Jennifer sounds calm and collected to me, and I read only frustration/dismay, and not anger, into her red Emoticon. . .Jennifer: Since you are at the very beginning of the career (I'm not far beyond that, myself), would you consider veering slightly away from your original training in order to get a grounding in hospital/facility coding? I am attempting to do that myself, now, based on my current experience, but before I explain, I should mention that getting into hospital coding from the ground up is as difficult as is finding that first physician service coding job, but as I see it, the struggle in that direction bears superior long-term fruit.
My first job as a CPC-A was labeled a coding job, but ended up being too heavy on mere charge entry. There were many areas, at my office, in which coding needed to be upgraded, and I attempted endlessly to innovate improvements, but the environment was unreceptive, and I was told in no uncertain terms to charge, charge, charge away, and keep up a very high volume of claims. Ethically, I could not continue in this way, and when I looked around me, I saw that too many physicians' offices are oriented this way: Confusion of coding with billing, and a disturbing lack of power, on the part of coders, to uphold correct and ethical coding standards.
I became intrigued with the parallel world of hospital/facility coding, as a result, and research showed that that universe is IMMENSELY focused on quality control and ethics, and also packed with layers of auditing. Also, hospital coding is generally separated from billing altogether, such that coders are immersed in medicine fully, with the exception of remaining aware of the DRG implications of one's codes. . .
To become a facility coder requires a whole separate training that CPCs don't really have, but as people who have already mastered the very arcane CPT, we can DEFINITELY master the principles of UHDDS-based coding, and can DEFINITELY navigate ICD-9, which is MUCH better written and annotated than the CPT.
Most facility coders are not graduates of HIM college programs, even though such programs aim to train in this arena. Most facility coders were selected from other hospital positions to train into hospital coding. Most importantly, once one gets the training, and works for a few years, work opportunities in facility coding are amazingly rich. Much more demand, from what I see, than there is for physician service coders. . .
Can you try to land a job in a hospital's HIM department doing records assembly, perhaps? That might position you to be selected later for coding training on the job. After that, the sky will be the limit. ALong the way, you'll want to take the CCS exam, but I'm told that a few years of steady HIM coding makes that exam quite do-able.
I would love to see more CPC-As like us try this different direction. Since the offices who do what we were trained to do don't want us (and that is certainly the norm: It remains nearly impossible for a CPC-A to get a physician service coding job), why not try a different milieu, where advancement is actually possible?
