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Medical Billing and Coding in Utah

Technology isn’t doing away with the need for skilled medical coders – far from it. It is, however, changing the way people carry out their job duties, including making it easier to code from home. Utah-based Aviacode is among the leaders.

Medical billing and coding, more so than most healthcare professions, is practiced nationally. Utah medical billing and coding specialists make themselves competitive the same way that those in other states do: through education and certification. The two main certifying agencies, AHIMA and the AAPC, are recognized around the nation. There are local chapters to help professionals stay connected.

Select a Utah Medical Billing and Coding Topic:

Medical Billing and Coding Foundations: Education and Certification

Coding varies some by setting, with significant differences in code sets used in inpatient hospital and physician’s office settings. The payment model affects coding as well as billing; some models are based on knowing the patient’s overall condition, including co-morbid diagnoses.

Most settings are designed to measure skills needed for a particular role or setting. However, industry-leading certifications are often valued even when they are not a perfect match. Some Utah employers list a number of acceptable certifications or simply note AAPC or AHIMA certification.

Some Utah employers do not state a certification requirement for professionals whose primary duty is medical billing. However, one can achieve billing certification through the AAPC. Medical coding certifications can also be a plus in billing positions. Professionals who advance into more specialized roles will find even more credentialing options.

The AAPC has provided extensive salary information based on surveys of its membership. Certificate holders in the Mountain Region average $49,978 (https://www.aapc.com/blog/33226-2015-salary-survey-credentials-tip-the-scale/). Salaries around the nation, however, are affected by various interrelated factors: workplace and job responsibility, type and number of credentials.

Medical billing and coding is a field where a degree has not become a universal expectation. However, employers do want associate’s degrees for some positions. The AAPC recommends having an associate’s degree but does not tie degree to certification eligibility. A high school graduate can vie for job and certifications on the strength of just a little post-secondary training.

Some billing and coding specialists are at an advantage because of degrees they have already earned. Some opt for degrees in health information management. This can put them at an advantage for hospital coding positions.

There are many sources of training, including professional organizations and proprietary schools. Coursework may be offered through the continuing education department of colleges or through traditional credit-granting departments. Some programs are designed to offer preparation for AHIMA examinations; others for AAPC examinations. A well-prepared candidate can ultimately test through either organization – or both.

AAPC Certifications

In many cases, individuals who certify through the AAPC begin with an apprentice designation. The experience requirement is just one year, provided that the individual has completed qualifying formal training. The apprenticeship requirement is in place for the Certified Professional Coder, or CPC, the AAPC’s best-known credential; it is also in place for the Certified Outpatient Coder (COC) and the Certified Professional Coder-Payer (CPC-P). It does not apply to the Certified Professional Biller (CPB) or to various expert-level/ specialty credentials. However, specialty certifications are generally only recommended for professionals who have considerable experience in the particular discipline being tested. Medical specialty certifications include the following (among many others): emergency department, anesthesia and pain management, and pediatrics.

Candidates will find upcoming test times on the AAPC site (https://www.aapc.com/certification/locate-examination.aspx). They may download materials from the site. They will be allowed to bring code books to the examination. Most examinations are multiple choice, but can be grueling nonetheless; candidates are allowed five hours and forty minutes for the CPC, CPC-P, or COC.

AHIMA Certifications

Requirement for the entry-level Certified Coding Associate (CCA) are, to the most part, informal. Candidates do have to provide evidence that they have at least graduated from high school. Those who have not spent at least six months coding are advised to take a few courses, including medical terminology and basic coding.

Certified Coding Specialist (CCS) candidates must take certain courses prior to examination unless they qualify through another pathway. Candidates who graduate from health information management programs and earn Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) certification can also take the CCS and earn coding-specific certification.

CCS examinations are four hours – twice the length of the CCA. They include case studies.

AHIMA certification examinations are made available through cooperation with Pearson VUE. Registration materials can be found on the AHIMA website (http://www.ahima.org/certification).

Entering the Utah Medical Billing and Coding Field

It takes a lot of practice to be accurate and efficient. Ideally this takes place in the context of paid employment, but there are other options. Some new graduates opt for Practicode, an online practicum that involves medical records that have had identifying information removed. Professionals can also use Practicode to practice new specialties.

Practicode was developed by Utah-based Aviacode but is available nationwide. The AAPC has partnered with Aviacode. New career professionals who attain CPC-A, COC-A, or CPC-P-A status can use the online practicum to work off their ‘A’ – the AAPC Practicode program can be credited as a year of experience.

Billing professionals sometimes work their way up from other medical office positions. Whatever one’s career goals, it can be a good idea to begin networking early.

Additional Resources

There are local AAPC chapters located in Ogden, Price, Provo, Salt Lake City, and St. George (https://www.aapc.com/localchapters/list-all-local-chapter.aspx). The following are among the continuing education topics slated for presentation at local Utah chapters in 2017:

  • Allergies, Asthma and the Immune System
  • All About Denials and Appeals

The Utah Health Information Management Association is the state AHIMA chapter (http://uhima.org).