Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top left corner of this page

Practice Exam

2016 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Tag Archives: Medical

20 Best From Home Top Medical Coding Schools and Programs

Image Source

Training for at-home medical coding jobs can be completed wholly online for the greatest flexibility and career-life balance. Whether you’re a parent, disabled, retired, a military spouse, or simply attracted to working in the comfort of home, medical coding is a hot job. CNBC reported that medical coding has a prescription for fast growth since healthcare facilities have switched to electronic records. The BLS predicts that medical records management will spark 29,000 new positions for a 15 percent hiring increase. Companies like Humana, Maxim Health, and Aviacode need fresh telecommuting talent, so consider these 20 Best From Home Top Medical Coding Schools and Programs.

Our ranking zeros in on top online medical coding programs that fulfill requirements for certification, such as Certified Coding Associate (CCA). That’s because pay climbs for credentials with an average salary of $ 47,796 per year. We used the NCES College Navigator tool to search for coding schools with distance education. Each prospective program had to be regionally accredited, uphold AHIMA standards, feature at least four courses, and include virtual practicum. Preference was given to colleges holding national or regional rankings for prestige. From home coding curricula was also judged for affordability, class size, placement, credit transfer, and academic rigor.

1. Drexel University

Image Source

Located in Philadelphia’s Powelton Village, Drexel University is a private, nonprofit research hub with cooperative education for over 26,300 Dragons. According to the U.S. News, Drexel is the 96th best national university, 65th top value, and 14th most innovative school. The College of Nursing and Health Professions confers an online, six-course Certificate in Medical Billing and Coding.

Tuition Total: $ 14,364

Learn more about From Home Top Medical Coding Schools and Programs at Drexel University here.

2. University of Utah

Image Source

Affiliated with 22 Rhodes Scholars, the University of Utah is a public, space-grant RU/VH institution selectively admitting 31,500 Utes in Salt Lake City and online. The U.S. News named Utah the 111th best university and 73rd best for vets school. There’s a three-part Professional Medical Coding and Billing program delivered online with real-world 3M encoding software.

Tuition Total: $ 3,495

Learn more about From Home Top Medical Coding Schools and Programs at the University of Utah here.

3. Indiana University – Purdue University Indianapolis

Image Source

Endowed for $ 601 million, Indiana University-Purdue University Indianapolis is a public, co-educational RU/H institution “Fulfilling the Promise” to over 30,100 Jaguars. The U.S. News ranked IUPUI as America’s 197th best university and 106th top public college. Online learners can pursue the 26-credit Medical Coding Certificate through the School of Informatics and Computing for AHIMA credentialing.

Tuition Total: $ 9,233

Learn more about From Home Top Medical Coding Schools and Programs at Indiana University – Purdue University Indianapolis here.

4. Keiser University

Image Source

Belonging to the NAIA Sun Conference, Keiser University is a private, nonprofit SACS-accredited college serving over 16,300 Seahawks in Fort Lauderdale and beyond. Keiser is the South’s 23rd top school and 11th best value according to the U.S. News. Online students can prepare for the AAPC exam in the two-year Associate of Science in Medical Administrative Billing and Coding.

Tuition Total: $ 37,728

Learn more about From Home Top Medical Coding Schools and Programs at Keiser University here.

5. Albany State University

Image Source

Established in 1874 for freed slaves, Albany State University is a public, TMCF-member institution with over 7,100 Golden Rams studying in southwest Georgia and online. The U.S. News lauded Albany State as the 32nd best historically black school nationwide. The 22-credit Online Certificate in Medical Coding builds expertise in ICD-10 coding systems from home.

Tuition Total: $ 2,860

Learn more about From Home Top Medical Coding Schools and Programs at Albany State University here.

6. Weber State University

Image Source

Attracting 26,600 Wildcats to 250+ academic programs, Weber State University is located in Ogden, Utah, with NWCCU accreditation for public, liberal arts education. The U.S. News crowned Weber the West’s 76th top regional university. The Dumke College of Health Professions confers a 10-course Certificate of Proficiency in Healthcare Coding online for a median salary of $ 34,000.

Tuition Total: $ 5,340

Learn more about From Home Top Medical Coding Schools and Programs at Weber State University here.

7. Florida A&M University

Image Source

Classified as a public, land-grant RU/H doctoral institution, Florida A&M University is endowed for $ 127.18 million to educate over 9,600 Rattlers from Tallahassee and beyond. High school counselors surveyed by the U.S. News placed FAMU 173rd nationally. The School of Allied Health Sciences follows AHIMA standards for an online, nine-course Medical Coding Certificate Program.

Tuition Total: $ 7,965

Learn more about From Home Top Medical Coding Schoools and Programs at Florida A&M University here.

8. Great Falls College Montana State University

Image Source

Founded in 1969 for “Changing Lives, Achieving Dreams,” Great Falls College MSU is a two-year, public teaching institution enrolling over 4,700 students in Montana and online. Great Falls is affiliated with the U.S. News’ 210th best university and 118th top public school. Students can pursue the 63-credit A.A.S. in Medical Billing and Coding Specialist online.

Tuition Total: $ 8,374

Learn more about From Top Home Medical Coding Schools and Programs at Great Falls College Montana State University here.

9. Herzing University

Image Source

Operating 11 campuses and an online division from Milwaukee, Herzing University is a private, nonprofit Highter Learning Commission and a Member of the North Central Association accredited institution enrolling over 330 adult learners. The U.S. News applauded Herzing for America’s 142nd best online undergraduate programs. In 12 months, online students can complete the 44-credit Diploma in Medical Insurance Billing and Coding Specialist for CCSA Associate certification. For more information regarding graduation rates, median student debt for students who have completed the program, and other information, to Herzing’s consumer disclosure website.

Tuition Total: $ 12,560

Learn more about From Home Top Medical Coding Schools and Programs at Herzing University here.

10. Peirce College

Image Source

Led by President James J. Mergiotti, Peirce College is a private, nonprofit MSCHE-accredited college based on Philadelphia’s Pine Street to educate over 1,200. Peirce is acclaimed for holding America’s 132nd best online undergraduate degrees by the U.S. News. The Allied Health Division offers a 39-credit, competency-based Certificate in Medical Coding online with a virtual practice workshop.

Tuition Total: $ 17,040

Learn more about From Home Top Medical Coding Schools and Programs at Peirce College here.

11. SUNY Herkimer College

Image Source

Celebrating its 50th anniversary, SUNY Herkimer College is a two-year, public lower-division institution registering over 3,300 Generals in Upstate New York near Utica. Herkimer was picked for the prestigious 2017 Aspen Prize for Community College Excellence. Home-based learners could finish the 12-month Online Medical Coding-Transcriptionist Certificate via the Internet Academy for mastering ICD-9-CM, CPT, and HCPCS codes.

Tuition Total: $ 4,490

Learn more about From Home Top Medical Coding Schools and Programs at SUNY Herkimer College here.

12. Great Basin College

Image Source

Governed by the Nevada System of Higher Education, Great Basin College is a public, two-year career-oriented institution with NWCCU accreditation to educate over 3,400 in Elko, Ely, Battle Mountain, and online. Niche placed Great Basin as America’s 116th “Best Online College.” Each Fall, online students begin the two-semester Certificate of Achievement in Professional Medical Coding and Billing.

Tuition Total: $ 3,060

Learn more about From Home Top Medical Coding Schools and Programs at Great Basin College here.

13. The University of Cincinnati Clermont College

Image Source

Sitting on 91.2 wood cares in Batavia, Ohio, UC Clermont College is a regional public, two-year satellite of the University of Cincinnati with over 3,700 Cougars finding “Strength in Unity.” The U.S. News placed UC as America’s 135th best university and 64th top public college. Clermont offers an 11-course Online Certificate in Medical Biller/Coder with open admission.

Tuition Total: $ 7,320

Learn more about From Home Top Medical Coding Schools and Programs at The University of Cincinnati Clermont College here.

14. Kaplan University

Image Source

Training 37,000 non-traditional students, Kaplan University is a primarily online private, for-profit HLC-accredited institution of Graham Holdings Company in Davenport, Iowa, with 14 national campuses. The U.S. News declared Kaplan’s online undergraduate programs as the 156th best nationwide. Students work from home for the 39-credit Online Medical Billing and Coding Certificate or 57-credit Online Medical Office Administration Certificate.

Tuition Total: $ 14,469

Learn more about From Home Top Medical Coding Schools and Programs at Kaplan University here

15. Central Texas College

Image Source

Since opening in 1965 for Bell County citizens, Central Texas College has expanded as a public, two-year SACS-accredited school with over 39,200 Eagles in Killeen and online. In Community College Week. CTC ranked 15th among associate degree producers nationally. AAPC qualifications can be fulfilled with the 39-credit Online Certificate of Completion in Medical Coding & Billing.

Tuition Total: $ 8,775

Learn more about From Home Top Medical Coding Schools and Programs at Central Texas College here.

16. Sullivan University

Image Source

As the SACS’ first accredited private, for-profit school, Sullivan University serves over 6,000 students from in Louisville, Lexington, Fort Knox, and online. Niche recognized Sullivan as America’s 64th “Best Online College” and 157th “Best College Campus.” The College of Health Sciences awards a 47-credit, 12-month Medical Coding Diploma online with courses like information literacy, human anatomy, and CCA review.

Tuition Total: $ 18,565

Learn more about From Home Top Medical Coding Schools and Programs at Sullivan University here.

17. Minnesota State College Southeast

Image Source

Accredited by the HLC-NCA, Minnesota State College Southeast is a public, two-year technical institution headquartered in Winona since 1949 to train over 2,700 professionals. Niche ranked MSC Southeast as America’s 42nd “Best Trade School.” Through D2L Brightspace, online students can attain the 46-credit Medical Coding Specialist Diploma or finish the 57-credit Medical Coding Specialist A.A.S.

Tuition Total: $ 8,644

Learn more about From Home Top Medical Coding Schools and Programs at Minnesota State Colleg Southeast here.

18. Bellevue College

Image Source

With Washington State’s third-largest enrollment at 37,000 Bulldogs, Bellevue College stands on King County’s Eastside as a public, open-access technical institution. PayScale recognized Bellevue for the 25th highest community college ROI with a median mid-career salary of $ 63,400. Online students can undertake the four-month, AHIMA-approved Professional Medical Coding and Billing Program with CareerStep for CPC credentialing.

Tuition Total: $ 2,995

Learn more about From Home Top Medical Coding Schools and Programs at Bellevue College here.

19. Mercy College of Ohio

Image Source

Opened by the Sisters of Mercy in 1917, Mercy College of Ohio is a private, bachelor’s-level health sciences institution with HLC-NCA accreditation to educate over 1,200 future practitioners. College Values Online included Mercy among the “50 Most Affordable Small Catholic Colleges” nationwide. Attend the Virtual Open House to consider the 26-credit Online Medical Coding Certificate Program.

Tuition Total: $ 11,600

Learn more about From Home Top Medical Coding Schools and Programs at Mercy College of Ohio here.

20. National American University

Image Source

Given HLC-NCA accreditation in 1985, National American University is a private, for-profit learning system based in Rapid City, South Dakota, that’s educating over 7,900 students at 33 U.S. locations and online. College Factual ranked NAU in the top 5 percent nationally for ethnic diversity. The College of Health and Sciences confers a 12-month Healthcare Coding Diploma adhered to AHIMA standards.

Tuition Total: $ 13,212

Learn more about From Home Top Medical Coding Schools and Programs at National American University here.

Top Medical Coding Schools

Interstate Medical Licensure Compact Commission proposes licensure process


The medical licensing tool aimed at expediting the process through which physicians can obtain licenses to practice in multiple states is one step closer to becoming a reality as more details of the process come into focus. Once it’s up and running, the Interstate Medical Licensure Compact will allow physicians licensed in one participating state to gain licensure in other participating states without having to repeat the entire licensing process in each state.

The Interstate Medical Licensure Compact Commission, which is responsible for the compact’s governing rules and administration, recently released a proposed process for expedited licensure through the compact and opened the period for public comments. The commission will consider the proposed rule at its meeting in early October.


The expedited licensure process

The basic process is the same as the one outlined in model legislation released two years ago, says Ian Marquand, chair of the Interstate Medical Licensure Compact Commission. Under the newly proposed process, a physician applies for expedited licensure via the compact through the state where he or she claims principal licensure. The state of principal licensure is where the physician resides, practices, is employed, or files a federal tax return.

"The physician will have to provide some information so that we can make sure that state is legitimately the state of principal license. A physician can’t willy-nilly pick a state in the compact," Marquand says. The applying physician will also have to pay the commission a service fee and submit to a criminal background check through a law enforcement agency, including providing fingerprints or other biometric data.

"There are no heavy applications at this point. The point of this is to make it much easier for a physician to get licensed in additional states and for much less time and energy expended," he says.

The principal licensure state would then review the applicant’s qualifications to determine if he or she is eligible for expedited licensure, perform a criminal background check, and issue a letter to the applicant and the compact commission verifying or denying the physician’s eligibility. Once the applicant receives that letter, he or she can then select from which member states to request expedited licensure and pay those states’ licensure fees. The relevant member boards would then issue full and unrestricted licenses to the applicant. Those licenses would be valid for as long as any other full and unrestricted license normally issued by that state board.


Application turnaround time

There is not a set amount of time to process the application for licensure through the compact due to several variables, Marquand says. These variables include how quickly the physician goes to a law enforcement agency to get fingerprinted, the amount of time necessary to complete the criminal background check and deliver the results to the medical board at the state of principal licensure, and how long it takes that state of principal licensure to review the criminal background check and the applicant’s other details (e.g., board certification and medical education).

A few test runs of the process have been performed in Marquand’s home state of Montana. "We find that it only really takes a matter of hours but it’s not the only thing our people have to do. So where it falls in the queue depends on how long it’s going to take for our people to actually get to do the work. That’s a variable. The communication between a state of principal license to compact commission and then compact commission to receiving state, I don’t think those should take very long at all."

In contrast, the applicant’s responsiveness will be a factor in the turnaround time. Marquand provides a hypothetical scenario to illustrate this point: Dr. Smith, whose state of principal licensure is Montana, applies for licensure in three additional states through the commission. He is prompt about providing his fingerprints and submitting to the criminal background check, which allows the staff in Montana to process his application fairly quickly. In a matter of days Dr. Smith is certified by the commission but then puts off paying the licensure fees.

"We can’t do anything until the fees have been paid. So if the physician is slow about paying fees, that’s on them, not on us," Marquand says. "But once the fees are paid and delivered to the receiving states, we don’t expect [the states] to take very long in issuing the license."

To help motivate physicians to stay on track with their applications, the proposed rule sets a 60-day limit for the applicant to submit all requested materials.

"With every application in the professional licensing world, there’s an expiration date on the application. It doesn’t sit there forever waiting for you to finish. If you don’t get it done, it expires. Putting a 60-day limit on that seems pretty reasonable to me," he says.

Returning to the example of Dr. Smith, Marquand says if the physician applies through the compact commission, pays the initial processing fee but then doesn’t have his fingerprints taken and is unresponsive to the commission’s requests for information for more than 60 days, the application is withdrawn.

"It put some onus on the physician to take some action. But will it take 60 days for processing? No, that’s just the time we give the physician to get any information that we need. But I can’t imagine that happening very often, if at all." Marquand says.

Once a physician is certified through the commission, that certification is valid for one year. This means that if Dr. Smith initially selects one compact state for licensure, such as Wyoming, and then decides six months later that he wants a license for Idaho as well, he will not have to reapply, Marquand says. Dr. Smith will simply need to inform his state of principal licensure?Montana?that he’d like to practice Idaho. The board in Montana will notify the commission and then Idaho will issue the license fairly quickly.

"The only thing that would preclude that would be if Dr. Smith gets in trouble with either the Montana or the Wyoming board and his license is suspended. Then his compact eligibility goes out the window," he says.

When a physician’s license is suspended, it is the responsibility of the member state in which the disciplinary action occurred to notify the commission, which in turn, would notify all the states in the compact. At that point, it would be up to each individual state to decide what to do.

"It’s presumed that reciprocal discipline will happen very quickly. So if Dr. Smith gets in trouble in Wyoming, Wyoming reports him to the commission and Montana would probably take very swift action to suspend his license there, Marquand says. "And if he’s licensed anywhere else in the compact, those states would have the option of doing the same. We want to at least make it possible for very swift action in all the states.

He adds that there are circumstances where reciprocal discipline is automatic, such as when a license from a state of principal licensure is revoked, suspended, or surrendered. In such cases, states can change that automatic action to something else, if they choose. So while states would have some discretion, it may come after an initial action.

Physicians who retain clean records and maintain their qualifications would be able to obtain licenses in as many compact states as they want within a year of achieving certification from the commission, as long as they’re willing to pay the fees.


Work to be done

Some details of this process have yet to be finalized. For example, the amount of the commission’s processing fee has yet to be determined. The commission will likely take up this issue by the end of the year.

"Each individual state within the compact also needs to have its own discussion of whether it wants to charge an application fee to cover the cost of reviewing the physician’s qualifications," Marquand says. In Montana there is a proposal put forth for a $ 100 fee. That proposal still needs to go through a public comment period and receive final approval from the state medical board.

After considering the provisions of the proposed rule, the commission will have several options: Adopt the rule as-is, adopt it with amendments, send it back to the committee for more work, or scrap it completely.

"I’m certainly optimistic that the commission will adopt these. And whether there are any changes suggested to them through comments, we’ll deal with them. I think the commission is anxious to get these rules in place and move on to the next topic," Marquand says.

If the commission decides that the proposal requires significant changes, the rule could be brought back to the commission as early as December.

Work on the application portal for expedited licensure is also underway but an open date has not been announced, Marquand says. However, the commission has set January 2017 as the target date for the first licenses to be issued by a member state using the compact process.

To assist with all the work that remains to be done, the U.S. Health Resources and Services Administration (HRSA) recently announced a $ 250,000 annual grant for three years to help the commission get up and running. The grant, which was requested by the Federation of State Medical Board, underwrites the cost of the commission.

"That takes a huge load off on us as commissioners. We know that through that grant there will be money available to cover technical costs, meeting costs, and maybe even staff costs for the next three years," Marquand says. He forecasts that after the three years, the commission should be able to stand on its own financially and operate on the service fees it collects.



Often the Interstate Medical Licensure Compact is discussed in the same breath as telemedicine but Marquand emphasizes the distinction between the two. The compact relates exclusively to licensing and therefore does not provide any rules, regulations, or even any guidelines on the use of telemedicine. Although physicians or health organizations may want to use it to allow their own practice or corporate practice to expand into more states, they will still need to follow the regulations of those states once licensed.

"I understand that there may be benefits of the compact for physicians who want to do telemedicine in more places, but that’s not specifically why the compact exists. The compact exists for licensed physicians to get licenses in other states quickly and efficiently, regardless of what kind of practice they want to do," Marquand says.

He recalls this topic came up at a press event in Washington, D.C., designed to promote the compact to members of Congress and major healthcare organizations. When the question was posed of who would be the major user of the compact?large healthcare organizations that want to use telemedicine, or individual physicians who want to expand a practice across state lines either in person or by telemedicine?the answer that came back was it would likely be both.

"Here’s how I look at this: Think of two parallel highways. On one, there are physicians using telemedicine. The compact is on the other, with ramps between them," he explains. "The folks on the telemedicine highway may take a ramp over to the compact highway to get additional licensure, but then they’ll get back on the telemedicine highway."


Moving forward

As this issue of CPRLI went to print, 17 states have enacted compact legislation and nine others have introduced it. Marquand is optimistic more will adopt legislation.

"There are a couple that haven’t quite got to the finish line and we understand there are going to be states that are on the sidelines, waiting to see what the commission does and see how the compact really works," he says.

That’s why Marquand says the work the commission is doing to get the compact up and running is so important. The successful operation of the compact will be the commission’s biggest promotional tool for convincing additional states to participate. The hope is to bolster the case for joining once the commission has concrete figures on time frames and the number of licenses issued. – Credentialing and Peer Review Legal Insider

What Are The Best Medical Billing and Coding Programs Online?

Image Source

Medical coding and billing is one of the few well-paid, in-demand healthcare jobs requiring solely a post-secondary certificate or associate degree at most. Good Financial Cents listed medical coder as the 20th “Best Job without a College Degree,” providing an average certified salary of $ 46,800. Online education is ideal for this digital IT profession that’s focused on the accurate organization of electronic health records. Online courses can train medical coding and billing staff to translate patients’ diagnoses and procedures into alphanumeric codes to file health insurance claims. As the health informatics field expands faster-than-average by 15 percent, the availability of online medical coding and billing options is becoming staggering. In this article, we’ll help point you to six of the best online colleges for tomorrow’s medical IT staff.

Herzing University

Image Source

Headquartered in Menomonee Falls, Wisconsin, Herzing University is a private, nonprofit HLC-accredited training institute that’s seen enrollment skyrocket by 260 percent since 2001. The U.S. News recognized Herzing for delivering America’s 142nd best online undergrad programs for $ 550 per credit hour. Adhering to the CAHIIM Academic Competencies, Herzing offers a 44-credit Diploma in Insurance Billing and Coding Specialist online over 12 months. Online courses like diagnosis coding and pathophysiology lead to a four-credit internship or research project and CCSA certification. Herzing undergraduates could also pursue the 61-credit A.A.S. Insurance Billing and Coding or 124-credit B.S. in Health Information Management.

Learn more about the Medical Billing and Coding Programs Online at Herzing University here.

Indiana University

Image Source

Endowed for $ 1.57 billion, Indiana University is a public, nine-campus teaching system in the APLU that’s regionally accredited to educate around 89,170 undergrad Hoosiers total. Graded America’s 27th “Top Public University” on Niche, IU offers the 54th best online undergraduate programs according to the U.S. News. The School of Informatics and Computing places CCA certification in reach for online learners with the 32-week Medical Coding Certificate. Full- or part-time students join each Fall to audit inpatient and outpatient health records. After the culminating, four-credit coding practicum, students can advance into the B.S. in Informatics – HealthCare Information Technology.

Learn more about the Medical Billing and Coding Programs Online at Indiana University here.

Keiser University

Image Source

Called the Keiser Institute of Technology until 1986, Keiser University is a private, nonprofit and nonsectarian SACS-accredited institution in Fort Lauderdale that’s educating nearly 18,000 Seahawks at an average net price of $ 21,129. Deemed America’s 30th “Best Online College” on Niche, Keiser is ranked the South’s 11th top value by the U.S. News. Distance learners could obtain the A.S. in Medical Administrative Billing & Coding, which meets CAHIIM standards. Conducted in English or Español, the 60-credit program features online courses from CPT-4 coding to medical ethics before an externship. Coders also have 100 percent job placement after the A.S. in Health Information Management.

Learn more about the Medical Billing and Coding Programs Online at Keiser University here.

Hunter College


Image Source

As a public, co-educational CUNY constituent, Hunter College is located on Manhattan’s Upper East Side near Lenox Hill to educate over 15,500 undergrad Hawks on a $ 99 million endowment. Ranked America’s 86th “Most Liberal College” on Niche, Hunter is the North’s 11th top public university according to the U.S. News. For $ 4,300 total, students can pursue the five-course Medical Coding & Billing Certificate in 80 hours online. Hunter also as a Combined Certificate in Outpatient and Inpatient Medical Billing for $ 5,300. Students progress through online modules like medical terminology and ICD-10 coding for CPC credentialing with exam discounts.

Learn more about Medical Billing and Coding Programs at Hunter College here.

St. Petersburg College


Image Source

Holding SACS and CAHIIM accreditation, St. Petersburg College is a public, four-year member of the Florida College System founded in 1927 that’s serving around 65,000 undergrads from Seminole to Clearwater and online. Crowned America’s 105th “Best Online College” on Niche, SPC ranked among Community College Week’s top 100 associate degree producers. Online learners could prepare for the CCA exam by completing the 37-credit Medical Coder Certificate and its two professional practica. Credits transfer seamlessly into the 70-credit Online Health Information Technology A.S. program, which has a 100 percent RHIT pass rate. There’s even a Health Data Management Advanced Technical Certificate.

Learn more about Medical Billing and Coding Programs at St. Petersburg College here.

Pace University

Image Source

Attracting around 12,700 Setters from all 50 states, Pace University is a private, nonsectarian ECAC institution tracing back to 1906 that’s located in Lower Manhattan with extensions in Pleasantville and online. Chosen as America’s 51st “Most Diverse College” on Niche, Pace is recognized by the U.S. News for the 36th best online undergrad offerings. Online students develop their e-portfolio with the asynchronous, nine-month Medical Billing & Coding Certificate program. Registering for the $ 3,995 program allows high school graduates to qualify for five certifications, including CCS and CPC-P. For taking the CEHRS exam, choose Pace’s seven-month Online Electronic Medical Records Specialist Certificate.
Learn more about Medical Billing and Coding Programs at Pace University here.

Image Source

Separating the good online medical coding and billing programs from the bad isn’t too difficult. Make certain you place accreditation, whether regional or national, at the top of your list to avoid registering at unaccredited diploma mills. Other important factors to search for are CPC certification rates, job placement, financial aid, awards or rankings, online technology, and curricular flexibility. Some honorable mentions to our above list include St. Catherine University, Drexel University, Central Texas College, Kaplan University, and Trident Technical College. The AAPC also offers online medical coding courses that cost members just $ 2,195 total for mastering ICD-10 classification.

Related Links

The 20 Best Medical Coding and Billing Programs Online

Top Medical Coding Schools

Should a Medical Practice Join Group Purchasing Organization (GPO)?

The small and medium sized medical practice is finding its profit margin shrinking with every new compliance regulation and insurance readjustment. The opportunity to save money on the operations side may help grow a bottom line without having to levy new fees on patients or giving up office services. A group purchasing organization (GPO) leverages the power of numbers to lower prices for members without having to give up on the quality of the product.

Improving Medical Billing for Practices

Are Your Medical Billing Mistakes Costing Your Patients?

The low estimate on medical billing errors is $ 17 billion, according to a report from the Institute of Medicine. Even if the $ 29 billion they state as the top of the range is an overstatement, do you have your share of $ 17 billion to give back to patients and insurance companies? Furthermore, do you even want a part of the 250,000 patients who die each year because of medical errors (according to the medical journal BMJ) on your conscience?

Improving Medical Billing for Practices

7 Benefits of Outsourcing Your Medical Billing with ICD-10

It can be difficult deciding whether to outsource your medical billing or not. With ICD-10 coming in October, There are many benefits of outsourcing your revenue cycle functions. Let’s take a look at 7 of those benefits.

#1 Economy of Scale
A billing service will distribute their expenses through their complete client base, which provide an economy of scale. They are able to operate with lowers costs than what a single practice can and those savings are passed on to their clients, making them very competitive. A billing service is able to afford to hire top-notch staff so you are able to pay less and get more.


#2 Highly Trained Dedicated Specialists
The outsourcing team has just one purpose – its focus is to increase your practice’s profitability. They will review and post payments from the carriers to ensure that you are getting the correct amount and preventing adjustments that are incorrect. Every claim that’s outstanding will be tracked until it is paid in full. The team that handles all elements of your medical billing is the same staff to ensure cohesion.


#3 Gain Control
There’s a mistaken assumption that if you outsource your medical billing you will give up control. In fact, quite the opposite is true. You tend to gain more control. You have a team of dedicate professionals that are taking care of this consuming task. They have the headache of dealing with monthly reports and ensuring that payments are forthcoming in a timely manner and that billing is carried out correctly and with complete transparency.


#4 An Industry That’s Changing
The landscape of healthcare itself is rapidly changing and medical billing has been dragged into the middle of this upheaval. Keeping up with all the changes in the requirements and rules can be difficult. It requires continuous learning. The delete and added CPT codes come out years. Carrier rules and fee changes occur almost daily. Most people simply do not have the necessary time to dedicate to this continuous learning curve. Outsourcing to a team of professionals is very helpful.


#5 Get Paid Faster
Cash flow is the key to your successful practice. Accounts receivable collections have a significant impact on your revenue and your bottom line. This is where outsourcing your medical billing can be beneficial allowing for claims to be submitted faster and with fewer errors. That means you’ll receive your payments in shorter period of time. By outsourcing, you have a team of professionals that all billing to be carried out in a timely manner, and the turnaround time can be significantly reduced.


#6 Focus on What You do Best
You spent so many years going to university to become a doctor so that you can help people. The little free time you have, you probably hate spending on the intricacy of medical billing or maybe you hate having people on staff that cost you a fortune. A better option is outsourcing, where you get a team of professionals at a much lower cost than having your own staff.


#7 Reduced Stress and Increased Cash
A top-notch billing service will charge a percentage for collecting the money but compared to having to run your own billing office and staff it the fee is really quite nominal. You are suddenly getting the highest rate of return from your carriers, which means that you have more disposable income. Almost all practices that outsource their medical billing see an increase in their revenue and a decrease in their billing costs.


ICD-10 is complicated and the number of codes is rising from 13,000 to 68,000. That’s huge! This is going to lead to a significant increase in the number of payer denials and it is expected that there will be a decrease in cycle time. Outsourcing is a great way to save you time and money learning all of the new ICD-10 codes leaving it to a team of well trained professionals.

The post 7 Benefits of Outsourcing Your Medical Billing with ICD-10 appeared first on Outsource Management Group, LLC..

Outsourcing – Outsource Management Group, LLC.

Is It Time to Outsource Your Medical Billing?

If you are noticing your medical billing claims are taking longer and longer to be reimbursed or you are having denials, rejections, or only partial reimbursements on your medical billing claims, it may be time to look at outsourcing your medical billing claims. You may feel as though you would be giving up control of your cash flow when actually you will have more control than ever. In fact, outsourcing your medical billing and coding needs through a medical billing partner is one of the smartest business moves you can make.

The best company to handle your medical billing isn’t necessarily located around the corner from your practice or even in the same town. Thanks to the power of the Internet, secure Internet connections, and advances in software and computer networks that allow for secure transmission of sensitive data, the process of finding a medical billing company to handle your needs is just a mouse click away.

This will free up your staff immensely as they will no longer have to spend long hours at the copy machine getting claims ready to send in. Your claims will be transmitted computer to computer via secure network transmissions and you can get real-time information on your patient accounts at anytime. Furthermore, outsourcing your medical billing will insure that all your claims are properly coded and documented properly. Your medical billing partner can devote 100% of their time to handling your coding and claims. That way your cash flow is steady and you can concentrate on growing your practice.

The post Is It Time to Outsource Your Medical Billing? appeared first on Outsource Management Group, LLC..

Outsourcing – Outsource Management Group, LLC.

CPC, CANPC, CCVTC searching for a medical coding position

6154 Black Mallard Place, El Paso, TX 79932; Karolinska Institutet, 171 77 Stockholm, Sweden;,, 678-427-6511 cell, 915-642-4269 home

GOAL: Medical administration including coding, billing, audit, compliance, analysis, and training.
Expertise in medical coding, billing, auditing, compliance and medical records administration with 4 years of experience as CPC, CANPC, CCVTC. Presently employed full-time. In addition, deep knowledge of anatomy, physiology, disease processes, surgery and medicine with 3 years in-patient hospital experience in medical care.

Medical coding (ICD-9-CM, CPT, HCPCS), proficient coding with ICD-10-CM including Ophthalmology and Cardiology. Certified AAPC Anesthesia/pain Management Coder and Certified CCVTC Cardiovascular and Thoracic Surgery Coder. Expecting AAPC certifications in CCC Cardiology coding, CPMA, CPPM, CPHRM. Deep knowledge of anatomy, physiology, and disease management, expertise in use of medical coding software, professional conduct HIPAA and joint commission, Registered Health Information Administrator (RHIA) training, medical records analysis and management, HCC, Epic-like training, extensive clinical research and training experience, training in all areas of medicine and patient care. Well-versed in correct grammar and spelling, Excel, Word, PowerPoint, Outlook, and have strong work ethics, leadership, and self-management discipline.

Certified Cardiovascular and Thoracic Surgery Coder (CCVTC), American Academy of Professional Coders (AAPC), Salt Lake City, UT, March 2017
Passed CCVTC exam, American Academy of Professional Coders, Salt Lake City, UT, March 2017
Certificate, ICD-10-CM specialty cardiology code set training, American Academy of Professional Coders, Salt Lake City, UT, 9/2016
Certificate of Cardiology coding and Certificate of General Surgery and Anesthesia coding, Greenville Tech, 2/2016
MOOC certificate of attendance Health Data Analytics with MS Excel, St. Scholastica, MN, December, 2015
Certificate of Achievement, Coding-Baseline-ICD-10 Inpatient Diagnostic, Precyse University, USA December 4, 2015
Certified Anesthesia and Pain Management Coder (CANPC), American Academy of Professional Coders, August, 2015
Certified Outpatient Coder (COC), AAPC, June, 2015
Passed CANPC exam, AAPC, August, 2015
Passed COC exam, AAPC, June, 2015
Certified Professional Coder (CPC), AAPC, March, 2015
Passed CPC Exam, AAPC, October, 2013
Certified Coding Specialist-physician based (CCS-P) and passed exam, AHIMA, May, 2015
Certificate of ICD-10-CM proficiency, American Academy of Professional Coders (AAPC), January, 2014
Certificate of ICD-10-PCS proficiency, AAPC, January, 2015
Certificate of CPMA Medical Auditing, AAPC, December, 2015
Certificate of CPPM Practice Management, AAPC, January, 2016
Certified Medical Administrative Assistant (CMAA), National Health Career Associates (NHA), November, 2014
Certified Billing and Coding Specialist (CBCS), NHA, November, 2014
ICD-10-PCS Code set training (16 hours), American Academy of Professional Coders, Salt Lake City, UT, 1/2015
ICD-10-CM General code set training (16 hours), American Academy of Professional Coders, Salt Lake City, UT, 1/2014
Triple Certificate in administrative medical specialist, medical coding and billing, +medical terminology (360 Hours), University of Georgia, 3/2015
Graduate, Medical Coding Specialist Course (87% B average) (600 Hours), U.S. Career Institute, 2012-2013
Licentiate (M.S.) degree, Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, October, 2006
B.S. in Molecular Biology, Summa Cum Laude, Vanderbilt University, Nashville, TN, 1993

Remote Medical Coder and auditor for Altegra Health, USA, 1/2016 to present (gained equivalent of one year four months experience)
Performing coding medical records for clinics, doctors offices and hospitals including allergy, immunology, internal medicine, cardiology, dermatology, ophthalmology, pulmonology, pediatrics, OB/GYN, general surgery, orthopedic surgery, emergency medicine, radiology, anesthesia and pain management. Completed coder refresh and compliance training.
Remote medical coder, HGS USA, LLC, Peoria, IL, 9/2015 to 2/2016
Performed medical coding at 50 hospitals in USA. Coded electronic health records for inpatient and outpatient. Assignments from Hinsdale clinic services; Florida Waterman; Florida Hospital; and Tampa Hospital. Abstracted medical coding. Managed medical records. Utilized software Cerner, Dolbey, 3M Encoder Systems, Powerchart, and Sunport.
Medical coding trainee, CPC-A ICD-10 Practicum, American Academy of Professional Coders, 11/2015-7/2016
Performed coding utilizing ICD-10-CM codes for diagnosis. Did coding on 600 medical records with ICD-10-CM, CPT, and HCPCS for one year equivalent work experience. Abstracted codes from E/M encounters, hospitals, office visits, operating room, radiology reports, and pathology reports.
In-patient hospital rounds including ICU and CCU at Emory University School of Medicine, Yale-New Haven Hospital (Waterbury, CT), and Brown University/Lifespan Hospitals. 1995-1999.
Medical Researcher and Teacher at Karolinska Institutet, Stockholm, Sweden, 2000 to 2010
Proctor, National Board of Examiners in Optometry (NBEO), Stockholm, Sweden, 2003 to 2005

Marquis Who’s Who in Medicine and Healthcare 2006-2007
Presented and planned lectures on cardiology, CANPC anesthesia and pain management coding, CCVTC cardiovascular and thoracic surgery coding to AAPC, Southwest University forums, and TXHIMA
Published a book on CANPC Anesthesiology coding essentials for successful anesthesiology coding through AAPC
Nominated for vice president AAPC local chapter in El Paso, TX

Medical Billing and Coding Forum – Resume Postings

Frequently Asked Questions for Medical Coding and Billing Students

Hello Professional Medical Coding and Billing Students! Here are some frequently asked questions and their answers to your program: Q: How do I navigate to the next module? A: The Program Modules navigation tool is on the left side of each page in the program. • Click the plus sign (+) to view the list of modules in the program. • Click the module name to navigate to the first page of that module. Use this menu each time you navigate from one module to the next. Refer to the Program Navigation unit of the Program Orientation module for more…
Career Step Coding and Billing Blog

The Medical Necessity Hot Button

Clearing up the confusion surrounding Medical Necessity!

by Lori-Lynne A. Webb, CPC, CCS-P, CCP, COBGC, CHDA  (originally printed through HCPro March 2017)

Understanding and determining medical necessity can be very complex for physicians, clinicians, coders, and billers.A physician or clinical provider of care may have a completely different understanding, interpretation, and definition of medical necessity than the patient or a patient’s family member. A third-party insurance payer may also have another completely different understanding and application of the term.

Defining medical necessity

So what is medical necessity? Coders or billers struggle to understand and sort out as the term, which leads to misinterpretation and misunderstanding of what needs to be communicated in a variety of areas.

CMS provides a specific definition under the Social Security Act:

… no Medicare payment shall be made for items or services that are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

In essence, the diagnosis drives medical necessity. Coders need to understand the diagnosis itself, as well as what services or treatment options are available to the provider.

Third-party payers add more confusion

Medical necessity can also be confusing when it comes to who is going to pay for the procedure or services. Many third-party payers have specific coverage rules regarding what they consider medically necessary or have riders and exclusions for specific procedures. Third-party payers may have a specific exclusion for procedures that they consider experimental, unproven for a specific diagnosis, or cosmetic.

One example is a surgeon using a daVinci robotic surgical device to perform a laparoscopic surgery. Upon pre-authorization for the surgery, the insurance payer states it will not pay for the surgery if the daVinci is used. The insurer’s policy includes a rider that deems the daVinci as an experimental surgical device. However, if the physician uses a traditional laparoscopic or open procedure, the third-party payer would reimburse. In this case, the insurance carrier is not stating that the surgery is not medically necessary, just that it will not reimburse for this surgery if the robotic device is used.

Even if a particular procedure or service is considered medically necessary, some payers impose limits on how many times a provider may render a specific service within a specified time frame. For Medicare and Medicaid, these limitations are known as National Coverage Determinations (NCD) and Local Coverage Determination (LCD). Private payers may simply refer to this type of limitation as a policy guideline or policy exclusion or rider.

Within these guidelines, payers may define where or when they will cover a specific service, but may limit coverage to a specific diagnosis. For example, insurance policies may have a wellness or preventive care benefit, but may only cover one such visit per year. Some payers may only reimburse for a single Prostate-Specific Antigen (PSA) test per year. The payer may require a documented screening diagnosis in coordination with the test.

If the patient underwent a PSA test January 1, 2012, for screening, his insurance may not pay for another test until 365 days (or one calendar year) have elapsed. However, if the patient undergoes a PSA blood test for screening and the test results are abnormal, the clinician may decide another PSA test is needed. The coder must submit that claim as a PSA blood test with the appropriate diagnosis for a sign, symptom, or abnormality, not as a screening.

Documenting medical necessity
Medical necessity continues to be open for interpretation by all parties involved. Many third-party payers have created lists of criteria they use to interpret medical necessity. These lists do not necessarily reflect all options, but payers include this reference in their policy guidelines.

Most providers have not developed a comprehensive listing of medically necessary qualifiers, so coders and clinicians must focus on good documentation and coding accuracy to communicate the medical necessity of services accurately to payers. If third-party payers deny reimbursement for medical services, physicians, clinicians, and coders need to rely on the formal appeal process.

Medical necessity documentation from a physician or provider should include the following:

§  Severity of the “signs and symptoms” or direct diagnosis exhibited by the patient. This is our diagnosis driver, and multiple diagnoses may be involved.

§  Probability of an adverse or a positive outcome for the patient, and how that risk equates to the diagnosis currently being evaluated. This is the medical risk vs. gain.

§  Need and/or availability of diagnostic studies and/or therapeutic intervention(s) to evaluate and investigate the patient’s presenting problem or current acute or chronic medical condition. In other words, does the facility, office, or hospital have what the provider or clinician needs to render care?

These bullet points reflect the basics of evaluation and management (E/M) guidelines that are currently in place from CPT®: the history, exam, and medical decision making processes. Coders will have an easier time evaluating medical necessity from this aspect. Of course, a good understanding of this integration of medical necessity within the E/M guidelines makes communicating this same principle to the providers much easier. Coders should encourage providers to continually enhance their documentation to improve overall coordination between the medical record, coding accuracy, and third-party payer reimbursement.

The third-party payers employ a wide spectrum of policies defining medical necessity is and should encompass. Physicians, clinical providers, and coders should review what these payers have established within their guidelines. Someone within the physician office, hospital, or medical facility should thoroughly scrutinize these guidelines before establishing a contractual relationship with a particular third party payer. This up-front communication will help avoid claim denials in the future.

Here are some examples of what some third party payers are currently including in their medically necessary verbiage:

§  Treatment is consistent with the symptoms or diagnosis of the illness, injury, or symptoms under review by the provider of care.

§  Treatment is necessary and consistent with generally accepted professional medical standards (i.e., not experimental or investigational).

§  Treatment is not furnished primarily for the convenience of the patient, the attending physician, or another physician or supplier.

§  Treatment is furnished at the most appropriate level that can be provided safely and effectively to the patient, and is neither more or less than what the patient is requiring at that specific point in time.

§  The disbursement of medical care and/or treatment must not be related to the patient’s or the third party payer’s monetary status or benefit.

Documentation of all medical care should accurately reflect the need for and outcome of the treatment.
Treatment or medical services deemed to be medically necessary by the provider of those services,(e.g., physician, therapist, clinician, etc.) does not imply or infer that the service(s) provided will be covered by or deemed a medically necessary service payable by a third-party insurance payer.

Medical Necessity Q&A

Q:  Could you give me some guidance on how I can instruct my MD’s on avoiding vague and/or subjective clinical documentation?
A:.  Ask your providers to adequately describe his/her skilled care providedand give a clear picture of the treatment and/or “next steps” to be taken.
Do not use vague or subjective descriptions like “tolerated treatment well,” “improving,” “caregiver instructed on med management,” or “continue with plan of care.”   “patient is here for follow up”
examples of more complete and compliant statements:
1.     Patient tolerated ROM exercises with a pain level of 6/10.
2.     Patient was able to verbalize understanding and importance of checking their blood sugars prior to administering insulin.
3.     Plan for next visit: to continue education on importance of daily inspection of feet for diabetic patient, provide wound care, etc.
Q  I work in dermatology and need to know what documentation is required for excisions?  We are struggling with getting paid  
A:  The provider should include the actual “size” of the lesion/mass they are going to excise.  Then they should document the area of the excision which needs to include the lesion + any margins.  (Height, Width, Depth) and if circular/elliptical etc… and denote the “why” it was performed that way.    If you have to appeal, the problem with using strictly the sizes from a pathology report, is that tissue “shrinks” once it is excised, and the would “enlarges” once the tissue is excised. 
Q.  What is the BEST way to document our time spent… the CPT codes state a vague “time” amount but the doctors struggle with this..  
A.  Notation of Time in/Time out is always very helpful…  it is also helpful if the provider “explains”  the time.  Eg –  spent 20 minutes of our 30 minute visit discussing how to properly use their new asthma inhaler.  Or  I was requested by Dr. Doe for “standby” for a possible cesarean section during vaginal delivery.  I entered the delivery room at 0800 and departed at 0915 status post a successful vaginal delivery.

Coders must understand the complex relationships between the physician, the patient, the medical record documentation, the coder, the biller, the insurance payer, and the communication between all of these entities to successfully guide the interpretation of medical necessity.

Lori-Lynne’s Coding Coach Blog