Credentials

Why Should a Coder Get Certified?

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By Torrey Kim, CPC

Remember the days when a physician could point to his or her receptionist and say, "From now on, you're my coder"? Those days are well behind us. In today's medical environment, it takes an intricate knowledge of government and private payer regulations, frequent code and coverage changes and myriad other technical facts to be a medical coder. Medical practices can't risk hiring an untrained medical professional, so they look for coders who have met the challenge of acquiring medical coding credentials.

But coding certification isn't just a plus for the physicians and other health care practitioners who hire coders. Certification can help the coder immeasurably as well, in several ways.

Hiring Plus

It wasn't that long ago that doctors thought "anyone" could be a coder, but today's physician practices are increasingly requiring certification. In a recent American Academy of Professional Coders (AAPC) poll, more than 40 percent of respondents said that certification was required for employment. Medical practices don't want to waste time interviewing candidates who are simply looking for a temporary job - they want coders who are committed enough to medical coding that they've made it their career, and certification is one sign of how serious and well-trained a coder is.

Likewise, the Office of Inspector General requires independent review organizations to use certified coders for claims review and some states, such as Hawaii, require certified coders to perform medical claims review.

Salary Boost

Once the coder gets the job, the next step is establishing a salary -and studies have shown that certified coders walk away with more annual pay than non-certified coders.

According to a 2006 survey conducted by the AAPC, the average annual salary is 21 percent higher for a certified coder than for a non-certified coder. A 2005 survey by The Coding Institute backed that data up, reporting that certified coders earned, on average, more than $5,000 more per year than coders without certification.

The most likely reason that physicians are willing to pay more for certified coders is that the medical practice's income is in the hands of the coder. You won't find many other careers where the employee has to protect the employer against fraud while still trying to capture millions of dollars in revenue each year. A well-trained coder knows how to seek the deserved amount of income for his or her practice while staying well within legal and ethical boundaries.

If the certified coder gets a denial from an insurer, he or she knows the process of appealing the claim to fight for accurate reimbursement. And on the other side of the coin, if the certified coder reads a chart and feels that the physician has recorded a code that appears too high for the service provided, that coder will speak up and let the physician know that a lower-valued code is more applicable.

In its occupational handbook, the Department of Labor considers medical coding a "high growth" career, meaning that demand for coders is on the rise. Coding and billing professionals who want their careers to grow along with the rest of the field should consider certification as the first step toward a successful professional future.

Torrey Kim, CPC, is senior editor at the AAPC. Visit the AAPC Web site at www.aapc.com


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