Sue Sonnen and Angela Poxleitner can now put the initials, CPC, after their names since taking five 2 hour classes and passing a five hour test consisting of a variety of medical scenarios and answering 150 questions related to those scenarios. Both are now certified coders at St. Mary’s Hospital and Clinics. Both are also members of the American Academy of Professional Coders.
“We take our jobs seriously and wanted to upgrade our skills because a lot hinges on knowing and applying the proper coding,” said Sonnen. “The health care providers, the business office and payors depend on us to code things correctly. Ultimately, the patients also depend on us to do a quality job.”
Once a patient is seen the provider dictates the findings which are then transcribed by the transcription staff. The coders then assess what level of care the doctor or family nurse practitioner has provided and attach a standardized CPT or five digit numeric code. They also read the transcript and assign an ICD-9 code to any diagnosis. Both are used for billing purposes. Medicare, Medicaid and private insurers reimburse based on those codes.
“The doctors carefully review those codes and will sometimes ask for a clarification,” said Poxleitner. “We all want to make sure the codes reflect the patient care process and result. It’s very complicated because we have to code to the greatest specificity possible. The standardized codes change some times and become more refined.”
To retain their certification coders must take 36 units of continuing education every two years. To achieve certification coders must have served as a coder for two years before taking the national test or serve as an apprentice for two years after passing the exam. They also must sign a code of ethics and submit two letters of recommendation from their co-workers and supervisors.
“It was so neat to go to the American Academy of Certified Coders website after we passed the test and see the CPC after our names,” said Sonnen. “I think everyone in the office saw me jump for joy.”
Poxleitner’s and Sonnen’s co-worker, Trina Geis, has been a certified coder for six years, as has Theresa Uptmor, SMH Clinics Manager. “I received my certification because I believe it is important for our patients to know the clinic managers is also certified. I am the one who oversees all the coders and have to answer the hard questions when people don’t like the charges that appear on their bills,” said Uptmor. “Having that additional knowledge helps me address their concerns.”