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Medical billing and coding programs in Montana are designed to get your career off to the right start

Rural or urban, Montana medical coders and billers have lots of options! Coursework and training can be completed online or in traditional settings. An experienced and successful coder will have those same work choices: remote or on-site.

There are many opportunities for advancement. The key is to get one's career off to the right start. Generally, a person will need to earn certification through one of two national third party certifying organizations: the AAPC or the American Health Information Management Association (AHIMA).

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Medical Billing and Coding Education in Montana

Students can look to the certifying organizations for educational standards. A candidate who is just starting his or her career will be eligible for ‘apprentice’ status through the AAPC before he or she is eligible for full professional status as a Certified Professional Coder, or CPC. Formal education in coding will reduce the apprenticeship period from two years to one. The program does not have to be lengthy. While the AAPC recommends that candidates hold degrees at the associate’s level, it recognizes even 80-hour programs.

Medical billing and coding certificate programs offered in college settings are typically between one and three semesters. Some career programs are even shorter. Longer programs, though, are more likely to include laboratory and fieldwork experiences.

A person who does not have past experience but wishes to test for the prestigious Certified Coding Specialist (CCS) or Certified Coding Specialist-Physician based (CCS-P) will need coursework in medical sciences (anatomy, pathophysiology, pharmacology, medical terminology) as well as coursework in insurance reimbursement and medical coding; coding coursework must cover procedure and diagnosis coding and must be beyond the basic level. AHIMA does not set minimum requirements for the entry-level Certified Coding Associate (CCA) certification but does recommend medical terminology, anatomy and physiology, and basic coding.

Some programs award Associate of Applied Science degrees. Longer programs, whether certificate or associate's level, typically include a good deal more than coding. A certificate program may cover medical office management. AAS programs often cover many aspects of health information management. Coding programs might include supportive coursework such as career development, office communications, and writing. They frequently include a limited amount of additional general studies coursework.

Gaining Medical Billing and Coding Work Experience

Employers like to see experience. Some Montana employers will consider related experience, such as healthcare or even customer service. As one moves up the ranks, though, the expectation will be for closely related experience. Sometimes this means experience in a similar setting. There are some differences between hospital and physician’s office coding; coding may be referred to as facility or practice.

The main coding systems are ICD-10, CPT, and HCPCS. The specialist may need to be knowledgeable of other systems used to classify illness or medical need. Higher level coders may be responsible for more complex cases. It's not always the medical aspects that make some treatment more difficult to code. It can be the circumstances -- for example, surgery that was performed same day.

Some medical coders eventually become experts in coding for specialized medical branches. This expertise is important because the number of codes is vast and professional judgment is often required. The work can include reading medical narratives and determining what information needs to be coded. Sometimes it includes requesting the missing information -- and even doing a little health practitioner documentation training. Clinical documentation is another potential area of advancement.

Other professional experience can be beneficial, even for some higher level positions. A recent example: Coding Investigator Auditor. The candidate was expected to have three years of claims processing experience plus either a bachelor's degree or comparable experience in a field such as law enforcement or business. Coding certification and nursing licensure were both listed among the preferred qualifications.

What can a coding specialist do if he or she is having a hard time securing that first position? One option is to complete a practicum or apprenticeship program through a professional organization. If there is nothing available in the immediate vicinity, the person might opt for the AAPC Practicode program: hundreds of actual medical records to work though and learn from. The experience can be used to move from CPC-A to CPC status.

Medical Billing and Coding Certification Examinations

The CCA is multiple choice. It had a 60% first-time pass rate in 2015. The exam assesses competence in the following domains:

  • Classification systems
  • Reimbursement methodologies
  • Health records/ data content
  • Information technologies
  • Privacy and confidentiality

Classification systems includes coding.

The CCS includes both multiple choice questions and scenarios. It assesses expertise in the following domains:

  • Health information documentation
  • Diagnosis and procedural coding
  • Regulatory guidelines and reporting requirements (inpatient)
  • Regulatory guidelines and reporting requirements (outpatient)
  • Data quality and management
  • Information technologies
  • Professional and legal issues/ privacy and confidentiality
  • Compliance

Candidates will find registration materials (as well as a list of allowable code books) on the AHIMA website. AHIMA can be reached at (800) 335-5535.

The CPC includes the following content:

  • 10,000 - 60,000 CPT
  • Evaluation and management
  • Anesthesia
  • Radiology
  • Pathology/ laboratory
  • Medicine
  • Medical terminology
  • Anatomy
  • ICD-10-CM/Diagnosis
  • HCPCS Level II
  • Coding guidelines
  • Regulatory and compliance

The CPB examination is 5 hours and 40 minutes. It includes 200 multiple choice questions. Candidates will need code books for this one as well. Examination content covers the following:

  • Types of Insurance
  • Billing regulations
  • HIPAA and compliance
  • Reimbursement and collections
  • Billing
  • Coding
  • Case analysis

Candidates can find upcoming examination dates -- and applications -- on the AAPC website (https://www.aapc.com/certification/locate-examination.aspx).

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

Additional Resources

There are four local AAPC chapters: Billings, Helena, Kalispell, and Missoula (https://www.aapc.com/localchapters/find-local-chapter.aspx). A person can click on the chapter link to contact local officers.

Sometimes local educational events are focused on learning coding changes; sometimes they are focused on learning about the world of medicine and therapy. Among the events scheduled for 2017 in Billings:

  • E&M Coding Review
  • Equine Assisted Psychotherapy

The state AHIMA chapter is Montana HIMA (http://montanahima.net/).