All originally written material, including articles, editorials, and descriptions of the websites are considered copyrighted material ( © 2008 C. Pearson), and
reproduction is prohibited without the consent of the author.



A simple Internet search will reveal many Internet sites that are trying to lure students to pay a great deal of money to learn medical coding.  Determining which educational
path will translate in a job for you can be an arduous task.  The following are some common sense steps to help you determine if medical coding is the best career for you,
and which educational path that you should pursue.  If you do not follow any of the other suggestions in this article, please consider seeking the advice of at least two
coding professionals located in you area.  Be sure that these profession do not sell coding education material, or refer to themselves as an instructor.  You must consider
what these individuals have to gain by providing "free advice", and do not base your educational decision based on the advice of someone with a financial gain at stake.
Coding professionals are usually giving people, who are willing to help students.  Please seek the advice of a local coding professional, by asking how they obtained their
education, and how the path they took to become a coding professional.

STEP ONE:  Determine if medical coding is a good fit for your learning interest and aptitude.  

You do not want to be a teacher if you do not like children, and you do not want be a medical coder if do not like to learn very detailed subjects such as medical terminology,
anatomy, and physiology.  There are free websites that provide resources for medical coders including several that offer free training in medical terminology, anatomy and
physiology, and much more. While no credential can be earned by using the free resources, it may be the best place to start because you can determine if you have the
aptitude for and interest in the subjects that are required to be a good medical coder before you invest your time and money.  The links that are included in this site provide
free resources for medical coders and students including a
free course in medical terminology, study aids,  anatomy, and much more. Check them out so that you can
decide if you really want to learn everything required to become a medical coder.  

STEP TWO:  Get a realistic view of the medical coding profession.

Coding can be a fun and interesting way to earn a living, but, as with every profession, there are some not so inviting facts that you will not learn from an educational
recruiter.  First, coding can be a hard profession to break into, even if you have the correct training and credentials.  On nearly every job board you will find many jobs for
medical coder, but most of those jobs require two to three years of experience.  So how do you get experience? Most professors will tell you that this requirement should be
considered just a wish list because most supervisors want to hire an experienced coder, but they are often hard to find. Instead they settle for a new graduate who has
passed the credential test  because they know that the student has a good background.  There are
discussion boards where students are posting that they are having a
hard time finding work because they either don't have experience or the education they received is not recognized.  It is important to get a realistic picture of the job
prospects in you area. (see Step 3)

While in school, you will learn good basic coding skills, but there is much more to learn.   Changes to the coding conventions are made twice a year, and you must stay up
to date.  Rule changes are also made by Medicare, Medicaid, and private insurance companies, which can affect medical coding. You must be open to change because
medical coding is continuously changing and you never stop learning.

Some educational paths require students to perform work at local Healthcare facilities as a part of the educational experience.  This is referred to by several names
depending on the school, but you may find it on the required courses listed as professional practice, directed practice internship, practicum, etc.  This is a good way for the
coding supervisor to get to know you, and may help open a door that could result in a job, or at least a good reference.  Also, working conditions and salaries vary greatly, so
finding a place to work that is right for you may require some insight into what to look for in a coding environment. Getting an inside view of the working conditions is the best
way for you determine if you would be happy working at that facility.  Some facilities have very strict requirements for production and accuracy, which can cause stress.  
Others may have few or no production requirements, but they may have some coders working very hard while others talk on the phone and play, which can also cause
stress. This is the type of information you will find out by having this inside view.

STEP THREE:  Find out what type of education and credentials are required to get hired as a medical coder in your local area, and the
future outlook for hiring in your area.

You can call a hospital's Human Resource Professional, Director of the Health Information Management Department, Coding Supervisors, and Physician Office Practice
Administrators to find out which education and credentials they recognize.  Most will be happy to talk with you because they really need trained medical coders.  You can
also use online job boards such as Career Builder, Monster.com, and Yahoo Hot Jobs, or your local hospital’s online job board to find out what credentials are required for
the advertised jobs.  

Some areas may be saturated with credentialed coders, while others may be in dire need.  If you are not willing to move to find employment, you will need find out the
prospects for employment in your local area.  If you want to code in a hospital, you can check the Internet Job Boards of the local hospitals. (Th
e Agape Center's website
offers a quick list of the websites for most of the Hospitals in the United States.)  Also, while you are talking with the local Coding Supervisors, HR representatives, or
Physician Practice Administrators, who are responsible for hiring, ask them, on average, how many positions they fill each year. If your local area has a Health Information
Technology or Coding Certificate school, you will likely face a great deal of competition, so be prepared by knowing the projected job market.

STEP FOUR:  Learn about the professional coding associations, and what is required to qualify for the credentials they offer.

After you have talked with local professionals, you may find that they require credentials such as RHIT, CCS, CPC, or other credentials that you may not be familiar to you.  
There is one not-for-profit  professional association and one for profit membership organization that offer members the ability to attain medical coding credentials, which
may be recognized by the professional community, depending on the type of facility and their hiring preference.  Having a credential, says that you have passed a
comprehensive test that requires proven knowledge of medical coding.  Who do you think would be hired first, a person who has taken a course that no one has ever heard
of, but claims to have professional coding skills, or a person who has followed an educational path prescribed by a professional association and has passed a
comprehensive exam?  

The not-for-profit professional association that offers credentials for medical coders is the
American Health Information Management Association.  This association is very
well recognized in the Coding and the Health Information Management Profession. It can trace its history back to 1928 when it was established by the American College of
Surgeons under the name Association of Record Librarians of North American. The association has a very specific education path for several of its credentials. A list of the
colleges that offer coding programs that are "approved" by AHIMA,  and  the degree programs that are accredited by CAHIIM are available at its website.  Some of the
credential tests can be taken without following a specific educational path, but AHIMA recommends several years of experience before taking the CCS exam because it
requires extensive knowledge.  AHIMA has credentials available to its members for both inpatient coding and physician based outpatient coding. Even if a school tells you
the are accredited or approved by a professional association, it is a good idea to visit the Association's website and make sure they are fully approved or accredited. If a
program is listed in "Candidacy Status", it may still be in the process of being accredited, and students should ask how that will affect their ability to take the credential
exams when they graduate.  The following is a list of some the credentials, and the educational requirements for each:  

    RHIA—Registered Health Information Administrator—Requires a four year degree B.S or B.A.in Health Information Management from a college or university
    accredited by Commission on Accreditation of Health Informatics and Information Management  (CAHIIM).  Students are required to pass an examination upon
    graduation to attain this credential. This qualifies graduates to perform management functions such as managing a coding department as well as other
    management and technical functions including coding.  Most AHIMA approved schools require RHIA student to take at least two semesters (1 year) of coding
    classes, and course work that includes information about Anatomy and Physiology, Disease, Pharmacology, Documentation Standards, Data Sets, and Medical
    Billing is also required. A list of accredited colleges is available at the CAHIIM website.

    RHIT—Registered Health Information Technician  - Requires a two year A.A. or A.S degree from a college or university accredited by Commission on Accreditation of
    Health Informatics and Information Management (CAHIIM).  Students are required to pass an examination upon graduation to attain this credential. This qualifies
    graduates to perform a variety of technical and professional functions in the Health Information Management Profession, including coding. Most AHIMA approved
    schools require RHIT student to take at least two semesters (1 year) of coding classes, and course work that includes information about Anatomy and Physiology,
    Disease, Pharmacology, Documentation Standards, Data Sets, and  Medical Billing is also required.  A list of accredited colleges is available at the CAHIIM website.

    CCA—Certified Coding Associate—No degree is required, however, AHIMA does offer "approval" of coding programs that requires an external peer review of the
    school's program. Candidates are required to pass an examination to attain this credential. A list of approved programs can be found at the AHIMA website. AHIMA
    also offers an online coding courses.  No experience is required to take this examination because it is considered an entry level credential.

    CCS– Certified Coding SpecialistNo degree is required, however, AHIMA does offer "approval" of coding programs that requires an external peer review of the
    school's program. Candidates are required to pass an examination to attain this credential. A list of approved programs can be found at the AHIMA website. AHIMA
    also offers an online coding courses.  AHIMA recommends that you have two years of experience before taking this exam, but no experiences is actually "required".

    CCS-P - Certified Coding Specialist—Physician Based— No degree is required, however, AHIMA does offer "approval" of coding programs that requires and external
    peer review of the school's program. Candidates are required to pass an examination to attain this credential. A list of approved programs can be found at the AHIMA
    website. AHIMA also offers an online coding courses.  

The American Academy of Professional Coders (AAPC), is for profit membership association that has been in existence since 1988.  While none of their credentials require
formal education, online training and book based training is available through the association for preparation to take its credential examinations.
 AAPC's website also
provides a list of colleges, businesses, and individuals that offer its "instructor lead"  
Professional Medical Coding Curriculum (PMCC).   AAPC offers a number of
credentials to it members, but according to its website, they are for
 "coders in physician practices and the outpatient/facility environment".  The following is a list of some of
the credentials available through AAPC, however the association also offers others specialty credentials that are limited to a specific type of coding such as Anesthesia,
Urology, etc, and a complete list can be found on its website:

    CPC-A Certified Professional Coder Apprentice - Attained by passing an examination, if the member does not have 2 years coding experience, or a combination of
    some education and work experience. (see AAPC's website for more details) CPC-A is the credential awarded.

    CPC—Certified Professional Coder – Members are required to pass an examination to attain this credential, and  have 2 years coding experience, or a combination
    of some education and work experience. (see AAPC's website for more details)

    CPC-H—Certified Professional Coder –Hospital - Members are required to pass an examination to attain this credential.  This is credential is for outpatient hospital
    coding.

STEP FIVE:  Check out the coding school thoroughly

After you decide which credential you want to pursue and have found the educational institution that offers training that will help you attain these credentials, you are not
finished.  You need to check them out throughly by asked as many questions as you need to determine if  you will get what you need from their school.  You should ask to
talk directly to the professors.  Do not  just speak  to a school recruiter because they may be trained marketing specialists.  Prepare a list of questions to make sure you do
not forget to ask something that is important to you.  Here are a few questions that you might want to consider asking:

    If it is an out of state school, be sure to ask,  "What is your out of state tuition?" Some universities offer a "self-support" or “online” rate for out of state Internet based
    students.  These rates may be the same or slightly higher than in-state tuition, but they should always be much less than out of state tuition. Be sure to compare the
    tuition rates of at least 3 to 5 schools.  Some of the tuition rates are very inflated, so the best way to avoid paying too much is to compare the rates.  Remember that
    paying more does not necessarily mean you will get a better education.

    How many people graduated from your program last year? A low number can mean a number of things, including a high dropout, a high failure rate, or the school
    may just have a limited number of students that they enroll in the program each year.   If the number seems low then ask how many were admitted last year.  Some
    universities limit their class size, and the number could reflect that policy.  You can determine if that is the case by asking if the class size is restricted, and if so, how
    many students can enroll each year.

    What percentage of your last year's graduates are now employed in the profession? If they tell you that they do not know, you may want to keep looking because they
    should care enough to know.  If they do not know, it may simply mean that the surveys they sent to their graduates were not returned, or it could mean that they are
    not concerned whether or not your get a job after you finish their program. In some states, the state funded schools are required to survey their student to determine
    starting salaries and employment status.  This is done because the state wants to make sure the program is successful, not only at graduating students, but also at
    making sure they are employable.  In other words, they do not want to fund programs that just churn out numerous graduates who cannot get a job.

    What percentage of the school's students passed a credential test after graduating within the last year? A low percentage would be an indicator that you should keep
    looking. If they tell you that they do not know and it is a school that is accredited,  then this is a clear indication that you should keep looking.

    Does your school arranges your professional practice facility? This is also referred to by several other names including, Externship, Internship, Professional
    Practice, Practicum, Directed Practice, etc.  This can be very difficult for you to do yourself.  HIM Directors may be very hesitant to take on students because it is very
    time consuming for them.

    Be sure to ask what organization accredits or approves the school.  This is especially important if your employer reimburses for tuition, or if you want to apply for
    federal education assistance. Some employers may have very specific rules, and will only reimburse tuition if the college is accredited through one of the regional
    college accreditation associations, or if the student is enrolled in a degree program, not just a certificate program.  My former employer would not pay for courses
    unless they were accredited by on of the six regional accrediting associations, and they would not pay unless the employee was enrolled in a degree program.  This
    practice will vary with different employers, but you should asked your employer their requirements, and ask the school who accredits their facility.  Also, ask the
    facility or instructor if their program qualifies for Federal Tuition Assistance Programs.

    Accreditation by one of these associations means the school has met and maintained a strict set of educational criteria. There are six regional accreditations
    including the following:  The Middle States Association of Colleges and Schools; The New England Association of Schools & Colleges; The North Central
    Association of Colleges and Schools;  The Northwest Association Of Schools And Colleges; The Southern Association of Colleges and Schools, and The
    Western Association of Schools and Colleges
       

If you are an older student returning to school after years,  you may also want to ask the following question:

    Does the school disqualify course work taken over five years ago? Some schools require you to repeat previously taken course work after a period of time. This is
    especially true for courses such as Anatomy and Physiology that are required for a career in health care.

The most important thing to remember is that
  • There are no shortcuts
  • If it sounds too good to be true then it probably is.  
If the time frame seems much shorter than other options, then you should consider
  • How much you can really learn in this short time frame.  
  • No good coding program will just teach coding.  
  • You need a solid background in Anatomy and Physiology (A&P), Disease and Pharmacology, and this information should be taught in the program, or you may find
    them listed as a requirement before entering the program.
  • If  you are not required to study these subjects, you may not be getting the best training to be a knowledgeable coder, unless you already have extensive prior
    knowledge of these subjects from on the job experience.  

Just keep in mind that in the coding profession, learning is an ongoing process, and you many want to pursue a higher education to qualify for  promotions, to get raises in
your salary, or just to learn more, so ask about the school's accreditation, and if the school's credits will transfer to other schools and colleges.

Please be prepared by doing your homework before you invest your hard earned money and precious time.  HAPPY CODING!


© 2008 C. Pearson

Resources:
www.AHIMA.com
www.AAPC.com
http://myfloridalegal.com/newsrel.nsf/newsreleases/3B329B4C21999DC38525735500569A0F
http://www.allbusiness.com/marketing-advertising/direct-marketing-direct-mail/3916504-1.html

Disclaimer, Please consider this an editorial because  it reflects the opinion of the author.
© 2008 C. Pearson
FIVE STEPS TO FINDING THE BEST EDUCATION FOR MEDICAL CODING
5 Steps to the best coding Education
RESOURCES FOR MEDICAL CODERS AND STUDENTS