Cathy

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A Certified Professional Coder™ (CPC™) is an individual of high professional integrity who has passed a coding certification examination sponsored by the American Academy of Professional Coders (AAPC). The examination consists of questions regarding the correct application of CPT®, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies. A CPC™ must have at least two years coding experience and maintain yearly renewal as well as submit Continuing Education Units (CEUs) every two years.A CPC™ is an individual who in addition to on the job experience as a coder has achieved a measurable level of knowledge and expertise in reviewing and adjudicating coding of services, procedures and diagnoses on medical claims.The CPC™'s abilities include:Demonstration of proficiency in adjudication claims for accurate coding for diagnoses, procedures and services performed by physicians and recognized licensed non-physician providers in physician-based settings. Proficiency is required across a wide range of services, which include: Evaluation and management Anesthesia Surgical services Radiology Pathology Medicine A sound knowledge of coding rules and regulations go hand in hand with keeping current on issues regarding medical compliance, and reimbursement. A trained coding professional can best handle issues such as medical necessity, claims denials, bundling issues and charge capture. A CPC™ will be able to integrate coding and reimbursement rule changes into practice culture in a timely manner to include updating fee schedules and super-bills. A CPC™ has demonstrated knowledge of anatomy, physiology and medical terminology commensurate with ability to correctly code provider services and diagnosis.
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