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Medical Billing and Coding in South Dakota

The process of becoming a medical biller or coder is much the same in Sioux Falls as it is in smaller South Dakota municipalities -- and in states around the nation. Rural or urban: It matters little. Many programs, initial and continuing, are available online.

Professionals often seek certification through one of two national organizations: the American Health Information Management Association (AHIMA) or the AAPC. Experienced South Dakota medical coders may even compete with professionals from other states. Many companies hire professionals who have proved themselves to work remotely.

Certified coding specialists can earn good money. The AAPC surveyed its membership in 2015 and reported an average salary of $49, 978 for the Mountain Region (https://www.aapc.com/blog/33226-2015-salary-survey-credentials-tip-the-scale/).

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South Dakota Medical Billing and Coding Education

The journey begins with education. Post-secondary education is not mandatory, but it is often expected. Some South Dakota employers note it. Formal training facilitates the certification process in both direct and indirect ways. Some certificates are dependent on meeting prerequisites for experience and/ or education. Whatever the formal requirements, passing a certification examination can be difficult. First-time pass rates for AHIMA coding examinations ranged from 46% to 60% in 2015.

The student may earn a certificate or Associate of Applied Science. A short program may be geared toward preparation for a particular certification. The school or program may maintain ties to a particular certification agency. The program may list several certification examinations as being appropriate for graduates.

Some medical coding schools put their students on-site at a healthcare facility for internship. This provides the opportunity for networking as well as real-world experience.

One can become a member of the AAPC or AHIMA at the student level. Members can use forums to ask certification- or employment-related questions.

Attaining Entry Level Credentials

Entry-level medical coders may take the Certified Professional Coder (CPC) examination through the AAPC. Eventually, this will lead to one of the industry’s premier credentials. However, first they will have Certified Professional Coder-Apprentice (CPC-A) status. A candidate who has completed a qualifying medical coding program (at least 80 hours) will need one year of experience. Ideally, this will be achieved through work experience.

Practicum that was completed as part of the educational program can be used to offset the experience requirement. An individual who is having difficulty finding that first job may want to complete a practicum through his or her professional organization. The AAPC has an online practicum program, Practicode, which is accepted as experience from a certification standpoint; the program involves working one’s way through hundreds of actual medical records.

Entry-level professionals may instead take the Certified Outpatient Coder (COC) or Certified Professional Coder-Payer (CPC-P) examination through the AAPC. The same experience requirements apply. A successful but inexperienced candidate will begin with apprentice or ‘A’ status. This is not the case with Certified Professional Biller (CPB). Nor is it the case with Certified Risk Adjustment Coder (CRC). However, the AAPC recommends that prospective CRCs hold off until they have completed a risk adjustment course or accrued sufficient experience in the discipline.

New career professionals may test at the Certified Coding Associate (CCA) or Certified Coding Specialist (CCS) level through AHIMA. The CCA is designed as a general credential for medical coders across settings. The examination is easier than the CCS. The CCS is intended for coding specialists in hospital settings. It is considered mastery-level, but some new graduates do pass it. An individual who does not have experience in the field can attempt the exam if he or she has completed an AHIMA-approved program or another program that includes the required coursework.

Students who complete health information management programs at the associate’s level can test for AHIMA Registered Health Information Technician (RHIT) certification. This may be looked on very favorably.

Attaining More Advanced Credentials

AAPC-certified CPCs can compete for many positions on the strength of their certification. Experienced coders may also test for various specialized credentials. They may call the AAPC at 877-290-0440 if unsure what to test for.

The AAPC’s new Certified Inpatient Coder (CIC) is considered expert-level: recommended for those with at least two years of experience in a hospital setting.

AAPC certifications are available in many areas of specialty medical practice, including the following:

  • Ambulatory Surgical Center
  • Cardiovascular and Thoracic Surgery
  • Evaluation and Management
  • Pediatrics

Experienced physician’s office coders may want to test for the AHIMA Certified Coding Specialist-Physician based (CCS-P) credential. This one does, however, have a lower first-time pass rate than the CCA or CCS: just 45%, according to recent data.

The Examination Process

One will find upcoming AAPC examinations listed on local chapter webpages (https://www.aapc.com/localchapters/local-chapter-info.aspx?id=01145071). The Mitchell, Rapid City, and Sioux Falls AAPC chapters each host at least four examinations in 2017. The AAPC also has a search function to locate upcoming exams.

AHIMA has partnered with Pearson VUE to administer its examinations. Candidates will submit their credentials and fees to AHIMA (http://www.ahima.org), then wait for an ATT to be issued. At this point, they will be allowed to self-schedule. A candidate who extends his or her ATT beyond the original four months will incur additional fees.

Additional Resources

There are three local AAPC chapters, located in Mitchell, Rapid City, and Sioux Falls.

The South Dakota Health Information Management Association is the state AHIMA chapter (http://www.sdhima.org).