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Medical Billing and Coding Specialist Requirements in Iowa: Multiple pathways to the most common and widely accepted certifications

Skilled Iowa billing and coding specialists may find themselves with a lot of choices. They may end up working for premier facilities or health systems like the following:

  • Genesis Health System
  • Mercy Medical Center
  • UnityPoint

Medical billers and coders in Iowa can work up to positions of responsibility, for example, coding coordinator, risk assessment coding auditor, medical billing insurance specialist II, or denials specialist. They may specialize in coding for particular medical specialties, for example, oncology.

An Iowa medical coding specialist can work for an organization located in another state -- without leaving home. Remote coding positions generally go to experienced workers. Even onsite positions are reserved for those who have proven themselves through some combination of formal education, practical training or experience, and credentialing. Iowa's medical coding specialists are not licensed, but they do frequently hold third party certifications. Some employers expect professional level credentials at the time of hire. Some job ads note that certification must be obtained within a set period of time after hire.

There are multiple pathways to the most common and widely accepted certifications.

Select an Iowa Medical Billing and Coding Topic:

Medical Billing and Coding Education in Iowa

Students may opt for medical billing and coding certificate, diploma, or degree programs. The format may be online, traditional, or hybrid. A student who pursues a certificate program in a college setting typically spends about a year completing courses. There are, however, much shorter programs. Some online programs can be completed within a couple months. Coding coursework, however, may be at the basic level.

The longer programs may include more in-depth coursework and practical experience as well as additional support courses. There can be a good deal of variety in non-core coursework. A program could include medical office procedures, career development, and/or general coursework like composition.

Some programs “narrow” the content by focusing on coding in a particular setting. Medical coding is slightly different in doctor's office settings than in hospitals.

Some Iowa employers ask degrees in health information – at least for some positions. Health information is a broader field that encompasses coding; electronic health records and databases would be among the typical courses. Other employers weight education and prior experience roughly equally; they may note two years of college or equivalent experience. Others just want "some college" – this can be accomplished by completing courses relevant to coding.

A medical billing and coding program will typically include the following:

  • Medical terminology
  • Anatomy and physiology
  • Disease process or pathophysiology
  • ICD-10 coding
  • CPT coding
  • Reimbursement methods

Expectations vary by job title as well as setting. Western Iowa Community College notes that professionals can move up the career ladder from entry-level coder to coding specialist to team leader, but that coding manager typically requires an associate's degree.

Iowa billing and coding programs have varying entrance requirements. Students may need to provide test scores (COMPASS, ACCUPLACER, SAT, or ACT).

Medical coding and billing programs are often geared toward the standards of a particular certification agency. This may go beyond merely designing the program with prerequisites in mind. The program may incorporate test preparation. It may incorporate products or programs developed by the certifying agency. Students may be expected to take a certifying examination upon course completion. The coursework is versatile, however. Neither certifying body requires a particular accreditation for billing and coding certification. Ultimately, the graduate can pursue certifications from either organization – or both.

The certifying agencies themselves are course providers.

Billing and Coding Certification Options

Certification may be pursued through the American Health Information Management Association (AHIMA) or the AAPC.

The best-known AHIMA coding certification is the Certified Coding Specialist (CCS); it is designed for hospital-based coding. The best-known AAPC certification in the Certified Professional Coder (CPC); it is designed for physician-based coding. Both organizations offer certifications for either setting.

It can take as long as two years to gain the experience necessary to become a Certified Professional Coder. This is the case for those who do not pursue formal education or training in medical coding. The educational program alone, though, is worth a year (even if it is much shorter). Practicum experiences can reduce the requirement further; this is the case even with some types of online experience. The AAPC has an online practicum program that is creditable as a year of experience. It involves working through hundreds of actual medical records.

A prospective CPC who has not yet met education/ experience requirements may take the test and, if successful, receive a Certified Professional Coder-Apprentice (CPC-A) designation.

AHIMA does not set any practicum or work experience requirement for CCS candidates. Those who are new to the field (no prior experience or credentialing) do, however, need to demonstrate that they have had required courses in medical sciences, procedural and diagnostic coding, and reimbursement methodology.

Coding certifications can be valuable even for professionals whose primary job description is billing. Those who want billing certification may go through the AAPC. The billing certification does not have mandatory experience or education requirements. This is also the case with many AAPC specialty certifications. However, the coding required is expert level.

Certification application materials can be found on the websites of the AAPC (https://www.aapc.com) and AHIMA (http://www.ahima.org/).

The AAPC can be reached at 877-290-0440.

AHIMA can be reached at 800-335-5535.

Continuing Education

Training is ongoing. One reason is that the medical coding profession is going through constant change. 2017, for example, will see some changes to CPT revision.

Both the AACP and AHIMA set continuing education requirements for certification maintenance.

Additional Resources

IaHIMA is the state AHIMA affiliate (http://www.iahima.org/). There are seven districts.

There are also seven local AAPC chapters in Iowa (https://www.aapc.com/localchapters/find-local-chapter.aspx).