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How Medical Coding Originated



How did medical coding originate? Well, once upon a time, a mommy and a daddy loved each other very much and decided to take that love and turn it into a quantified system of medical coding. Okay, that’s not quite how it went.

Although medical coding is currently employed alongside the use of advanced medical and computing technology, the practice is much older than one might initially guess. In fact, the earliest noted form of medical coding is cited in the 1660s – before computers, type writers, and digital thermometers. See this post for more of what medical coding is today.

How did something so advanced date back so far in history? Out of necessity. Any high school student who has had a history or social studies class can tell you that the seventeenth century was rough on London, with plague decimating populations of people. The bubonic plague outbreak was so devastating that doctors decided to record the circumstances of the deaths it caused for some hope of beating it.

The next big round of early medical coding was late nineteenth century France. A physician named Jacques Bertillion developed the Classification of Causes of Death, which became standardized within a decade.

Today, medical coders work with ICD-9 codes (or ICD-10 for those who’ve already converted to the most current codes), which stand for International Classification of Diseases, ninth (or tenth) revision. Like its predecessors, the ICD code system is death-driven, primarily codifying conditions that result in fatality.

Differing in this respect, CPT (Common Procedural Terminology) codes that developed in the 1960s in the United States offer a standard set of codes to describe medical procedures ranging from diagnoses to various treatments. This set of codes is the last major development to the system of medical coding.

When you look at its place in the grand scheme, however, it’s not so much a dead-end for coding but the jaw-dropping final chapter if we think about coding as a film franchise.

See this post on the future of medical coding.

How Much Does It Cost To Maintain AAPC Certification?

There are many questions a medical coder, current or aspiring, must ask his or herself. “Am I capable in the field?” “Does it interest me?” “What will it require of me, and am I prepared to do those things?”

Any job comes with its share of expectations, but many pale in comparison to those of medical coders. Although coders typically enjoy a steady work environment with normal weekday hours, medicine (and healthcare at large) is a constantly changing landscape; progressive scientific research and adapting policies create a necessity for all its workers to keep current with these changes.

A certified medical coder spends months preparing for the examination that certifies him or her, but the expectation of learning continues. This is where CEUs come in, also known as “continuing education units.” CEUs are the AAPC’s (American Academy of Professional Coders) way of gauging whether a coder is staying current. The more certifications a coder holds, the more units he or she is required to acquire on a two-year basis.

A major concern of obtaining CEUs regularly to stay certified is the cost. Workshops and conferences – regarded as the best ways to earn CEUs – can become rather expensive and reach into hundreds of dollars. But fear not! All is not lost, as there are several recognized ways to earn CEUs without spending too much money. Because the number of units required depends on number of certifications and the cost depends on what you choose, we’ll simply provide some options as food for thought:

  • AAPC official 3-hour workshop (6 CEUs): $149 for members, $189 for non-members
  • AAPC audio conference (2 CEUs): $149 for members, $189 for non-members
  • AAPC national/regional conferences (up to 20 CEUs): anywhere between $300 and $600
Here are some free methods:
  • Local chapter meetings (I CEU/hour)
  • Complete self-test in monthly Coding Edge magazine and newsletter EdgeBlast (up to 12 CEUs/year)


The Main Differences Between The CPC Exam And The CPC-H Exam

If you are looking into taking either the CPC exam or the CPC-H exam, chances are that you have chosen to seek certification from the AAPC (American Academy of Professional Coders) for a reason. Becoming a certified professional coder through the AAPC puts you at a significant advantage, as the organization reports a 20% higher earning potential than those without certification.

Employers are also more likely to opt for a certified coder because the AAPC has a standing reputation of turning out efficient and effective workers. But you probably know this, so let’s address something a little less obvious: the CPC exam versus the CPC-H exam.

Both exams contain 150 multiple choice questions, for which you have 5 hours and 40 minutes to complete. Both exams are open book and give you a single chance to re-take the exam for free. (Even though you can re-take it, study thoroughly the first time to avoid having to sit for another five hours!) AAPC students can take either exam at a $40 discount, paying $260 instead of $300.

Both exams test knowledge in procedural terminology and medical equipment in addition to the standard background in anatomy and physiology. However, the CPC exam prepares the taker for work in a physician’s office, where as the CPC-H exam prepares the taker for work in hospital groups.

According to the AAPC, the following are content areas found on the CPC exam:

  • Anesthesia, Radiology, Medicine, Nervous, Endocrine, Digestive, Urinary, Musculoskeletal, Evaluation and Management, Anatomy and Physiology, Mediastinum & Diaphragm, Practice Management, Male/Female Genital, Hemic & Lymphatic, Maternity & Delivery, Eye & Ocular Adnexa, Pathology, Integumentary, Respiratory, Laboratory


The following are content areas found on the CPC-H exam:


  • Medical Terminology, Anatomy, Coding Guidelines, Payment Methodologies, Surgery and Modifiers, Code Assignment ICD-9-CM Vols 1 & 2, Compliance

Need help deciding which exam to take. This post outlines the differences between the CPC and CPC-H credential.

Are All Medical Coding Vendor's Approved With The AAPC?

As if studying for medical coding certification wasn’t tough enough, a coder who passes not only faces the job market – which, although favorable for coders, is still in a bit of a dip – but also faces the requirements to maintain certification. Depending on how many certifications a coder possesses, he or she is required to complete a certain amount of continued education units (CEUs) every two years to stay certified.

Here’s a quick idea of the CEU requirements per the AAPC:
  • One certification = 36 CEUs every two years
  • Two certifications = 48 CEUs every two years
  • Three certifications = 60 CEUs every two years
  • Four certifications = 72 CEUs every two years
  • Five certifications or more = 80 CEUs every two years
There are dozens of possibilities for obtaining CEUs, such as conferences, webinars, and teaching (or completing) post-secondary course work. Any organization providing these CEUs is considered a vendor, and one fact is absolutely essential to earning CEUs: not all vendors are approved by the AAPC.

(Below is a link to the AAPC’s official website and its page addressing approved vendors. This page features a tool that allows the user to browse approved CEU vendors or search a vendor or event to see if it is currently approved.)

http://www.aapc.com/medical-coding-education/vendors/index.aspx

Any conferences, workshops, or webinars hosted by the AAPC (naturally) approved means of earning CEUs. Anything else, for the sake of the coder, should be verified as approved. Visiting the above link is one method, and another is consulting and networking with fellow coders and addressing vendors directly for proof of AAPC approval.

For the anxious coder, a quick browse through the approved list online will show that there are countless numbers of activities and vendors he or she can approach for CEUs. After all, it shouldn’t be a limiting burden but a boundless opportunity!

Can You Work In Medical Coding Without Being A Member Of The AAPC

A person hoping to break into the medical coding field must not be a stranger to endurance, as the studying, certification, and training process is vigorous and filled with thorough testing and evaluations. In order to become a medical coder, you have to obtain official certification that qualifies you in the field. This requirement however is not a legal requirement but is simply required by virtually every reputable recruiter.

There are two main types of certification that employers will accept: one from the AAPC (American Academy of Professional Coders) or the other from AHIMA (American Health Information Management Association). Because both organizations are recognized and both of their certifications are respected in the medical community, it is up to you which organization you go through to obtain certification.

AAPC membership is popular among medical coders, leading prospective coders wondering if AAPC membership is necessary to break into the field. The short answer is “No.” The long answer, fortunately, is no more complicated than that.

In reality, AAPC membership is a good thing to have due to the numerous benefits. For instance, a member has access to online forum discussions and similar tools to network to other coding professionals. A member also receives exclusive discounts on conferences and coding books to keep fresh in their profession as well as job placement resources.

If you’re looking into medical coding but haven’t yet worked toward certification, becoming an AAPC member can help you acquire the tools to become certified. For instance, the organization has designed its own study and exam materials to make the process smooth and comprehensible for you.

Ultimately, there are countless methods through which to get into medical coding, and there are countless strategies and resources you can employ to help your chances at succeeding professionally. Aside from joining the AAPC or AHIMA you can always take a coding course and get a certificate from any one of the many schools offering medical coding programs. Some employers will be fine with this but many will look for the actual credential that you can only get with membership status.

AAPC membership should be considered as one of these strategies or resources rather than being regarded as the sole asset in your career but you shouldn't write membership off as unnecessary just yet.

How Long Does It Take To Get Into Medical Coding

One thing that is critical to bear in mind about the field of medical coding is that it is a field without explicit requirements in some respects. For example, on one hand certification in medical coding is not an absolute requirement to work in the field; on the other hand, you cannot reasonably expect to be employed without it. In addition, continuing education is not an absolute requirement, but you cannot reasonably expect to stay employed without it.

If you are not already sensing a theme, it is that medical coding is a field without absolutes. A rigid plan of action carved into a stone calendar, therefore, is the wrong approach. In order to successfully get into medical coding, you have to figure out how to gauge your time commitment based on your circumstances.

For example, a person with an undergraduate degree in biology with a medical focus can expect to take less time preparing for CPC certification because he or she is already familiar with human anatomy and medical theory/terminology.

You might be thinking, “Alright, cut the nonsense. Really, how long does it take to get into medical coding?” Assuming you go through the typical steps, here is a timeline for the average medical coder:


  • Choosing a certification program – as long as needed. Common certifications include the CPC and the CPC-H. Here is a comparison of the two.
  • Taking medical coding courses – 45 days to 3 years. Online courses can be completed within several months, whereas vocational programs at universities can take as long as several years. In all actuality these courses are not exactly nessesary but most people need them to learn enough to actually get certified. See this post for more info.
  • Obtaining certification – as long as needed. If you take a 2- or 3-year program at a college or university, doing so earns you a certificate and degree (which are valuable) but doesn't actually certify you. While certification from the AAPC or AHIMA is preferred by employers, a certificate from your program is a fine asset. If you seek certification, however, you will need to allow time to apply for AAPC or AHIMA membership and exam preparation. Taking the exam isn't long, just five hours and forty minutes but preparing for the exam takes some time depending on how much preparation you want to put into it. This post covers getting your AAPC CPC certification in short order.

Ultimately, getting into coding will take as much or as little time as you need to learn the content and be able to demonstrate it. Once you have that cert however then comes finding your first job. For some people this is hard. Check out this post on getting experience in coding for some ideas on breaking into the industry.

Medical Coding Training Programs: Which One Is Right For You?

To get into medical coding or to advance your career as a medical coder it is imperative that you improve your skills as a coder and obtain the highest level of training and credentials as possible.

Despite the fact that you are not required to be certified to work as a medical coder does not mean that you can skip this step.

Below I've outlined a few of the most common types of medical coder training programs and career paths available. Some require more time than others and some requires more financial investment than others.

Medical Coder Degree Programs

There are two main types of degree program paths. You can:

  • get a medical coder's certificate from a trade school or
  • you can get an Associates degree in Medical Billing & Coding from an accredited University.

Both of these options will get you in the door and both will make you look like an attractive candidate to prospective employers but neither come with a Certified Professional Coder (CPC) designation.

After completing either program you may still want or need to take the CPC Exam to get fully certified by the American Academy of Professional Coders (AAPC). This will ensure you have the best chances of scoring the best of all medical coding jobs available.

Training For A Medical Coding Certificate

If you choose to train for a Medical Coding certificate your educational path will be much shorter. You do not need these certificates to work in the industry and you don't need a certificate to test for your CPC credential but you do need to show prospective employers that you have some educational background in the industry.

Most certificate programs are short and sweet and provide students a quick and easy process for learning the basics of coding and billing and working in a medical setting. The certificates do not cost as much to obtain either so they are excellent options for people looking for a quick change in careers or for those who need to get working as soon as possible.

Training For A Medical Coding Degree

If however you are fine with a bit more of an investment in time and money you can really set yourself up nicely for a career in coding by enrolling in a 18-24 month medical coding degree program. These programs are much more extensive and show employers that you have a much superior knowledge of the job.

Credentials from AHIMA such as the RHIA or RHIT credentials cannot be obtained by someone who has not obtained a medical coding degree. If you want or need to get credentialed by AHIMA then these classes will have to be taken.

Even though the AAPC doesn't require a medical coder's degree to take the CPC exam doesn't mean this is not a good option for them either. Like all other jobs having the degree makes a huge difference to employers looking for new talent in the coding and billing office.