The healthcare industry is rapidly evolving in every aspect—practicing physicians are constantly finding themselves scrambling to manage the onslaught of code changes, maintain compliance and stabilize profitability. Medical coding and billing are becoming the fastest growing professions in the industry, and, with this development, physicians are more interested in hiring individuals who are certified and have the qualifications to comprehend clinical documentation.
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Explore This IssueFebruary 2015
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In addition to the increasing use of electronic health records and the new code set ICD-10 for diagnoses, more coders will be needed to complete the new responsibilities associated with electronic data management and code mapping.
To support this need, the American College of Rheumatology in collaboration with the American Academy of Professional Coders created the certified rheumatology coding certification to enable coders to demonstrate superior knowledge in coding for rheumatology services.
“This specialty certification carries a lot of weight for employers seeking to hire coders in their practice,” says Antanya Chung, CPC, CPC-I, CRHC, CCP, director of practice management at the ACR. “It’s not just letters behind one’s name; it says the individual understands the coding concepts and principles of coding, especially in rheumatology.”
Advantages of Certification
Obtaining the CRHC certification has inherent advantages, because it distinguishes an individual as competent, knowledgeable and committed to quality healthcare through quality information. It will also give one a competitive edge in career advancement and in being considered for higher administrative positions in the medical industry.
Earning the rheumatology coding certification represents a high level of achievement and demonstrates coding proficiency. The CRHC certification requires personal commitment and accountability, because it includes an eight-hour review course and the passing of a rigorous exam. But the rewards for earning the certification include improved earning potential and career advancement.
“I probably would not have advanced in my career as a practice manager if it were not for my CRHC certification,” says Cheryl Johnson, CPC, CRHC, CPAR, CMA, of Piedmont Arthritis & Rheumatology. “Actually I started out as a coding administrator, and for this advancement I competed with a candidate who held similar qualifications but lacked rheumatology coding experience.”
The ACR places a concentrated focus on the importance of continuing education and certification in coding as a critical element in effective healthcare management in rheumatology practices. Coders are instrumental in keeping physician practices compliant by coding documentation accurately, properly reviewing medical records and staying up to date with code changes. A certified rheumatology coder knows the correct application for CPT and ICD-9 diagnosis for rheumatologic services—this means they are more able to translate diagnostic and procedural phrases into numerical codes used for billing and reimbursement purposes by insurance companies, safeguarding a practice against unnecessary audits.
Credentialing is very important for coders, because the codes change yearly, and the guidelines are constantly being expanding, says Johnson, but most importantly, having a CRHC coder in the office is beneficial to providers; it lets them know they have a trained professional on staff to help with lowering coding error rates and maximizing reimbursement.
The Review Course & Exam
The CRHC review course teaches the fundamentals of medical coding, prepares the participant for certification (https://www.aapc.com/certification) and helps them establish a career in the medical coding industry.
The CRHC’s coding abilities include:
- Expertise in reviewing and assigning accurate medical coding for diagnoses, procedures and services in rheumatology practices;
- Proficiency in evaluation and management of documentation coding;
- Knowledge of coding guidelines and regulations, including compliance and reimbursement;
- Knowing how to integrate medical coding and reimbursement rule changes into a practice’s reimbursement processes; and
- Expert knowledge of anatomy, physiology and medical terminology necessary to correctly code provider diagnoses and services.
Medical coding is on the verge of change; rheumatologists and their staff should educate themselves with the coding principles now to prevent decreases in reimbursement and coding productivity.
Understanding the coding, billing and claims process is crucial to keeping rheumatology practices running smoothly and profitably. The ACR can help you reach that goal through training and education. Contact the ACR certified course instructors, Antanya Chung, CPC, CPC-I, CRHC, CCP, and Melesia Tillman, CPC, CRHC, CHA, at 404-633-3777 to set up a course in your area, or visit the ACR website for additional information.