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Looking for Direction... - chickadee

Posted: Sep 06, 2011

I am in need of a career change and am currently exploring coding. I've gone through a few websites, like AAPC, and some of the archives here, but I'm still confused and have a bunch of questions! Please help where you can.

What really is the difference between the CPC and CCS? I understand that the CCS is more beneficial, but I don't quite understand the mechanics of either. Is office coding more like a billing/clerical position? Do I have to have a 2-year HIM degree too? Does that help? How much experience would one need to have to Possibly be able to work from home? With EMR, do you think working from home would become more common? With in-house positions, what types of shifts are typical? Are they usually just 8-5 type, or do they staff for afternoons and/or overnights? If you work in a hospital, do you have to have a bunch of vaccinations? (I know, that's an odd one) =]

I assume they teach this one in school, but how do you really differentiate what's important and what's not? How do you really know what to code and what the main code should be? Example, some one comes in with shortness of breath because they think they are having an asthma attack... turns out to be MI... what do you do? (This is one of the reasons I really haven't jumped into coding...not confident that I'll know/learn what's what!) Is there a lot of memorization? I know, from archives, this tends to not be the case; however, when I was at my local CC for some classes, the coders were just down the hall. Anyway, I overheard their conversation of a test they took that was All memorized codes. All "What's the code for X?" questions. Scared the p. out of me! Is that a typical instruction/class technique? Or was that program probably just not quality? Any thoughts/reccomendations on the program offered by Andrews?

I realize this is a lot and that many of you are busy. Feel free to pick-and-choose! Or not answer at all, too ; ]

Thanks a bunch and I hope all of you have a wonderful week!

Answers - Coder

[ In Reply To ..]
What really is the difference between the CPC and CCS?

The CPC focuses on physician services coding, i.e., the type you would see in offices, hospital outpatient, services a physician provides to patients in a hospital, the physician's charges for surgeries and procedures. It codes mostly individual visits, although some might be coded on a monthly basis (dialysis, for instance).

The CCS focuses on hospital inpatient coding. It codes an entire hospital stay in one set of codes. It also covers hospital facility coding for things like ambulatory surgeries, radiology, pathology, and so forth.

I understand that the CCS is more beneficial, but I don't quite understand the mechanics of either.

It isn't more beneficial. They're both equally good. It's just that if you have both, you can get any kind of job. The CCS also carries a bit of a "ok, this person is really on the ball" cachet. Given a choice between a person with one credential or two, employers may choose the one with two. If you have no experience to fall back on, it makes sense to get both credentials because that might help you get a job. It also does a lot for your overall level of learning, your ability to use it, and your self-confidence.

Is office coding more like a billing/clerical position?

It is if it's IN an office, especially a small one. You may end up making appointments and changing paper on tables, too. It is possible to code outpatient services at a large facility and never have anything to do with billing.

Do I have to have a 2-year HIM degree too? Does that help?

No and no. A 2-year degree is not required. Many people who do that program never pass the RHIT exam and may learn so little coding that they can't work as a coder, either. It takes longer because a lot of it is general requirements like English, math, and history, which you do not need for coding. You need coding for coding, so you should choose a program that has a lot of coding. Aside from the basic sciences, it should be CODING CODING CODING.

How much experience would one need to have to Possibly be able to work from home?

Depends. Two years, maybe. Some employers may allow you to go home after 3 or 6 months. Depends on you. If you can code well, they'll let you go sooner.

With EMR, do you think working from home would become more common?

Yes, it IS becoming more common.

With in-house positions, what types of shifts are typical? Are they usually just 8-5 type, or do they staff for afternoons and/or overnights?

Usually 8 to 5, I would say.

If you work in a hospital, do you have to have a bunch of vaccinations? (I know, that's an odd one) =]

Depends on the hospital and possibly your state, but I doubt it. If you have some sort of medical condition that prevents vaccination, that shouldn't be a problem. We are offered a flu shot every year, but can sign a paper if we decline. I get free tetanus, pneumonia, and other vaccines, and I'm happy to get them. I don't know that you would have to prove egg allergy, for instance.

I assume they teach this one in school, but how do you really differentiate what's important and what's not? How do you really know what to code and what the main code should be? Example, some one comes in with shortness of breath because they think they are having an asthma attack... turns out to be MI... what do you do?

There are rules for deciding this. You learn the rules. It's not that complicated. If it's an outpatient visit and the MI isn't diagnosed at that visit, the dx is SOB. Otherwise it's MI. If it's a hospital stay, it would be the MI. As I said, there are rules, and they aren't complicated. And you can look them up--they're in the code book. You won't forget them, though, because they're NOT THAT COMPLICATED.

This is one reason you should take a course that teaches both inpatient and outpatient, and does not lump them in together. The rules are different and you need to learn them that way so that you can sort them out.

This is one of the reasons I really haven't jumped into coding...not confident that I'll know/learn what's what!)

That's like saying you won't learn to drive because you don't already know the driving rules. Of course you don't know the rules already. Why would you? That's what the school is for.

Is there a lot of memorization?

No, there shouldn't be. Some programs may thrive on it, though. Choose wisely.

I know, from archives, this tends to not be the case; however, when I was at my local CC for some classes, the coders were just down the hall. Anyway, I overheard their conversation of a test they took that was All memorized codes. All "What's the code for X?" questions.

You only got half the story. The rest of it was that they took the test with a code book. They looked up those codes.

No, you do not memorize them. You look them up. There is a process for doing that. It's not that complicated.

Scared the p. out of me!

It would scare me, too. Before I could code, coders told me you had to memorize the codes. They said it was really, really hard, if not impossible. Kept me out of coding for a long time, sad to say. That's why I emphasize that it's not that complicated.

Coders love to terrorize others. It's how they keep out the competition. Don't fall for it.

Is that a typical instruction/class technique? Or was that program probably just not quality? Any thoughts/reccomendations on the program offered by Andrews?

Again, I think you didn't realize that they were using code books. If the test did, in fact, ask for codes outright, then it's a silly technique. I don't think you'll see that at Andrews.

Great Answer - Soon-to-be-Coder

[ In Reply To ..]
I'm in the final course to get CCA certification at my local community college. Your answer to Looking for Direction has helped me clarify a lot about ICD-9 and CPT in my mind. Thank you for taking the time to give such a thorough response.

Thank you so much! - OP

[ In Reply To ..]
I really appreciate the time you took to answer me. You really clarified a lot and gave me some piece of mind!

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