable”.

While medical billing and coding have an overlapping skill set, they can be pursued separately. Some certificate programs require a limited amount of general education coursework, for example, English composition. Some programs include online coursework. Even the practical experience may be completed online. (However, some students will find it beneficial to complete an internship and make connections out in the ‘real world’.)

Additional Information

Delaware has a local AHIMA chapter, the Delaware Health Information Management Association (http://www.dehima.org/).

Currently, Delaware has two local AAPC chapters, one in Dover, the other in Lewes (https://www.aapc.com/localchapters/find-local-chapter.aspx).