# Need documentation why CPC beneficial



## gski (Oct 1, 2009)

HELP!  My employers, who informed me that I needed to obtain my CPC certification (which I did in MAY) in order to keep my position, have been dragging their feet about the raise & promotion that were promised to me.  They are stating that they need salary documentation and if there is anything by OIG or Medicare which states that CPC's are going to be required, or are recommended/essential etc.  I gave them copies of the salary survey that was in our recent issue from the AAPC, but I can't find a good article to support the government or insurance company's recommendations to employ a CPC.  Does anybody know of a good place to get one??    Thanks!


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## kevbshields (Oct 1, 2009)

Look at the OIG Compliance Plan.  I feel certain that supports the use of certified coders.  In addition, the Medicare Modernization Act also discussed and either recommended or required certification for contractors.

Although the MMA may not have "direct" influence over the practice, you could point out that this is certainly an illustration of how the industry is leaning.


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## mmorningstarcpc (Oct 2, 2009)

You could also try making a list of how you have helped the practice since studying and/or taking the exam and becoming certified.  Maybe you have found a service that is only paid for certain reasons, notified the providers and now they are more careful of services and meeting medical necessity.  I had a practice that once gave tetanus to every patient when they were due, not necessarily when they had an injury and it was needed (I discovered these type of things when I was hired).  A lot of these were denied as routine and therefore not payable.  Notifying the providers of this, made them aware that these may not be covered services even though it may be standard of care.  While not "official," if you can show money not lost and other things such as compliance, because of your guidance, that may show them your worth also.
Just my thought on this Friday morning.  Good luck!


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## LLovett (Oct 2, 2009)

The OIG brings in CPCs to do a lot of their audits, you can just search "certified professional coder" and they will come up. I have seen some CIAs on their site the require the audits be done by CPCs as well.

Another site I have found

http://www.stormingmedia.us/79/7990/A799024.html

"These studies indicate that professional coders produce significant improvements in coding data quality."

Good luck,

Laura, CPC, CEMC


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## gski (Oct 5, 2009)

I have over 20 years experience in billing, the certification was obtained because of my employer.  I have been working with this particular cardiology practice (11 docs, 1 PA, 1 NP)  for 1 1/2 years, and have given them numerous education on coding issues.  I am their "Coder", but I get paid the same as the beginner "billing" staff since the practice merged with the attached hospital last year in July.  Now the hospital is supposedly saying they have no job description for a "coder" and need documentation that this is a position that is warranted.  

I found a article on the OIG website that states:  "We contracted with certified professional coders who have extensive experience reviewing Medicare claims to determine if each service was billed with the correct code and documented adequately."  (OEI-09-02-00030 Consultations in Medicare: Coding and Reimbursement, March 2006).  Hopefully this will help.  

Thanks for the info!  If anyone else knows of anyplace else I should go, please let me know.


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