# COC/CIC changes



## Norine H (Aug 12, 2014)

I would like to start a discussion about the new credential changes being implemented for CPC-H certified individuals. 

What do you all think?
I have significant concerns that after training and passing the exam, we are being restricted with the change to outpatient services only being covered by our credentials. We are losing part of what we are qualified to do as previously stated by AAPC, which may have impacts upon employment. 

I am proposing, and have written to AAPC to propose, that all current CPC-H certified individuals be given dual certification as CIC and COC's, since we were taught, tested and given credentials for both inpatient and outpatient sides of coding business. 

I'd like to see what CPC-H's think about this proposal. Thanks. I trust this post will remain for discussion. 

Norine G Holland MSN, RN, CPC-H
Hampton VA


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## mitchellde (Aug 12, 2014)

I must have missed a memo!  What changes to the cert are your referring to?  I have not received any notice regarding this.  Are you saying we will be restricted to working in outpatient clinics only?  I am not sure how that can be accomplished.  Where can I find info on this?


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## Naveen Rachagolla (Aug 13, 2014)

Even I am concerned about this, I got update last note from aapc regarding the new credentials COC and CIC, I booked CPC h, but now it has been restricted to out patient coding only, and again we need to spend on CIC to qualify as inpatient coder.


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## Candice_Fenildo (Aug 13, 2014)

Norine, The CPC-H has always been for hospital "Outpatient" Nothing has changed there at all. AAPC simply is now offering an "Inpatient" Hospital course and credential.

Outpatient ambulatory coder jobs are trending faster than ever before. As physicians move away from private practice and join hospital groups, career opportunities in Outpatient Facilities such as Ambulatory Surgical Centers or hospital outpatient billing and coding departments are opening for coders. The CPC-H? exam validates your specialized payment knowledge needed for these jobs in addition to your CPT?, ICD-9, and HCPCS Level II coding skills. Invest in your future with the CPC-H? certification. *NOTE: ICD-9-CM Vol 3 and DRG code assignment (inpatient coding) are not tested during the CPC-H exam*

The CIC course and credential is specifically for the "Inpatient" coder. I hope that this eliminates any confusion. It focuses on DRG, ICD-9 Volume 3 etc....


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## tschipani@ymail.com (Aug 13, 2014)

*Re: Cic & coc*

I was always under the impression that the two work hand in hand. When taking courses for CPC-H, we were instructed in both inpatient and outpatient coding guidelines. I did not pass the first exam for CPC-H, too slow on my part. Maybe there was a reason for this. 

Of course, there are no employment opportunities in on the job training for entry level coders. I cannot afford to keep paying for something that I will not benefit from. Very expensive. I do believe in investing in myself, but not if this is not reciprocated through employment.

I will be completing my bachelors' degree in Health Information Management through local university very soon.


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## tschipani@ymail.com (Aug 13, 2014)

Norinne,

We should take this one step further and those that have been certified with AAPC should be given the opportunity to sit for re-certification for both CIC and COC free of charge.


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## Norine H (Aug 13, 2014)

My basic question is: are you now saying that the certification you provided, after instruction and testing, that did not correctly reflect what our capabilities were? 

I would like to see the marketing materials surrounding CPC-H that you present to potential candidates and also to employees prior to this change. It is not the fault of the CPC-H if AAPC is now finding that their educational preparation does not live up to the credential that they provided the CPC-H. 

I can understand all of this moving forward, but even University programs/State licensing bureaus provide grandfathering for those already certified. 

Thank  you.


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## mitchellde (Aug 13, 2014)

Candice_Ruffing said:


> Norine, The CPC-H has always been for hospital "Outpatient" Nothing has changed there at all. AAPC simply is now offering an "Inpatient" Hospital course and credential.
> 
> Outpatient ambulatory coder jobs are trending faster than ever before. As physicians move away from private practice and join hospital groups, career opportunities in Outpatient Facilities such as Ambulatory Surgical Centers or hospital outpatient billing and coding departments are opening for coders. The CPC-H? exam validates your specialized payment knowledge needed for these jobs in addition to your CPT?, ICD-9, and HCPCS Level II coding skills. Invest in your future with the CPC-H? certification. *NOTE: ICD-9-CM Vol 3 and DRG code assignment (inpatient coding) are not tested during the CPC-H exam*
> 
> The CIC course and credential is specifically for the "Inpatient" coder. I hope that this eliminates any confusion. It focuses on DRG, ICD-9 Volume 3 etc....


Ok so nothing has changed with the CPC-H.  I was a little concerned for a bit.  You are correct the CPC-H has always been an outpatient certification.  Just because courses may have covered inpatient material, the test and the certification never pretended to be anything except outpatient.  You can still be hired to work inpatient if the employer so chooses, that is not changing either.  A certification in a certain area of expertise never guarantees a position in that area.


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## jkea (Aug 13, 2014)

VERY, VERY displeased with the way that the AAPC has chosen to handle the new COC,CIC credential issue! Those of us who now hold the CPC-H have tested on Volumes 1,2,3! I understand making the distinction NOW between the two, but those fo us that currently hold a CPC-H should be credentialed with BOTH the COC and the CIC--- because we have previously passed the exam. To remove our credential for hospital inpatient coding is a DEMOTION for a credential that we studied hard for. Such a demotion will affect our ability to move into more lucrative positions in the future without having to take the CIC--it unqualifies the qualified! To make us retest for a credential that we already acheived would be unfair as well. the only just solution would be to award current CPC-H credential holders with both certifications and to separate them going forward.  

I certified for CPC-H in 2004 and I did have to use Volume 3. My certification is supposed to be for the HOSPITAL. It was not separated for inpatient/outpatient then, and for those of us who hold the CPC-H certification, it should not be now. We should hold both under a grandfather ruling.


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## mitchellde (Aug 13, 2014)

The CPC-H did not have Vol 3 questions when I took it in 2000 and I know several who have taken it since I did and none of them were tested on vol 3 either.  There were no DRG question or issues either.  AAPC is not changing our cert only adding an inpatient cert.  this is a good thing for the AAPC and makes it more equitable to AHIMA Certs.


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## Candice_Fenildo (Aug 13, 2014)

Very well said Debra,  That is correct. the CPC-H has only been for "Outpatient" Hospital, which is why I cited the description of the CPC-H course. 

AAPC is changing the name in 2015 to COC so it is not confused with the CIC ( Certified Inpatient Coder).

If the certified coders that work "inpatient" at the hospitals want to be dual certified in Outpatient and Inpatient Hospital Coding, this would be a GREAT course and exam to take. 

to me it is like having my core (CPC) and then me continuing my education and expertise in the fields I am most passionate about. Hense the CPMA, CENTC and CPB after my name. 

It was NOT to "Guarantee" a job in that specialty, but to enhance my skill set and understanding of a specialty in which I LOVE  


Have an awesome day all


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## jkea (Aug 13, 2014)

I can not answer for what was on the CPC-H exam in 2000, or to any other exam but my own. I can tell you that I had to answer questions with codes from volume three and on the hospital chargemaster. There is more than one version of an exam. I do not disagree that the separation will allow for more precise training going forward, BUT it should not take away from the certification of those that have tested previously. When I elected to take the CPC-H, it was because it was represented to be the hospital version of the CPC credential. I was required to have all three volumes at the exam and i was tested on all three. If it had been represented to just be for outpatient, then I would not have elected to take it--as i am sure others would not have as well.


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## mitchellde (Aug 13, 2014)

jkea said:


> I can not answer for what was on the CPC-H exam in 2000, or to any other exam but my own. I can tell you that I had to answer questions with codes from volume three and on the hospital chargemaster. There is more than one version of an exam. I do not disagree that the separation will allow for more precise training going forward, BUT it should not take away from the certification of those that have tested previously. When I elected to take the CPC-H, it was because it was represented to be the hospital version of the CPC credential. I was required to have all three volumes at the exam and i was tested on all three. If it had been represented to just be for outpatient, then I would not have elected to take it--as i am sure others would not have as well.


I cannot speak to what was on your exam, however since its beginning the CPC-H has always been represented as outpatient.  There were chargemaster questions on the exam, but as it related to APCs.  Even the exam description has always indicated that there would be no Vol 3 or DRG questions.  The AAPC is not changing the CPC-H cetification, they are adding a new certification.  This is something not previously offered and not previously granted.  It moves the AAPC forward not backward.  There is nothing to grandfather the CPC-H into, as we were never PROPERLY tested for inpatient.  So even if there were a few questions on your test, it was not a sufficient amount to qulaify as in inpatient certification.  If your course instructor mislead you then that is not the fault of the AAPC.


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## jkea (Aug 13, 2014)

the discussion on grandfathering is not intended to represent that the CPC-H, as opposed to the COC/CIC, guaranteed that a person would get a job in a hospital, but rather that it would not "shut the door" on consideration for jobs that require in-patient coding credentialing. Currently, most hospitals accept the CPC-H. They may be reluctant or even refuse to consider the COC in the future.

It's not an issue of whether the coder loves his/her job, but whether his/her credential is being compromised. Why would one want to retest for something they already attained? That would be like taking away one's high school diploma because the state had raised the minimum credit hour requirement.


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## mitchellde (Aug 13, 2014)

jkea said:


> the discussion on grandfathering is not intended to represent that the CPC-H, as opposed to the COC/CIC, guaranteed that a person would get a job in a hospital, but rather that it would not "shut the door" on consideration for jobs that require in-patient coding credentialing. Currently, most hospitals accept the CPC-H. They may be reluctant or even refuse to consider the COC in the future.
> 
> It's not an issue of whether the coder loves his/her job, but whether his/her credential is being compromised. Why would one want to retest for something they already attained? That would be like taking away one's high school diploma because the state had raised the minimum credit hour requirement.


I am not seeing where the point is, the CPC-H is still the same cert it has always been, it is being renamed to COC, no one is taking anything away from you.  IF you want to show proficiency in inpatient then obtain the CIC.  The COC + CIC does not = CPC-H.  
The CPC-H NEVER represented itself as an inpatient proficiency exam.  I am still not sure where you are coming from on this.  Nothing is changing with your credentials except the initials, all is still the same.


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## suela923@aol.com (Aug 13, 2014)

So what were the credentials for inpatient coder prior to this change?


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## agibson (Aug 13, 2014)

I for one am grateful that inpatient is being offered as I have been considering CCS, but would rather have all credentials through AAPC.  My question is there going to be a study guide available through AAPC or are the ones currently available through AHIMA sufficient to pass the AAPC CIC exam and not be forced to sign up for the prep class to obtain a study guide?  I would like to study and take the test before ICD-10 is implemented.


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## PhysiCodeHS (Aug 13, 2014)

*COC/CIC Changes*

I agree with Candice Ruffing?s response. The CPC-H credential has always been for hospital ?outpatient? coding and not ?inpatient? coding.  There are key differences, which is primarily in the way procedural coding is captured (using ICD-9 vol. 3 and the MS-DRG reimbursement methodology).  AHIMA has always been the primary credentialing organization for the ?inpatient? portion of hospital coding (e.g., CCS). AAPC has always focused on outpatient [hospital] and physician based coding credentials.  Adding the CIC (inpatient hospital) is a huge plus for AAPC.  

I make it a point to always explain the differences to my potential students before they invest in the CPC-H training if their overall objective is to be an inpatient hospital coder.  In fact, many managers that are hiring for inpatient hospital coders do not recognize the CPC-H as they know this does not cover training on inpatient hospital components (DRG, I-9 vol. 3, etc.).  When taking the CPC-H exam, you are primarily tested on your ability to code surgical and operative reports using the CPT manual (in addition to ICD-9 vol. 1&2, HCPCS level II).  Inpatient hospital coders do not code using the CPT coding manual.  Only if they are coding for outpatient surgical cases.  

So, there really isn?t much taken away from the CPC-H.  It?s just differentiating between the two unique skill sets.  

Simone M. Johnson, BA, CPC, CPC-H, CPC-P, CPC-I 
Owner/Sr. Healthcare Consultant 
PhysiCode Healthcare Services, LLC 
sjohnson@physicode.com
www.physicode.com


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## PhysiCodeHS (Aug 13, 2014)

In response to suela923@aol.com, AAPC did not have a specific credential for "inpatient" hospital coders. There is a big difference between an "inpatient hospital" and "outpatient hospital" coder. I have experience in both, but prefer to focus on the outpatient side of coding.


Simone M. Johnson, BA, CPC, CPC-H, CPC-P, CPC-I
Owner/Sr. Healthcare Consultant 
PhysiCode Healthcare Services, LLC 
sjohnson@physicode.com
www.physicode.com


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## ssmiley (Jan 30, 2015)

*Very displeased*

I was certified as a CPC-H not a COC... I'm not seeing this new credential in job requirement for coders...I'm still seeing CPC-H.. I am very concerned that this new credential will not be recognized by the coding community.... I think they should have kept the H on the end of it  ex. COC-H... COC is to broad of a description, it does not identify what we truly do...

Sabra R. Smiley, CPC-H


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## ltthomas (Feb 4, 2015)

I totally agree that people studied and passed the CPC-H should be give a dual credential of COC and CIC.  It was part of our study and unfair to now restrict us.  I studied for the CPC-H and now am being restricted.  I think this is not right or fair.  Although there were no volume three questions, it was certainly part of the course materials.


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## mitchellde (Feb 4, 2015)

If inpatient coding and DRG was a part of your course curriculum specifically for the CPC-H then that is a fault of the course you went through.  The AAPC never pretended that the CPC-H was anything other than an outpatient credential.  To rephrase it to COC in no way diminishes its value.  They are identical to say you are a certified coder for hospital outpatient (CPC-H) or to say you are a certified outpatient coder(COC)..  I fail to see how anything has been lost.


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