Monday, August 15, 2011

Spotlight on Certification: The Certified Coding Associate (CCA)

I get a lot of questions from interested individuals about coding certifications. Like it or not, employers are looking more and more to credentialed coders to staff the workforce. It's almost impossible to get hired without a coding certification -but which one is right for you? What do the different certifications say about your qualifications? And what will you have to do to maintain your certifications?

I thought I would help out by spotlighting different coding credentials. There are two main organizations I will focus on and there are a lot of certifications. So be patient - I will get to all of the AHIMA and AAPC credentials eventually! And remember - I hold certifications with both organizations, so I'm not here to sell you on any single credential. If you plan to work in hospitals, AHIMA credentials are more widely recognized whereas physician offices usually require AAPC certifications. Before you decide which organization to join, do your homework and find out what credentials they require where you want to work.

I'd like to start with the newest AHIMA credential, the Certified Coding Associate (CCA).

I've never taken the CCA exam because when it came out, I was already certified as a Certified Coding Specialist (CCS). And while many aspire to be a CCS, AHIMA doesn't recommend taking that exam until one has at least 2-3 years of experience as a hospital inpatient and outpatient coder. But what about those people who have taken coding classes and want to prove they know a thing or two so they can land an entry-level coding position? Enter, the CCA credential.

AHIMA created the CCA credential to demonstrate one's "coding competency in any setting, including both hospitals and physician practices." In essence, it lets your future employer know you've taken the core coding and HIM classes. When I talk to people who are trying to begin coding careers, I often hear them say something along the lines of, "Why should I waste my time with an introductory credential?" or, "It's a waste of money."

Well, from my perspective, if you have taken the time and effort to take the CCA exam, it tells me one big thing: you're serious about coding as a career because you took the initiative to study for an exam. And if I were hiring, that is something I would definitely take into account. Coding certifications cost money - it's an occupational hazard. But being without a coding credential most likely means not having a career as a coder. Which do you want more?

CCA Specs
The CCA credential, as mentioned, is available through AHIMA. It costs $199 for AHIMA members to take the test. If you aren't a member of AHIMA and plan to work as a hospital-based coder, I highly recommend joining. Again, another cost that is important to your career if you're serious about working as a coder. If you aren't a member of AHIMA, the cost is $299. The CCA credential is the only HIM credential worldwide that is accredited by the National Commission for Certifying Agencies (NCCA), although I've heard AHIMA is seeking the same approval for other credentials.

As for content, it's not just coding. And I think this surprises a lot of people who take the test. It also tests for HIM-related competencies. That's something to keep in mind when you're studying for it. There are six domains that make up the CCA test:
  1. Health Records and Data Content (20%)
  2. Health Information Requirements and Standards (14%)
  3. Clinical Classification Systems (36%)
  4. Reimbursement Methodologies (10%)
  5. Information and Communication Technologies (6%)
  6. Privacy, Confidentiality, Legal, and Ethical Issues (14%)
The tasks for each domain are outlined on AHIMA's website along with FAQs and other important exam information. If you plan to take the CCA exam, I recommend spending a lot of time on the CCA page.

CCA Jobs
The CCA credential is still relatively new for those of us who have been around for a decade or so. And I admit, as a profession, we're a little slow to accept new ideas sometimes. Job postings may not state the CCA credential as one that is accepted. My general rule is, if the job calls for a CCS and you have the CCA, apply for it. The employer may not get enough job applications from qualified individuals. And if it was me, I would certainly look at a CCA with more interest than someone without any certification. The credential is catching on, though, and I'm starting to see it in job postings. So, do I think it's a credential worth getting? If you don't have any other certifications, then yes. Absolutely!

Curious about whether or not to take the CCA if you have an RHIT? If so, check out this past blog of mine on the HICareers website: "Should There be a CCA After RHIT in Your Title?"

Monday, August 1, 2011

I Love ICD-9-CM - What if I Don't Feel the Same Way About ICD-10?

I think there are a lot of students out there learning ICD-9-CM right now who are feeling a certain apprehension about the ICD-10 implementation. It's a tricky time to be educated in coding right now - you may decide you love ICD-9-CM only to have it ripped from your grip in 2013 and replaced by something that doesn't closely resemble your new found love. So maybe you've been reconsidering a field in coding.

Well, let's not overreact! First of all, let's look at what it is you like about coding, what will be changing, and then decide if it's time to overreact!

First of all, ICD-9-CM, Volumes 1 and 2 (the diagnosis codes) are being replaced by ICD-10-CM. And although there are some tricky areas and all of the code numbers are different, the overall feel and use of ICD-10-CM is not that dissimilar to what we're used to today. Yes, it will be more difficult to roll codes off the top of our heads like many of us can now with ICD-9-CM, but it will not be impossible (after a week coding in ICD-10, I found it was not difficult to memorize frequently used codes. The major changes? We have extensions now to indicate the episode of care for patients with injuries and we have codes for underdosing of medications - something that's completely foreign. And although in ICD-10 there are two types of excludes notes instead of one (not coded here vs. not coded in addition), that's a nice change that most coders are happy about.

ICD-10-PCS on the other hand, is very different from Volume 3 of ICD-9-CM, which includes procedures. In fact, ICD-10-PCS is very different from anything we've ever used for coding. The fact that there are no inclusion and exclusion notes - no tabular listing, in fact - only pages of tables, makes it seem daunting. This will be a huge impact, no doubt.

But should you worry about it? Remember - ICD-10-PCS has limited application. It is only required for billing on hospital inpatient claims. So if you work for a physician - or plan to - you will not have to learn ICD-10-PCS. If you code outpatients in a hospital, the jury is still out. Many hospitals still collect ICD-9-CM procedure codes for outpatients so they can use the data internally (remember - coding is about data collection too, not just billing). There is much discussion in the industry on the productivity impact of having coders code in both ICD-10-PCS and CPT for hospital outpatient services.

CPT is not at all affected by ICD-10 implementation. If you code for a physician, you will continue to use CPT to code and bill for his services and procedures.

Of course, if you find you have an affinity for ICD-10-PCS, perhaps this will help you determine your career path and you can look for opportunities to code in a hospital. Inpatient coding is usually a higher level coding position, so it may take time to get promoted up, but if you have the skill for ICD-10-PCS, it's my belief that you will be in demand. I think some current inpatient coders may decide they don't care for ICD-10-PCS at all and make some changes in their career paths.