Coding, Classification and Reimbursement

Coding Auditing Credential

Sharon A. Hekimian, RHIT,CCS25 days ago

Robin L Millard-Sparacino, Merchandising and Marketing,RHIT,R.H.I.T, AHIMA A25 days ago

  • 1.  Coding Auditing Credential

    Posted 25 days ago
    AHIMA recently announced their Vision for Transformation and 2019 Strategic Plan.  Part of this included areas they were going to put more resources in and areas they are going to evaluate or discontinue.  As part of areas to put more resources in--coding was a part of that.  I was wondering if anyone would like AHIMA to put out a coding auditing credential.  The AAPC does, but it seems to focus more on billing than coding.  With the advent of CAC, coders are going to have work more like auditors in the future and it seems this would be a good transition for them.  I don't want what happened to transcription to happen to coding professionals.

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    Melissa Minski, RHIA, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
    Assoc. Dir., Staff Development, Revenue Integrity
    Stony Brook University Hospital
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  • 2.  RE: Coding Auditing Credential

    Posted 25 days ago

    I work in the long term care setting and with upcoming changes to our payment system, the ICD-10-CM coding will be up front and center.  So specific & accurate coding will be imperative.  In our setting there is a clinical assessment which can only be signed off by an RN, I have always hoped that coding would follow that same requirement.  Where the diagnoses added onto a claim, must be signed off by either an RHIT or RHIA.  I have worked in LTC for some time and have seen some crazy inaccurate codes assigned by staff which were 'given' the duty of coding with little to no training.  I am seeing now more denials based on inaccurate code assignment.  Having that RHIT or RHIA audit those codes prior to the claim being submitted would provide that review from someone which has the training and understands, not only the book, but the coding guidelines and coding clinic references.  I would love to see that within AHIMA's Vision for Transformation.

     

    Shan Miller, RHIA

     






  • 3.  RE: Coding Auditing Credential

    Posted 25 days ago

    Interesting consideration!

     

    Sharon Hekimian, RHIT CCS                                                                

    HIM Coder

    PH #  781-453-5215

    HOME OFFICE  # 617-312-9205

    FAX # 781-453-5783 ATTN: SHARON

     






  • 4.  RE: Coding Auditing Credential

    Posted 25 days ago
    I'm Interested.

    Leola Burke
    lburke63@gmail.com
    (919) 357-3298 NC mobile

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    Leola Burke MHSA, CCS
    AHIMA-Approved ICD-10-CM/PCS Trainer
    HIM/Revenue Cycle Consultant
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  • 5.  RE: Coding Auditing Credential

    Posted 25 days ago
    ​Definitely interested!

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    Lynn A. Wall, RHIT, CCS
    Interim Coding Supervisor
    Maricopa Integrated Health System
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  • 6.  RE: Coding Auditing Credential

    Posted 24 days ago

    Definitely interested

     

    Sent from Mail for Windows 10

     






  • 7.  RE: Coding Auditing Credential

    Posted 25 days ago


     No. I believe you dilute the value of certifications by having too many. Creating a certification just to "compete" with another organization isn't good use of finances. AHIMA now is becoming like AAPC, jack of all trades but master of NONE. Before, they were known for Inpatient/hospital coding. Now, since they have literally abandon the CCS to create new certifications, they are lagging. The pass rate is almost 80% which is way higher than when I took it in 2013 (passing rate was low 40%). So, instead of having the CCS certification that use to "mean something," they have CCS's now that cannot find jobs. So, I don't think extra certifications will help.

    AHIMA must create excitement and bring in young talent to run the organization under the direction of past directors. If we continue to vote the same people year after year after year without instilling fresh eyes and ears, it will continue to dwindle. We must think outside the box and not be afraid to color past the lines. For one, I think we have to work with other federal and private organizations such as OIG, AHIA, HCCA rather than being siloed. Recently, HCCA worked with OIG in creating a resource called "Measuring Compliance Program Effectiveness: A Resource Guide." AHIA worked with HCCA on creating Whitepapers on Auditing and Monitoring Guidance. So, maybe AHIMA can work with CMS to come up with acceptable documentation standards? Or work with HCCA on Compliance guidance in a particular area? Right now, HCCA believes a coder should be AAPC certified. BUT, when majority of Compliance risks as identified by OIG are hospital based and DRG related, AAPC credentialed individual are for the most part useless. AHIMA credentials are best known for that (CCS, CDIP), not AAPC. If you were a compliance officer and did not know that, you would have hired someone with AAPC credentials because the HCCA said so. So, collaboration is imperative for growth.

    That is my soapbox for today. Have a great Thanksgiving everyone!



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    William Wong, CHC, CHPC, CCS, CPC, CPMA, CDEO
    AHIMA Approved ICD-10 CM/PCS Trainer
    Compliance Analyst
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  • 8.  RE: Coding Auditing Credential

    Posted 25 days ago
    Hi Mr William Wong... I totally agree with you with regards to the value of certifications by AHIMA.... when I took the CCS in 1995, so many applicants did not report in the PM exam because the exam was really tough especially with the Microbiology and Pharmacology/Therapeutics and Pathology questions which really were my expertise....  there were a few administrative questions which were beyond my knowledge at that time.... yes roughly only 40% pass the CCS..... in the ensuing years, in the scramble to get so many AHIMA members, so many became CCS with certificates which were useless because many of them do not even know basic coding guidelines..
    I basically taught myself how to code as during my early years in the late 80s, coding was still in its infancy, I cut my  teeth in the Coding Clinic that by 3 months as I was correcting my Director's coding who was just too happy that I found the basis of the codes we are using in our hospital..
    It is sad to know many CCS credentialed aspirants can not even get a job.....
    How did it happen?


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    Josefino Lim
    CODER II
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  • 9.  RE: Coding Auditing Credential

    Posted 25 days ago
    Mr. Wong,

    While I agree that AHIMA doesn't need another credential (I fought like hell to have them leave the RHIT alone and just update the curriculum) as it is obvious they are dropping support and resources for more recently created credentials, I don't feel the CCS is being given away. I studied in-depth for a long time using various resources, including your CCS Prep study. It is true that there are many, many who obtain the CCS and are unemployed. That can be said for other credentials as well, even for AAPC credential holders. We have the AHIMA Foundation Apprenticeship Program. However, If you already have the CCS, you don't qualify. Experience is the missing element for those trying to get employed. The Apprenticeship is working. But, is it yielding the results that it was intended to produce? Has this program been re-evaluated for process/performance improvement?

    AHIMA does not need another credential, especially to compete with others. If that is the case, AHIMA will be creating credentials like Hot Wheels creates toy cars. There would be a million of them. Investment in AHIMA Members is what AHIMA needs. I work in a Metro region with 3 major health systems among countless other healthcare-related facilities. AHIMA members can almost be counted on one hand. Inpatient or outpatient, AAPC is predominate here. and you wonder why there are CCS-credentialed members without jobs, members who worked extremely hard to obtain the CCS. Little-to-no experience, Little-to-no presence of AHIMA. Little-to-no support for local CSA.

    Hopefully, AHIMA will begin to focus in on their members and the credentials/products they already have.

    My $0.02

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    Robb Rogers RHIT, CCS
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  • 10.  RE: Coding Auditing Credential

    Posted 24 days ago
     "No. I believe you dilute the value of certifications by having too many. Creating a certification just to "compete" with another organization isn't good use of finances. AHIMA now is becoming like AAPC, jack of all trades but master of NONE. Before, they were known for Inpatient/hospital coding. Now, since they have literally abandon the CCS to create new certifications, they are lagging. The pass rate is almost 80% which is way higher than when I took it in 2013 (passing rate was low 40%). So, instead of having the CCS certification that use to "mean something," they have CCS's now that cannot find jobs. So, I don't think extra certifications will help.

    AHIMA must create excitement and bring in young talent to run the organization under the direction of past directors. If we continue to vote the same people year after year after year without instilling fresh eyes and ears, it will continue to dwindle. We must think outside the box and not be afraid to color past the lines. For one, I think we have to work with other federal and private organizations such as OIG, AHIA, HCCA rather than being siloed. Recently, HCCA worked with OIG in creating a resource called "Measuring Compliance Program Effectiveness: A Resource Guide." AHIA worked with HCCA on creating Whitepapers on Auditing and Monitoring Guidance. So, maybe AHIMA can work with CMS to come up with acceptable documentation standards? Or work with HCCA on Compliance guidance in a particular area? Right now, HCCA believes a coder should be AAPC certified. BUT, when majority of Compliance risks as identified by OIG are hospital based and DRG related, AAPC credentialed individual are for the most part useless. AHIMA credentials are best known for that (CCS, CDIP), not AAPC. If you were a compliance officer and did not know that, you would have hired someone with AAPC credentials because the HCCA said so. So, collaboration is imperative for growth."

    William--I completely agree that the CCS has become completely "diluted" and has lost a lot of its meaning.  However having a CCS does not mean that you have the analytical skills to be an auditor.  I have worked with coders who have their CCS who have been coding for 10+ years--they are excellent coders, but would make horrible auditors because they can't grasp higher level concepts that validators and auditors do.  AHIMA is doing away with some of their credentials (which is part of the transitional plan), so in that way hopefully they will not become like the AAPC, but rather condense and refocus their resources.  An AHIMA auditing credential wouldn't be made to compete with the AAPC credential, but rather to fill a gap in the market where a credential does not exist.  You also raise some great questions and points in your second paragraph.  Especially the point that right now, to get into compliance in the hospital setting, its recomended to have an AAPC certification by the credentially body, which is inaccurate for the hospital environement.  We do need to work toghether and break down silos and it would be great if AHIMA and other professional associations could advocate for that.

    ------------------------------
    Melissa Minski, RHIA, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
    Assoc. Dir., Staff Development, Revenue Integrity
    Stony Brook University Hospital
    ------------------------------



  • 11.  RE: Coding Auditing Credential

    Posted 19 days ago
    Hi, Melissa - I just wanted to mention that I have the CICA auditing credential from HFMA.  I was on the item-verification committee.  It is a well-rounded credential, including IP coding, OP coding, and administrative items.  It would have been nice if my main professional association, AHIMA, had done something about this sooner, but I don't think at this point it would be helpful to the profession.  On the other hand, though, there are some out there that may see that this credential is sponsored by HFMA and consider it more for practices and OP, but that is not the case.  I feel it is a matter of getting the word out - not just starting another credential to put initials behind your name - it has to mean something.
    Thanks for letting me voice my opinion!

    Janice

    ------------------------------
    [Janice] [Noller, RHIA, CDIP, CCS]
    [Inpatient Coding Educator][University of Utah Health Care][Salt Lake City][Utah]
    [Janice.noller@hsc.utah.edu]
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  • 12.  RE: Coding Auditing Credential

    Posted 25 days ago
    I think that this would be a great opportunity for coders and anyone else interested in this type of credential.





  • 13.  RE: Coding Auditing Credential

    Posted 24 days ago
    ​Hello everyone!!
    I am with the Maryland CSA . Our President is Godwin Okafor and he is newly elected to the AHIMA Board.  I will pass all these comments onto him to see if we can get this wonderful idea sent up the chain.

    Christina


    ------------------------------
    Christina Donahue-Taylor
    RHIA, CCS
    Section Head-Coding
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  • 14.  RE: Coding Auditing Credential

    Posted 24 days ago
    Thanks Christina!!  Could someone also see if we can get a link or attachment for the presentation that AHIMA did entitled "AHIMA's Vision for Transformation and 2019 Strategic Plan", I think it would address some of the other commenters concerns and questions

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    Melissa Minski, RHIA, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
    Assoc. Dir., Staff Development, Revenue Integrity
    Stony Brook University Hospital
    ------------------------------



  • 15.  RE: Coding Auditing Credential

    Posted 23 days ago
    HFMA offers a certification (CICA)-Certified Inpatient Coding Auditor.  HFMA offers the exam, and for those who need supporting/additional education are referred to a CareerStep course on inpatient coding (though this apparently is not a requirement).

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    Robert Muehring
    CCS, CCS-P, CPMA, CRC
    Senior Coding Quality Auditor
    Cleveland Clinic
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