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Can you take the RHIT or CCS having just finished coding school? - wondering sm

Posted: Apr 01, 2010

I am thinking about taking a billing/coding class, but noticed that getting a job after that involved having the RHIT or CCS. I am wonding if this will be a catch 22 and don't want to spend time in school for coding if I cannot pass these 2 tests when I am done, as it looks like I will not be able to get hired without these certificates. Sorry about the confusion on this. Thanks for your time and info.

Not all jobs require that - Redpen

[ In Reply To ..]
You can take the CCS exam regardless of whether you've taken a course or not--all that is required is a high school diploma.

The RHIT is a health information management credential, not a coding credential. It requires completion of an associate's degree program in HIM.

Not all jobs require an RHIA or RHIT. Lots of coders have neither, and they don't have any trouble finding excellent jobs.

If you keep seeing only jobs that require RHIAs and RHITs, then you're not looking far enough or in the right place. I'd guess that very few of the jobs on the AAPC website require those credentials.

I know literally hundreds of coders who make up to 70K or more. Very few are RHIAs, a few more are RHITs, a few have AHIMA coding credentials, but the majority are AAPC credentialed.

And, yes, it is entirely possible to get a job in coding without having any credentials at all.

It sounds like coding is better than MT. - Thank you for the info!! sm

[ In Reply To ..]
I was and am just so nervous that taking coding classes would be a waste of time, but I am looking for something that pays better than MTing. My concerns are how difficult it would be to break into coding and that I would still be making minimum wage. Obviously I am just very frustrated with MTing and am looking for a more decent job.

Response - Redpen

[ In Reply To ..]
No matter what occupation you choose, getting a job requires a lot of work. Getting a first job requires a lot MORE work and you have to start at the bottom, not the top.

There is a pervasive view that all college graduates are snapped up into jobs of their choice, but it's a false view. A lot of computer science and accounting grads end up never working in the field at all, and this is true of any field.

Your concerns are valid. You owe it to yourself to find out how the job market works in your area and nationally. This information is readily available through networking with memgers of professional organizations and by obtaining salary information those organizations post on their websites.

The federal government publishes job outlook information which indicates health information technology (the field containing coding) is a good choice. Both of the professional organizations and Advance for HIM publish salary survey information on their websites.

I won't post the links because they change and because it will be a good experience for you to find this information yourself. In particular, go to the AAPC website and the Advance for HIM website and find their salary surveys. You'll see decent incomes listed there. From the AAPC website, you'll also see that there are a lot of coders who have jobs--that entire organization wouldn't exist if there weren't enough coders to need it.

Also find the contact information for the local AAPC chapter. Make a point of attending one of their local meetings so that you can meet working coders and see for yourself that there ARE jobs and determine your chance of success. Not one person there started at the top and not one person there was handed a job on a silver platter, but they're all working.

I can tell you that I don't make minimum wage and that nobody I have ever seen in coding makes minimum wage, but you have no reason to believe me. This is something you will need to ascertain for yourself.

Get the information you need to make an intelligent, informed decision so that if you decide to tackle coding you'll be able to devote your best effort toward it. You're on the right track--information-gathering is what you're supposed to do at this point. Just don't stop with taking anyone's word for it. The people here don't know the information you need, but you can find it at the websites I mentioned.

Redpen, ? - Jan

[ In Reply To ..]
Can you explain the difference in job duties of a CCS (hospital) and a CCS-P (also hospital)? One hospital is looking for a CCS, the other hospital is looking for a CCS-P. What would one expect going from one to the other? I have read the descriptions on AHIMA, but I would like to hear from someone in the field who has seen the difference first hand. I have seen conversations about Ã�Â¢Ã¯Â¿Â½Ã¯Â¿Â½the facility sideÃ�Â¢Ã¯Â¿Â½Ã¯Â¿Â½ and the Ã�Â¢Ã¯Â¿Â½Ã¯Â¿Â½payer or physician side.Ã�Â¢Ã¯Â¿Â½Ã¯Â¿Â½

Please check the ad again - Redpen

[ In Reply To ..]
Before I answer, look back at the ad again and check to see that the second hospital is looking for a CPC-P. Are you sure it's a CPC-P? Not a CCS-P or CPC-H?

If it does say CPC-P, what does it say about the job duties?

I ask because it's unusual for a hospital to want a CPC-P. Unusual, but not unheard of. I just want to make sure it's a CPC-P for sure, and not a CCS-P.

I can still answer if you don't have the information, though. :)

CCS-P or CPC - Jan

[ In Reply To ..]
I don't have the first ad, but it was a hospital looking for a CCS. The other ad is looking for a CCS-P and/or Certified Professional Coder CPC. It is a medical center. Basically, I just want to know what a "pro" or "payer" coder would be doing as opposed to just a hospital inpatient/outpatient coder. Thanks!

Differences - Redpen

[ In Reply To ..]
Basically, the one hospital wants an inpatient coder who can code inpatient stays. The other wants a coder who can code the facility portion of things like ambulatory surgeries, cardiac caths, chemotherapy, dialysis, or whatever it is that the hospital provides for outpatients.

The whole concept of inpatient versus outpatient in coding is an oversimplification. It's the general breakdown of services and also the main division in the coding rules, but there is a lot more to it than that.

Inpatient coders code an entire stay of a patient who was admitted to the hospital. That might be a day, a week, or a month. They sum it all up in one set of ICD-9-CM codes using certain rules. The CCS covers this type of coding in particular.

Hospitals do more than just inpatient stuff, though. They have diagnostic services like x-rays and lab, and they have outpatient surgery centers, nuclear medicine centers, and so forth. When patients come to the hospital for a day to use those services, and they are not formally admitted, those services are coded using outpatient rules for ICD-9-CM diagnoses and CPT procedures.

The inpatient and outpatient diagnosis rules are slightly different and the procedure coding rules are slightly different. This difference makes it more challenging to learn and use both types of coding.

Notice that the hospital itself does not DO the surgery or interpret the x-ray. It provides staff to help with the surgery and take the x-rays, but a professional provider has to actually show up and DO the surgery or READ the x-ray. There are thus two parts to these services -- the facility part and the professional part.

The medical center is going to code their part themselves. They'll code for the use of the OR, the recovery room, and everything on their side. The doctor who did the operation or read the x-ray will code their part of it, too. You then have two separate sets of codes being submitted to the payer, the facility portion and the professional portion.

In fact, when a patient is admitted to the hospital, the inpatient codes cover the facility part of the procedures, but the doctors still code and bill their own services. The doctors will also code and bill their professional services for seeing the patient, reading x-rays, etc.

The CPC covers the ICD-9-CM and CPT coding for these outpatient services, both the facility part and the physician part.

However, things become more complicated as time goes on. At very small facilities, a single coder might do everything. At larger facilties there is too much and it is a lot to remember--it's hard to juggle all the differences. It might be more effective for coders to specialize. There are thus the CCS-P and CPC-H credentials which kind of cover the facility part of the game.

The CPC-P, or payer, credential kind of covers what all the above looks like when it is viewed from the side of the insurer (the entity which will be paying).

These aren't hard and fast exclusionary differences, either. The CCS talks about CPT procedures, and some inpatient coders also assign CPT codes to their inpatient stays, and some ambulatory surgery coders at facilities might assign ICD-9-CM procedures, as well as CPT, for the benefit of the hospital's database.

There is overlap among the credentials. They're all kind of different, though. It's not really possible to say that one is the equivalent of another offered by a different organization. They're all unique and slightly different. They test different things and their focus differs.

Generally speaking, if you have either a CCS or a CPC, you're going to be ok. Those are where most people start out. If you have both, you're really doing well. If you have a need for one that is more specific, you can get that one, too.

Now, too, there are subspecialty credentials. The one in interventional radiology and cardiology offered by the AAPC is notoriously difficult and very valuable, too.

The one thing that is never appropriate, in my opinion, is credential-bashing. As I pointed out above, all of these credentials demonstrate mastery-level skill, but do so in different areas. In my experience, the exams offered by one organization are not easier than those offered by the other--they're just different.

What do schools teach? Some teach "generic" one-size-fits-all coding. This may be inpatient only or or a mush of inpatient/outpatient. The student has an overview, but can't really do either well enough to work without substantial OJT. Other schools teach only outpatient coding. Still other schools teach both outpatient and inpatient coding separately, so that students can see and understand the differences.

Do experienced coders typically code everything? No, they quite often specialize. Many prefer whatever type of coding they began with and stayed with, and they may heartily dislike the other type. As with anything in life, we're more comfortable if we're familiar with something. Long-time inpatient coders seem to have the most difficulty switching, while outpatient coders can pick up inpatient with little difficulty, often thinking it is easier because it doesn't use CPT. Of course, everyone is different, so this doesn't hold true for everyone.

I hope that answered your question!

Yes - Jan

[ In Reply To ..]
It answers it perfectly, thank you! I work in a small hospital and have my CCS and CPC-H. I got the CPC-H instead of the CPC or CCS-P because I thought I never wanted to work at an office for physicians - only hospitals. I mostly code OP surgeries and some inpatient so am lucky to do both. But, I am also kind of blind to the â��other side,â�� the payer side. When I start looking around for greener pastures and they want a CCS-P or CPC, I wonder how big a change it would be or if they would accept other credentials when they specifically are asking for CCS-P. Thanks for taking the time to answer.

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