|
A Certified Professional Coder™ (CPC™) is an individual of high professional integrity who has passed a coding certification examination sponsored by the American Academy of Professional Coders (the AAPC).
A CPC is an individual who in addition to on the job experience as a coder has achieved a measurable level of knowledge and expertise in reviewing and adjudicating coding of services, procedures and diagnoses on medical claims.
A CPC is an individual who has achieved a certain level of knowledge and expertise in coding of services, procedures and diagnoses for physician practices. The CPC’s responsibilities may include: ·
Determining accurate codes for diagnoses, procedures and services performed by physicians and recognized, licensed nonphysician providers in physician-based settings (These services may include evaluation and management services as well as reviewing operative notes)
- Keeping current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues
- Performing various auditing duties related to physician practice management and coding to maintain compliance with payor reimbursement policies and governmental regulations as well as Medicare/CMS guidelines
- Monitoring progress resulting from periodic internal audits
- Providing training in coding and compliance issues to physicians, nonphysician providers and staff on an ongoig basis
- Providing physicians and staff with up-to-date coding information from reliable, accurate sources, such as specific payors, the AMA, AHA’s Coding Clinic, and CMS, to name a few
- Providing orientation training to include medical practice guidelines for new physicians and non-providers to the practice
- Implementing of new coding guidelines in a timely manner within the practice
- Updating encounter forms/superbills on an annual basis with respect to diagnostic, procedural and supply code changes
- Updating other patient information forms as necessary from time to time
- Updating the clinic’s fee schedule based on Relative Value Unit (RVU) updates that come out annually and based on additions and deletions to codes for procedures, services, and supplies
- Preparing and/or submitting completed HCFA-1500 forms for services and procedures performed by the practice’s physicians and nonphysician providers, such as CRNAs, nurse practitioners and physician assistants
- Reviewing explanations of benefits from payors, evaluating denied claims and filing appeals for denied claims
CPC Examination
The examination consists of questions regarding the correct application of CPT®, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies. A CPC™ must have at least two years coding experience and maintain yearly renewal as well as submit Continuing Education Units (CEUs) every two years.
Certifying Organization:American Academy of Professional Coders (AAPC)
The American Academy of Professional Coders (AAPC) was founded in an effort to elevate the standards of medical coding by providing ongoing education, certification, networking and recognition. Currently the AAPC has a membership base of nearly 38,000 worldwide.
Why train with New Horizons?
At New Horizons, our experienced instructors will help you develop the skills you'll need to begin working in the medical field. We've created a training program designed to not only teach you skills but to help give you an idea of what to expect on the job, and we've done it in the most cost-effective way. |
