# Elimination of “A” Designation: The Apprentice designation is not needed anymore



## semaxwell1

The following is a shortened version of an article from the AAPC Coding Edge magazine January 2012 issue written by Reed E. Pew, AAPC Chairman and CEO.


Effective July 1, 2012, the CPC-A credential will no longer be granted. All current CPC-As would have their “A” removed  by doing one of the following:
1.  Getting at least one year of on-the-job experience no later than 12/31/2013, (helpful to those with a job and currently working towards that end)
2.  Successfully passing a clinical exam consisting of coding 20 operative/office notes.
3.  No current CPC-A would be grandfathered into the CPC credential.

Those taking the CPC exam after July 1, 2012 will have two ways to get their CPC credential: 
1.  Have one year of coding experience prior to taking the CPC exam with proof given at the time of the exam, and then pass the CPC exam or
2.  Pass both the CPC exam and a clinical exam by coding 20 operative/office notes.
On the job experience after taking the CPC exam will not be required. It does not matter in which order the two exams are taken.

The clinical exam will include a sampling of office visits, surgical notes, E/M coding, ancillary services, modifier usage, and diagnosis coding. A 90% pass rate on the clinical exam will be required and will be determined by correctly coding 18 of the 20 notes. The clinical exam will not be multiple choice, it will be free form and hand graded. The same 5 hours and 40 minutes time restriction and code books will be allowed, and the clinical exam can be taken at any AAPC proctored exam site.

Both exams will be paid for at the same time and the cost for both exams will increase by $35. Applicants may still take each exam twice to pass it. If the examinee already has one year experience, then he or she would pay only the CPC exam price. If one exam is passed after two attempts, but not the other, then the fee for the exam not passed would be paid to retake it.

Of course, current CPCs are not affected by this change. We would appreciate comments to this important change to our credentialing program through 1/31/2012. You may go to www.aapc.com/cpc-acomment to submit your comment. From those comments, we will either proceed ahead, make modifications that strengthen the change, or slow down the change due to legitimate concerns that AAPC has not properly considered.​

To me this sounds promising. Though I'm not looking forward to spending a total of over 11 hours of testing time and paying for two exams, but whatever it takes and hopefully it'll better help me reach my goals. I'm not fond of the $35 increase of the CPC exam price, and they don't mention how much the clinical exam will be, either.

I'm presuming AAPC has terminated the "Virtual Experience: Apprentice Removal" program. I was seriously thinking of signing up for that, but now am glad I didn't. I feel badly for those that started that program and were unable to complete it because AAPC brought the program's website down sometime last year. I would hope AAPC would recognize those that started it and give them some sort of credit towards this new clinical exam, at least financially.


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## mitchellde

I think this is fantastic


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## Mojo

I was impressed to read AAPC is encouraging feedback on this decision.

Now, if the industry would eliminate outsourcing of coding jobs to foreign countries, 2012 would be prosperous for more coders.


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## Pam Brooks

I think that the AAPC is moving in the right direction, by requiring experience in order to be certified. However, the AAPC is in a quandry, in that they really can't leave all of those inexperienced coder apprentices out to dry. They've suffered enough, don't you think? The AAPC has to come up with a reasonable way to move those CPC-As into the CPC designation before it's too late, while maintaining the integrity of the certification (although I am not sure that 20 notes substitutes for a year of sitting in the midst of the revenue cycle). Regardless, I like the format of the exam; it requires some solid coding know-how and independent thinking in order to pass. It's a fair compromise, and will likely provide us with some sharp new CPCs. 

On a go-forward basis, I would prefer that we require at least a year's experience, preferably two...in the medical office setting, medical records, front desk, billing or even coding in order to sit for the CPC exam. I think that the 20-question exam is an appropriate (short term) stop-gap to further certify the current apprentices, but I absoultely disagree that it's sufficient to credential a new CPC. I have long felt that the apprentice designation diluted the certification as a whole....it assumed that as long as you could pass the exam, even if you'd never set foot in a physician's office before, you could code. But I'm only speaking from experience as a hiring manager, who has had to endlessly train new apprentices. 

By the way, who's going to tell all those career schools and community colleges??


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## pamps76@yahoo.com

None of this really makes ANY sense to me.  I graduated from an AAPC- approved 1 yr. rigorous coding school 1 yr. ago.  At the same time, I was/am pursuing an A.S. degree in Health Information Technology (will graduate in May and then take the RHIT exam).  I passed the AAPC certification exam as a CPC-A. I have been very diligent trying to get any experience to get rid of the "A" on the end.  I have tried to participate in the Apprentice program that AAPC offers, with the closest office being 45 minutes away from me and they had nothing available for me.  My question to ALL seasoned coders, hiring managers, etc.. is how do we gain experience (and therefore get rid of the "A" on our credential) if no one is willing to hire non-experienced coders???  You can't get experience if you don't have any experience!!! It is highly FRUSTRATING!!!!!  Passing the CPC exam was grueling in and of its self only to be "awarded" with a credential that means nothing...and even less than nothing if you have the scarlet "A' attached. Woopee, now I get to pay more money, and take yet another test to get rid of the "A".....and guess what, still no experience, so still NO JOB!!!!!

I am  highly-motivated and generally possess a positive attitude, but this whole thing really rubs me the wrong way!!!  Any thoughts or suggestions would be greatly appreciated!!  Happy New Year!!


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## lorig

I have to agree with you.  I have worked in the medical field in various capacities for the last 20+ years.  I was offered an opportunity to participate in a class that was given to several employees in a local billing office by a certified instructor.  Although not a formal class, I participated for over a half a year, attended all but one of the weekly classes and did all of the required work.   I am proud to say that I passed the CPC exam on my first try, and,  I was the only one of eight students who passed on the first try.  The test was grueling, both mentally and physically. 
I now feel that my efforts may have been wasted since my passing that test will basically mean nothing unless I take and pass the new test.  I don't feel it's fair that I will have to sit for another 5 1/2 hour exam, which is what I will be required to do given the nature of job openings for coders in my town.  Most practices here don't even hire certified coders.  The few that do, require 5 years experience. Extern programs are all but non-existent. The ones I checked on require that an extern work during the day. Unfortunately, I have to work at my full-time job in order to pay my bills so this would be impossible. In addition, even if I pass the add-on exam, it will still not give me the coding 'experience' that is required to get a job.  I don't see how this is helping apprentices at all.  It appears to me that only the AAPC stands to gain since apprenticies will be required to pay additional money to take another exam.  
While I'm at it, I will also say that I know of serveral 'certified' coders who do not have the required experience, but still their employers were willing to write letters for them so they didn't have to have the "A".  If this "A" is so important that maybe ALL coders need to take both exams so that it will be a level playing field.   
I will carefully consider what to do since this will now become an issue for me and I'm sure for so many others.  I will also make sure to bring this up at my local chapter meeting, which I attend faithfully. 
Thanks so much for making my day!


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## buckston

*Apprentice "A" is ridiculous!!*

This "A" designation is absolutely ridiculous!  What other field has such a thing?  
I am an RN and when I took my registered nursing exam and passed, I was awarded the title of Registered Nurse (RN).  There was no scarlet letter on my sleeve that said I was new and inexperienced.  That's what the resume and hopefully interview is about.  What I as a new RN could bring to the job and my skill set/experience came through in my discussion w/ the RN hiring manager.  I was as much a RN when I first received my results that I had passed as I am today after 25 years experience.  No "newbie" designation required!

I just took the CPC exam and thought it was one of the most, if not "the" most difficult exams I've ever taken.  Particularly in the face of the 5 hr. 40 min. time limit.  If you can pass this exam, why in the world would yet another exam be needed?!  As with all national exams for certification in a particular field, that IS the proof of proficiency!  CEU's are needed to further expand on one's expertise in the coding field each year and that is what elevates the coders knowledge, not this philosophy of yet another test!!


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## ollielooya

Pam, I was hoping that you'd respond to this current thread.  And, seeing that this is a spin-off  to another active thread with the same subject felt reposting might be appropriate..

Why not simplify the process instead? Why not revamp the actual CPC exam to include scenarios where codes must be selected rather than subsisting entirely of multiple choice questions. The exam is difficiult enough as it is, but by adding this element would really go the one step necessary to test the capability of those testing. Remove the A, and let the resume speak for itself as the candidate and prospective employer can discuss the experience factor.  JUST A THOUGHT to add to the mixture---Suzanne E. Byrum CPC


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## w.baxter1073@gmail.com

*Apprentice "A" for CPC*

I too am an "Apprentice", for sake of a better term.  I graduated from a one year AAPC accredited school with coding occurring throughout the course of the class.  I have been with a billing and coding company for 21 months, of which, 14 of them have been in the coding department.  My supervisor will not approve a letter from corporate for me, beacuse I do not code 'all' of the types of ASC cases that we code for.  
     I was trained on how to properly look for and code for ANY type scenerio.  I have a "A" hanging over my head, and with the limited range of coding that I am doing, I am not certain that my employer would give me a good reccomendation should I choose to apply elsewhere as a coder.  It is frustrating to have to jump through so many hoops, when dependant upon your state, the carrier, and the contract, coding will NEVER be the same from one local to the next.  That is why we must continue with our CEU's and the "A" should not exist.
     I understand if your employer places restraints on your coding until such a time that he/she feels confident with your abilities as a coder, but what employer doesn't do that anyway, no matter what job your have?  And I too have 25+ years experience in the healthcare field and found that this test was challening, but rewarding.  I had one hour remaining when I completed my exam, and passed with an 83%, so WHY do I have to sit with an "A", when I can obviously code?


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## dclark7

Many moons ago when i took my exam you were required to have at least two years of experience (and a letter stating such fromyour employer).  Why the AAPC moved away from that I don't know.  Pam is right the AAPC can't leave alll those CPC-A's hanging out to dry, but in order for the credentials to be taken seriously (and for years they weren't) there has to be some sort of segue.  I like the idea of actually coding from the notes rather than a multiple choice test.  As difficult as people feel the test is, it doesn't begin to compare with abstracting information from a patient record where not everything is neatly in place for you.

As for other fields requiring apprentices, physican are not allowed to hang up a shingle once they complete medical school, they are required to go through both an internship and residency.  Plumbers, electricians and carpenters all have apprenticeships. And nurses are required to go through clinical rotations PRIOR to graduation.

Years ago before managed care, HIPAA, the ACA, CERTS, RACs and ZPICs it was easy to walk into a medical office and do any job.  Now all that has changed and from my experience, most of the coding courses do not adequately prepare new coders for the "real world".  People who have other experience in the medical field are more prepared, but most new coders have never set foot in a medical office except as a patient.  One thing the AAPC has accomplished with the apprentice designation is to over saturate the field with inexperienced coders.  What is the answer?  I'm not sure, but I agree with Pam, I think the AAPC is heading in the right direction.


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## chshaffer41@gmail.com

*C Shaffer,  CPC-A*

I'm a CPC-A and I am quite unsure of what I now may need to do to get the"A" lifted from my credential.  I have a particular concern with this change because I actually did sign up and work through, all but about 100 of the 800, doctor notes for the Online Apprentice Removal Program this past summer when the site went down and I was not able to complete it.  I am sure there are some of you who have read some of my posts since this all went down, and you are probably tired of hearing about it, but let me just share my story once more... 

      I decided last summer to take some time off from a job I had as a Medical Assistant,  which I had worked for 14 months.  I thought this was going to be my "foot-in-the-door",  but it was clear it was not going to happen with this practice due to nature of it being a small practice( one doctor),  no room to move up.  Anyway,  I decided to leave the practice-due to other unfortunate reasons as well,  to per sue the Online Apprentice Program.  I dedicated my ENTIRE summer to try and finish this with the hopes of finishing by fall,  so I could get back to work with this experience behind me. I literally worked all day, and night, every single day this past summer (from 8:00 am to at least 10:00 pm).  Unfortunately,  the site went down when I had about 100 to do in order to finish.  This was in Aug/Sept,  and I have been patiently waiting for the site to come back up so I could finish.  I even participated in helping with providing feedback to the AAPC during this time.  I want to say that having nearly finished this program,  it was very exhausting and every bit as grueling as the CPC exam. I feel I have worked extremely hard, and dedicated a large amount of time working on this progam,  only to possibly have it no longer be available as an option for removing my "A" status.  I signed up for this program because it allowed me to do it on my own time,  at my own pace,  and from home.  I think the idea of this program was a good one in that it teaches you not just what to code, but if you submit incorrectly, to do some research to find the correct codes, and understand why you may have an incorrect code.  I think a coder gets a better understanding of the process as a whole.  If you sit for a test consisting of only 20 notes,  and have a time limit how is this considered an apprentice program where a new coder is being prepared for real world?  Everyone needs to be trained for any job, and there aren't many employers willing to train a coder, so I think an apprentice program should be an option to train and further teach a new coder to prepare them for the real world.  New coders still need experience to get a job,  they cannot get a job and then sit for the test,  because they won't be hired without the credential either.  And it is another, additional expense.

      All this being said,  there definately needs to be a change on how new coders can obtain the experience,  and the credential,  to help them gain the employment.  But from my point of view,  I am very upset about how this is potentially going to affect me.  I have spent a large amount of time,  AND money persuing this credential/education.  I am beginning to feel I have wasted alot of my time,  money,  AND energy trying to obtain this credential.  Maybe I should go back to Accounting,  where I DO have the experience,  in addition to a degree from a state college.  I love the medical feild and I have the compassion for this line of work,  and I thought I had found where I belonged,  but I have to say this has been a dissapointing experience.  I hope those at the AAPC will read my post and try to help me understand what exactly MY options are now....?


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## SCPage

*Apprentice*

This is quite a surprise. 

Basically, AAPC is moving the goal post so that rather than allow you to sit for the exam and THEN get one year of work experience on your own before getting the full credential, now you will be required to _already have _a year of experience before you can even sit for the exam - unless, of course, you're willing to take not one, but TWO five hour and forty minute exams, and, of course, pay AAPC for this priviledge. (The orginal post didn't specify the cost of this new exam, but I can only assume that if the same time limit is alloted for it, the cost will probably be the same as the first exam - $295 for members,  including the $35 price increase - a total of $590 for two exams, which according the president's announcement, must be paid for up front at the same time.)

It appears AAPC has painted itself into a corner and found itself with a LOT of newly certified (CPC-A) coders and is trying to find a way to still collect money for membership dues, online courses, books, practice exams, study guides, and exam fees without diluting the integrity of the certification by having too many certified coders flooding the market.

As it stands, it looks pretty grim for those of us struggling to break into this field. If employers were reluctant (at best) to take a chance on a coder with an Apprentice designation, they certainly aren't going to jump at the chance to hire a candidate with NO certification and NO work experience.

I challenge any senior coders and hiring managers to take the chance on that eager, enthusiastic new graduate and/or newly certified coder and reap the benefits of establishing a relationship of trust and loyalty that will pay big dividends.

Just my two cents.


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## Lashel

I really hope the AAPC puts some more extensive thought into this before they rush forward. I like that they give an opportunity for students with no experience to get certified. Students come to school and work really hard to learn this stuff, and then pursue a career. There is no reason they should be required to have the career first, before they can get certified. If you think it is difficult to get a job with the CPC-A credential, try getting your foot in the door with nothing. 

I see nothing wrong with the apprentice title. I would be fine with it going away too, but what I don't want to see is students not be able to pursue certification at all because they don't have experience. That seems backwards to me.


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## marver

Although I think gaining experience is the key to successful coding, I have to disagree with parts of this proposal.  Take the people who just passed the rigorous CPC exam for instance, like myself.  We went into this process knowing that passing the exam would give you the CPC-A status, like all of the CPCs before us.  To remove this status, one has to prove on-the-job training.  This is great.  You pass the exam and get the training needed to code "in the real world" without time limits.  Now the AAPC proposes to put a time limit on when the apprentice can submit this letter (December 2013, I believe).  But did anyone think about the fact that the AAPC are favoring those who are already in the medical field.  I have decided to change careers like many people out there.  We are stuck in a horrible economy (not to mention I am living in the state with the worst unemployment rating) and not able to find jobs.  It disgusts me that I studied hard and passed the exam, only now the AAPC is saying that it is not good enough.  Not to mention some of my fellow test takers will only have to have their employer write them a letter, when I will have to sit through another rigorous exam.  This is absolutely not fair!  I feel you are not doing me any favors by taking off the -A designation (and making me sit for another exam), because as the proposal reads, it only tells the employer that you do not have experience.  But with or without the -A, my resume shows that I do not have on-the-job experience...that I only have educational training.  What harm is it to leave this -A for the people who already have it until they have the opportunity to get the on-the-job training needed (with no time limits)?  This way they can phase out the -A designation without changing the process altogether.  The people who are getting ready to take the CPC exam understand what will be needed of them (2 exams totaling almost 11 hours--ouch), and not take the exam and find out (only a few days later in my instance) that because you do not have have a job in the industry, you have to sit through another gut wrenching exam.  I am not asking for a free pass (being grandfathered into CPC status), only that I have the same opportunity as those who are in the medical field and were sitting for the exam at the same time as I.  I feel that the AAPC should just revamp the old test if they feel that straight coding is needed and remove the -A designation for current test takers.  For those who already have the CPC-A, let them follow the protocol the AAPC laid out for them and gain the on-the-job experience in there own time (since there are no jobs out there right now).  I ask that the AAPC please re-evaluate their proposal before rushing forward.


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## mitchellde

As I stated earlier I think this is fantastic.  I have no problem with expecting newly certified coders to also sit for a 20 question non multiple choice exam.  I am also good with revamping the existing exam to be all fill in the blank with op notes to code.  The idea is with no experience you have to show that you can take the ball and run with it.  I have run into many new coders that cannot code without someone first giving them the suggestion of what the code might be.  You have to be able to think independently.  The provider is selecting the codes in todays world with the way the EMR is set up, but many times they are incorrect, a coder needs to know how to read the note and to be able to extract the correct codes.  I worked with a billing service not long ago.  they had many newly certified coders and those wanting to become certified.  They allowed them to work to get the experience and then sit for the exam so as not to have an A.   I suggested an exam to determine the level of expertise for each coder, a test was administered that was fill in and used the op notes and office notes from their clients.  Easy right?  there were only twelve questions and only 3 were op notes.  It took everyone a full 8 hours to answer the questions, and the highest percentage achieved was 35%!  They were all angry because the test was not multiple choice.  This told me then why there were so many rejected claims and why so many denials were not being appealed.  They were using the codes "suggested" by the physicians without ever considering they could be incorrect.  
So to take a part of a test or even an entire test that is not multiple choice is a good thing, it is a true measure of your abilities to code.  I am not sure why you would not welcome the opportunity.  As far as the AAPC goes I think it is good for them to elevate the credential.  I also think they are really working in the best interest of the coder by making it more apparent to the future employer that AAPC coders really do know how to code.


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## espressoguy

marver said:


> Although I think gaining experience is the key to successful coding, I have to disagree with parts of this proposal.  Take the people who just passed the rigorous CPC exam for instance, like myself.  We went into this process knowing that passing the exam would give you the CPC-A status, like all of the CPCs before us.  To remove this status, one has to prove on-the-job training.  This is great.  You pass the exam and get the training needed to code "in the real world" without time limits.  Now the AAPC proposes to put a time limit on when the apprentice can submit this letter (December 2013, I believe).  But did anyone think about the fact that the AAPC are favoring those who are already in the medical field.  I have decided to change careers like many people out there.  We are stuck in a horrible economy (not to mention I am living in the state with the worst unemployment rating) and not able to find jobs.  It disgusts me that I studied hard and passed the exam, only now the AAPC is saying that it is not good enough.  Not to mention some of my fellow test takers will only have to have their employer write them a letter, when I will have to sit through another rigorous exam.  This is absolutely not fair!  I feel you are not doing me any favors by taking off the -A designation (and making me sit for another exam), because as the proposal reads, it only tells the employer that you do not have experience.  But with or without the -A, my resume shows that I do not have on-the-job experience...that I only have educational training.  What harm is it to leave this -A for the people who already have it until they have the opportunity to get the on-the-job training needed (with no time limits)?  This way they can phase out the -A designation without changing the process altogether.  The people who are getting ready to take the CPC exam understand what will be needed of them (2 exams totaling almost 11 hours--ouch), and not take the exam and find out (only a few days later in my instance) that because you do not have have a job in the industry, you have to sit through another gut wrenching exam.  I am not asking for a free pass (being grandfathered into CPC status), only that I have the same opportunity as those who are in the medical field and were sitting for the exam at the same time as I.  I feel that the AAPC should just revamp the old test if they feel that straight coding is needed and remove the -A designation for current test takers.  For those who already have the CPC-A, let them follow the protocol the AAPC laid out for them and gain the on-the-job experience in there own time (since there are no jobs out there right now).  I ask that the AAPC please re-evaluate their proposal before rushing forward.



No one is forcing existing CPC-A's to take the additional exam. Yes, taking the exam would allow your A to drop off sooner. If you don't take the exam, your experience requirement will have been cut in half from 2 years to 1 year.

Based on my massive 3 months experience as a coder D), I feel as though coding 20 op/clinical notes is a much better indicator of whether one understands coding or not. While the current exam is long and difficult, it really isn't coding. You are already given the correct answer among 4 choices. On the job, who is going to give you the answer?

This doesn't really effect me since I'll have 1 year experience with 80 hours of classroom (current rules) or 1 year experience (proposed rule) in October. I would feel no need to take the exam in July just so that my A will drop off 3 months earlier.


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## Pam Brooks

mitchellde said:


> As I stated earlier I think this is fantastic. I have no problem with expecting newly certified coders to also sit for a 20 question non multiple choice exam. I am also good with revamping the existing exam to be all fill in the blank with op notes to code. The idea is with no experience you have to show that you can take the ball and run with it. I have run into many new coders that cannot code without someone first giving them the suggestion of what the code might be. You have to be able to think independently. The provider is selecting the codes in todays world with the way the EMR is set up, but many times they are incorrect, a coder needs to know how to read the note and to be able to extract the correct codes. I worked with a billing service not long ago. they had many newly certified coders and those wanting to become certified. They allowed them to work to get the experience and then sit for the exam so as not to have an A. I suggested an exam to determine the level of expertise for each coder, a test was administered that was fill in and used the op notes and office notes from their clients. Easy right? there were only twelve questions and only 3 were op notes. It took everyone a full 8 hours to answer the questions, and the highest percentage achieved was 35%! They were all angry because the test was not multiple choice. This told me then why there were so many rejected claims and why so many denials were not being appealed. They were using the codes "suggested" by the physicians without ever considering they could be incorrect.
> So to take a part of a test or even an entire test that is not multiple choice is a good thing, it is a true measure of your abilities to code. I am not sure why you would not welcome the opportunity. As far as the AAPC goes I think it is good for them to elevate the credential. I also think they are really working in the best interest of the coder by making it more apparent to the future employer that AAPC coders really do know how to code.


 

Bravo! 

Although the CPC exam is challenging, it's not an absolute indicator of coding competency, and elevating the difficulty of the CPC examination will only improve the integrity of the certification. The apprentice certification, in my mind, was well-intentioned, but generated a huge glut of inexperienced (and unemployed) would-be coders, regardless of their abilities and willingness to work. I'm glad that the AAPC has recognized this, and is moving towards re-recognizing that we are setting a higher standard. 

I'll never forget the words of one of my staff members, who was struggling early on to grasp the coding concepts in my department. He said, "I passed the CPC examination, but I had no idea that it would mean that I wouldn't just be able to sit down and do this work. There's a h$ll of a lot more to this coding stuff than just passing an exam".


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## chshaffer41@gmail.com

*Cshaffer, CPC-A*

Although I am an apprentice,  I am well aware of the fact that the CPC exam is multiple choice, and in the real world there are no multiple choices.  A coder DOES need to be able to read a note and pull the appropriate codes for the procedures and/or diagnoses,  and that truely IS a good measure of the ability the coder has. That is why I strongly suggest that the AAPC really take a look at continuing to offer the Apprentice Program, wether it be an online or on site program,  I feel that is a great way to get the "new" coders the experience and/or education that is needed in order to be a successful coder.  Since there are not many providers that have the time,  or the finances to train "on the job", it seems to me that someone appointed by the AAPC should lead an apprentice program (like the online program), to work with the new coders, and mentor them on the issues in a real world situation. I would rather pay for an apprentice program that's going to give me the "real world" information needed to be a certified coder,  than pay for yet another test that is timed, and does NOT offer any feedback on why a code would NOT be correct,  and WOULD get denied in an actual coding setting. 

 I am speaking from actually having attempted the on-line prgram.  Although it had some bugs that needed worked out,  I feel it was quite challenging and offered a very real picture of what it is truely like to be in a coding position.  The program consisted of 800 doctor's notes,  from EVERY specialty.  It is alot of hard work,  but I felt that it really showed how the real world looks and what is expected of the coder.  I REALLY hope that the program will become available again soon,  with the bugs worked out,  because I think the program, along with a mentor to guide the coder,  will make the "new" coder much more successful in understanding the field.  I also feel that it will better prepare them for the challenges they will face,  and how to do research in order to figure out what the proper codes may be.  

One more thing about the CPC test....It is a very hard test and I don't think the fact that it IS  extremely challenging should be dissmissed.  But I do feel that there should be some actual,  fill-in-the-blank notes included in the future.  But the amount of time to complete it may need to be increased...just a thought.


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## Lashel

why not revamp the existing exam, vs. adding a second exam? Just because you have one year of experience doesn't mean you can code either! I have worked with plenty of experienced coders, who were basically selecting codes based on what the person who trained them told them the right codes were for that condition. Or hey just add a modifier 25 to get paid, with no idea of what modifier 25 even means.

Make the exam more difficult, add the clinical op notes to part 2 of  exam, and elevate the pass rate to 80%. I bet that most folks could get on board with that. But, keep it one exam, and make it the same for everyone.


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## halld1

*"A" Removal*

UNBELIEVABLE!!!!!!!!!!!!

So much red tape to remove an initial that means nothing (other than hendering your job search) and for what?  A job paying $14.00 - $20.00 hr.


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## ndhight

I agree with you it is frustrating. I too am a CPC-A and have been for 4 years. No one will hire me without experience as well! Last year I had 5 different interviews and didn't get a job. This is my last year to try and the last year I will pay the 125 dollars! I paid all this money into this academy and the test fee to have to put more money to drop my A or lose my certificationl; is BS!! I think it says a lot if you pass the test without experience! The AAPC should offer a cheaper online class to take or exam should be free! 
Excuse me but how can you code from op scenarios without experience to know what codes to pull if it isn't multiple choice?


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## wbown

*Fighting for futures*

*OOOO MY GOD!!!  *So what do I do now?  I'm one of the thousands CPC-A's that this decision will affect.  I sat and passed the exam  a year ago October; spent 1 year in the class room and the 2nd year just studying the coding books, page-by-page, line-by-line; took free on-line anatomy classes and every practice test I could find; now you're telling me all of my efforts may have been for not!!!  There is no way that I can afford the expense of taking yet another exam. When you're living on $400 a month, it is hard enough keeping up with the yearly AAPC Membership costs, the cost of the chapter meetings, and the CEU's.

I have been hunting for a medical coding job every day for the past 14 months, sending out hundreds of resumes and made just as many cold calls, resulting in only 1 interview.  The only company in 14 months, that was looking for newly accredited medical coders. I was told I was in the running for a job, but then the company decided to “reorganize”; what does that mean?  So I keep looking.  There is nothing out there if you don't have at least 3 to 5-5 to 7 years of experience (yes, I've even applied for those jobs too).

This is nothing more than another excuse to squeeze us for yet one more fee.  How will this AAPC's new Clinical Exam, help us obtain jobs?  It won't.  At present the A is removed after completing 1 to 2 years of on-the-job experience; employers still request 3 to 5 - 5 to 7 years of actual on-the-job experience.  So whether or not, you have an A at the end of your credentials changes nothing.  Let the employers decide for themselves.  With the economy in a depression/recession (whatever the politicians and economist are calling it this week, it's bad), why does it seem like we're being penalized when the hospitals, clinics, doctor offices (I've even tried senior living facilities) that no one is hiring??? . Don't hinder me anymore than I've already have been by this economy.  

Now AAPC said *SORRY *and wants to wipe away my last 3 years because of 1 letter!!!  It's not fair, it's not right, to all of the CPC-A's, like myself, who have been struggling, barely keeping our head above the flood waters.  We've paid for classes and studied, we've paid and sat for the exam, and we've paid our yearly AAPC membership dues, and paid for chapter meetings.  We've done everything that was asked of us, and more.  *SORRY!!!!!!!!!!!!!!!!!!!!!!!  *If others are similar to me, we have sacrificed years of family time, knowing doing this will better ourselves and our families; so we thought.  *THIS IS VERY FRUSTRATING!!!!!!!!!!!!!!!!!!!!!!! * 

The NAB and the AAPC are changing the rules after the game has been played and we've gone home – now they want a do over. It's not fair; we've played your game, by your rules and won; now let us move on to the next challenge, without hindering us further.  Our credentials matters (I worked very hard for that CPC); the apprentice (A) may be out dated or obsolete, but we have more than earned that CPC after our names. I demand on behalf of the thousands of current CPC-A's that we are grandfathered into the CPC credentials.  Let our resumes speak for themselves, and let the employers decide. 

If the objective of the apprentice (A) was to show prospective employers – an individual had passed the CPC exam.  Why not, then, grandfather the CPC-A's into CPC's?  We've passed our CPC exam, that fact hasn't changed, (or is the NAB & the AAPC now saying otherwise).  Like it states in the AAPC's own Coding Edge article, our resumes will indicate our experience level and speak for itself.  To eliminate our credentials because a group of people, sitting behind desks, who are not out in this economy job hunting, have decided our credentials are obsolete, and believes 1 letter at the end of our credentials has out lived its usefulness …. Is to discredit my time, (I've never worked harder for anything), and will now be meaningless; it is disrespectful of our commitment to try to better ourselves and our families futures.

*WE'RE NOT ASKING FOR A HANDOUT; WE'RE JUST ASKING TO BE ALOWED TO KEEP WHAT WE HAVE ALREADY EARNED, NOTHING MORE, AND NOTHING LESS.  THIS IS A FIGHT FOR OUR FUTURES.!!!!!!!!!!!*

P.S.  And Pam Brooks, I'm sure that when you were a new CPC (with or without the A), someone had to sit and endlessly train you, also.  I only pray that someday I might have the same privilege.


----------



## ajs

Wow....I think the folks with CPC-A need to take a step back and breath.  Realize, you are not required to take the new test.   You can choose to keep the "A" part of the credential and continue to work towards getting experience to have the A dropped.  This was just a way of removing the one thing AAPC keeps hearing is a stigma that is hindering coders looking for jobs.   It was a way to give you an opportunity to take a test that is more "real world" than the multiple choice CPC exam and show how good your skills really are.

Also, AAPC asked for input.  Please email your concerns to your National Advisory Board representative or to Reed Pew.  If there is a consensus among the people with CPC-A that this is not a good alternative, then they will go back to the drawing board.

I have a beloved former supervisor that taught me something I will never forget, "don't bring me a problem without also bringing a solution".  So everyone who is upset over this proposal needs to start thinking about viable solutions to the problem and send your solutions to AAPC.


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## ndhight

I will express my concerns to the board thank you! I realize we don't have to take the test however they are trying to put a deadline on when we must have 1yr of experience. In this economy and state I live I may not have the 1 yr experience by 2013; for Gods sake it has all ready been 4 yrs! How much more waiting and patience can we take.


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## SLeingang7572

I would have to say that I agree with most of what has been posted here. I was glad when I saw that someone actually started this post.

There is also a link in the article posted in the January 2012 Coding Edge to leave your comments. I would urge all the CPC-A's to let AAPC know your concerns. I feel that if they want to change the system then it should be started from the date they have stated in the article of July1 2012 and it should affect any new coder not be retroactive back to us coders that have already taken the steps to obtain our CPC-A certification. We should be allowed to go by the requirements that were in place when we were certified.

As one person mentioned in a previous post when she obtained her RN degree and took her boards she did not have the scarlet letter A behind her RN credentials.  When I graduated from dental hygiene school and then passed my Washington and Oregon board I was considered a RDH (registered dental hygienist) and not a RDH-A. And hygienists are actually working on live people. I have taken many dental hygiene state boards and can say that the CPC certification test was the most intense test I have ever taken.

Also if CPC-A's do decide to take the 20 question clinical exam and pass it what good is it to then be CPC without the 1-2 years experience that most employers require for a coding job? 

Maybe the AAPC should have made it so that you would need at least 1 year of experience before signing up for the CPC exam but to change the rules on CPC-A after the fact and affect them is crazy. It is bad enough in this economy to find a job and now they are adding another test.

And what if one decides not to take the extra exam and doesn't get a job and have the 1 year experience by Dec 31 2013 is their CPC-A credential just going to be dropped where they will not have any credentials and then all the studying and money they spent  for schooling, coding books, the exam, CE's and membership all for nothing?

Sharyl Leingang BS RDH CPC-A
Washington State


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## bettinadodd

As a practicing R.N. for 30 years, I was able to get the "A" removed from my CPC because of my ICD-9 experience, which I did for Medicaid enrollments under the community-based care EDCD waiver. 18 months later, I still am unable to land any coding position because I lack 'real' coding experience; that is, I have not done any CPT coding. The presence or absence of the "A" is not the determining factor for landing a coding job - it's whether or not you have done actual coding (both ICD-9 and CPT).


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## SLeingang7572

bettinadodd said:


> As a practicing R.N. for 30 years, I was able to get the "A" removed from my CPC because of my ICD-9 experience, which I did for Medicaid enrollments under the community-based care EDCD waiver. 18 months later, I still am unable to land any coding position because I lack 'real' coding experience; that is, I have not done any CPT coding. The presence or absence of the "A" is not the determining factor for landing a coding job - it's whether or not you have done actual coding (both ICD-9 and CPT).



Exactly! It is all about having the experience!


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## rthames052006

I've been following a few threads regarding this issue I have to say that I haven't received my Coding Edge at home as of yet to read the article in question.

I think if AAPC is going to " do away with the A" then maybe as some posters have already mentioned ( maybe not in this particular thread but in another) that the actual CPC exam should have less multiple choice questions and force the examinee's to provide the cpt, icd or hcpcs codes for the scenario's.  That would actually prove that someone does "know how to code" without using the process of elimination for 4 answers.  

I also agree with the RN who said she doesn't have the "scarlet letter A" behind her degree.  Most employers will test a coder prior to offering a position anyway.  I've heard it said before that some of us who've been coding for years w/o credentials sometimes are better coders that ones who have the credential behind them and that, in my opinion comes down to someone who is not certified but has been doing the same work as someone who is certified.... boils down to alot of what people have been saying... "Experience is the best teacher".  Having that hands on experience makes a world of difference (again, my opinion).

My heart goes out to the newbie's with the A behind their credentials.  

I can honestly say that when I first started off after received my credentials I applied for jobs regardless if the advertisement  said must have 2-3 years experience or not, you never know if you happen to get an interview even though you don't have the years of experience required and you can prove that you know how to code real  op cases/ notes etc.... that speaks volumes ( in my opinion) than if you've been certified for 10 years or 1 year.

It took me 5 years after achieving my CPC credentials to land a true " coding position".  And I can honestly say now ( back then no) that I am glad I wasn't offered any of those jobs I applied for because I now know that I really did need the hands on experience that I received being in the billing dept, billing supervisor etc... has made me a better coder in the longrun....

Best of luck to you all...


----------



## dclark7

halld1 said:


> UNBELIEVABLE!!!!!!!!!!!!
> 
> So much red tape to remove an initial that means nothing (other than hendering your job search) and for what?  A job paying $14.00 - $20.00 hr.



Ok, for all of you new coders who believed the hype that you can make over $40,000/yr AND/OR work from home.  YOU SHOULD HAVE DONE YOUR HOMEWORK!!!  If you check out the AAPC salary survey from 2010 which is when they broke it down by years of experience you'll see that most people with one year were making $16.61/hr,  coders didn't get to over $20 until they had 10 years of experience ($21.96).  So....if you who don't have any experience are not willing to accept jobs that are paying "$14-$20"/hr then you have no reason to complain.  If you actually read the salary survey report you'll find that the people making the most money are usually self employed, are consultants or are in managment positions.

Every post from experienced coders have adivsed the newbies to take any job they can get.  Yes jobs are hard to come by and if you take the front desk position you're NOT going to make $20/hr but you will be getting experience in the medical field and if you prove that you want to learn most employers will give you a chance.  However, if you go into an interview expecting that because you went to school and passed a multiple choice test they're going to look at you like you're the answer to they're prayers you are sadly mistaken.  Everyone has to start somewhere and most people are NOT going to start at the top.  So lower your expectations and get some experience.


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## MnTwins29

*Do I dare say this?*

I know in some circles that "other" organization is a terrible thing to mention, but the AHIMA coding tests do have the format some are suggesting - both multiple choice (primarily for items like coding principles, etc) and coding questions where the code must be filled in, not multiple choice.   Several other posters have made that suggestion for the CPC exam, and I say bravo, that is a good compromise between status quo and this change requiring a second test.   

As for the experience, something again I will take from that "other" place is that they strongly SUGGEST, but don't require, 3 years of coding experience before taking the test.   I followed that advice, and it was very beneficial for both the test and the future job prospects.   Yes, I was luckier than most because I got my experience because the place where I interned (in HIM work that was not coding) liked that work, asked me if I would be a per-diem coder and did that for 4 years.   

Finally, before anyone asks if that other place is so great, why am I here, I will state that AAPC is the best organization for coding materials, references, feedback and information.   Discussions like this is precisely why I wanted to be part of this family as well.  I discovered that long after getting into this business, but better late than never, obtained a specialty credential that is related to my current position, and will utilize AAPC benefits in the same way I have for AHIMA for years.   A professional organization is only as good as the members and how the members take advantage of the opportunities is the way to advance not only the goals of the orgainzation, but also enhance the careers of the members.  

Okay, off the soap box for now.


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## mmorningstarcpc

wbown said:


> *OOOO MY GOD!!!  *So what do I do now?  I'm one of the thousands CPC-A's that this decision will affect.  I sat and passed the exam  a year ago October; spent 1 year in the class room and the 2nd year just studying the coding books, page-by-page, line-by-line; took free on-line anatomy classes and every practice test I could find; now you're telling me all of my efforts may have been for not!!!  There is no way that I can afford the expense of taking yet another exam. When you're living on $400 a month, it is hard enough keeping up with the yearly AAPC Membership costs, the cost of the chapter meetings, and the CEU's.
> 
> I have been hunting for a medical coding job every day for the past 14 months, sending out hundreds of resumes and made just as many cold calls, resulting in only 1 interview.  The only company in 14 months, that was looking for newly accredited medical coders. I was told I was in the running for a job, but then the company decided to “reorganize”; what does that mean?  So I keep looking.  There is nothing out there if you don't have at least 3 to 5-5 to 7 years of experience (yes, I've even applied for those jobs too).
> 
> This is nothing more than another excuse to squeeze us for yet one more fee.  How will this AAPC's new Clinical Exam, help us obtain jobs?  It won't.  At present the A is removed after completing 1 to 2 years of on-the-job experience; employers still request 3 to 5 - 5 to 7 years of actual on-the-job experience.  So whether or not, you have an A at the end of your credentials changes nothing.  Let the employers decide for themselves.  With the economy in a depression/recession (whatever the politicians and economist are calling it this week, it's bad), why does it seem like we're being penalized when the hospitals, clinics, doctor offices (I've even tried senior living facilities) that no one is hiring??? . Don't hinder me anymore than I've already have been by this economy.
> 
> Now AAPC said *SORRY *and wants to wipe away my last 3 years because of 1 letter!!!  It's not fair, it's not right, to all of the CPC-A's, like myself, who have been struggling, barely keeping our head above the flood waters.  We've paid for classes and studied, we've paid and sat for the exam, and we've paid our yearly AAPC membership dues, and paid for chapter meetings.  We've done everything that was asked of us, and more.  *SORRY!!!!!!!!!!!!!!!!!!!!!!!  *If others are similar to me, we have sacrificed years of family time, knowing doing this will better ourselves and our families; so we thought.  *THIS IS VERY FRUSTRATING!!!!!!!!!!!!!!!!!!!!!!! *
> 
> The NAB and the AAPC are changing the rules after the game has been played and we've gone home – now they want a do over. It's not fair; we've played your game, by your rules and won; now let us move on to the next challenge, without hindering us further.  Our credentials matters (I worked very hard for that CPC); the apprentice (A) may be out dated or obsolete, but we have more than earned that CPC after our names. I demand on behalf of the thousands of current CPC-A's that we are grandfathered into the CPC credentials.  Let our resumes speak for themselves, and let the employers decide.
> 
> If the objective of the apprentice (A) was to show prospective employers – an individual had passed the CPC exam.  Why not, then, grandfather the CPC-A's into CPC's?  We've passed our CPC exam, that fact hasn't changed, (or is the NAB & the AAPC now saying otherwise).  Like it states in the AAPC's own Coding Edge article, our resumes will indicate our experience level and speak for itself.  To eliminate our credentials because a group of people, sitting behind desks, who are not out in this economy job hunting, have decided our credentials are obsolete, and believes 1 letter at the end of our credentials has out lived its usefulness …. Is to discredit my time, (I've never worked harder for anything), and will now be meaningless; it is disrespectful of our commitment to try to better ourselves and our families futures.
> 
> *WE'RE NOT ASKING FOR A HANDOUT; WE'RE JUST ASKING TO BE ALOWED TO KEEP WHAT WE HAVE ALREADY EARNED, NOTHING MORE, AND NOTHING LESS.  THIS IS A FIGHT FOR OUR FUTURES.!!!!!!!!!!!*
> 
> P.S.  And Pam Brooks, I'm sure that when you were a new CPC (with or without the A), someone had to sit and endlessly train you, also.  I only pray that someday I might have the same privilege.



wbown,

Respectfully, it is not polite to call out someone on the forums, especially Pam Brooks who does nothing on here but give GREAT advice.  I know Pam, and like Pam, I took my exam after many years of coding and reimbursement experience.  So no, I don't believe someone had to sit with her and train her.  When I took my exam and passed, I continued in the job I had.  The difference between Pam and I, and many others, may be that we are always striving to learn new things.  We are like the little kids that continuously ask "why?"  Not that we are better than anyone else, I don't mean it that way.  We, as well as many other senior coders, continuously strive to do better and/or more.  So even though we "grew up" with coding, instead of going to a school, we still started at the bottom in our field just like any coder with no experience, or like any other profession with no experience.  Its called life, we may not like, it may not be fair, but it is what it is.


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## Alicia Scott

*Instructors perspective*

From a college instructors perspective, I could understand the "A". That being said, I also knew it was a catch 22 for the students. They spent over a year getting trained and then had a hard time getting a job because of the "A". 

I say let the resume speak for itself. If you pass the exam, which everyone agrees is hard. Then you are qualified to get a coding job. Are you an excellent coder? Becoming a really good coder comes with working on the job. Just like another person mentioned that she graduated as an RN. If you are hired right after you pass your boards then your employer knows you are a new RN and need some working experience under your belt before they send you out there on your own. They have a mentor program now in a lot of hospitals for that very reason. If you pass you CPC in Jan. 2012 and get a job in March then that employer knows you passed and that you may need some time with a mentor but you are qualified to start coding. 

In my opinion they could drop the "A" and extra testing. Let the resume and dates speak for experience. Most employers offer a pre-employment exam. The coder does not need any more testing then that.


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## halld1

TOTALLY AGREE.  Right On WBROWN. and DCLARK; my point exactly...much expense and time for $12.00/hr???????????


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## chshaffer41@gmail.com

*CShaffer, CPC-A*

Alicia,  I was glad to see your post on this issue.  As an instructor,  I am sure you understand how important it is to teach your students what is to be expected of them out there in the "real world".  But, I also realize just having the "book" education is not enough to be labled "Experienced",  and that is why I have made the suggestion of some type of mentoring program for the "Apprentice".  I don't know if you had the opportunity to see the Online program for the removal of th "A" that the AAPC initially offered, and I know I am being reppetitive in my opinions,  but I still think that it was potentially a great way to give new coders a chance to experience "real world" coding.  And I still believe that if this program is offered with someone to mentor them,  it would greatly improve the skillls of those of us who want to continue to learn,  and provide us the opportunity to ask questions that would greatly enhance our abiilities to understand how, and where, to research, in order to find solutions to coding errors that are made.  Although this is not considered "experience" from an employer's point of view,  it allows the coder to work towards removing the "A" status,  and rewards them with the CPC credential.  And believe me when I say this program IS ALOT of work,  I know, because I spent my entire summer working on it and I did a tremendous amount of research.  But the site went down in the midst of all this,  and I personally do not feel rewarded.  That being said, I think that after the coder completes this experience I think they should be awarded the CPC status and leave it up to a prospective employer to make the decision to hire, based on wether they have enough experience or by requring a pre-test prior,  to determine if they think a coder has what they are looking for. If a new coder has to take a job that isn't a "coding" position in order to get their foot in the door,  I think most of them would have no problems with that,  but the "A" status is a label that just gets looked past by those hiring.  If the CPC-A's go through an apprentice program, that just shows they are willing to work hard and I believe this dserves to be recognized by awarding the CPC status.  I think this is what should be done to help the current CPC-A's,  and if AAPC wants to chang the way the testing is done in the future (by adding the op notes to be coded, along with the multiple choice),  then that's ok too.  But I really feel the new coder would benifit GREATLY from an apprentice experience....  there just has to be someone willing to mentor us...


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## hawkinsj

*Janet*

When I tested for my CPC I was proud and thankful that I passed.  I had been working in a myriad of settings involving coding and documentation for years yet my CPC showed me how
little I really knew!  Any CPC person is pretty much job specific, we don't know a lot about all other areas of coding but we sure do know the field we work in.

Having said that, I think the A should be left in place for one year.  It is or can be expensive to get your CPC and to add yet another lengthy test at another cost seems unfair.  They are still a new coder with no experience.  Just because they can do op reports or office visits would be of no help to our Hospitalist company.  

Jobs are hard to find with out without the A attached however being a CPC sure does open doors and I think it is up to the person to prove to the prospective employer they have what ti takes to learn and grow.  I have hired people with zero coding experience because I see their potential and trust my intuition.  An A after CPC would not have mattered to me.

Anyway, I love my job, I love auditing and Compliance, I am the luckiest coder I know and either way, as a coder we are WINNERS!!!!


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## garlynd32@comcast.net

I just finished a year of 20 hours a week of class room learning for medical billing and coding(I dont know how many hours of homework) . I also did 180 hours of externship. I took and passed my CPC exam. I am now looking for a job in the field. 
    I left a very successful career in the retail management job as I wanted a change in careers. While in my retail job, I was the hiring manager. I had to do the interviewing, hiring and training of all new imployees. What I would love to have had, is my new employees to have completed a year of schooling and a grooling exam. Then, I would have known they were serious and smart enough to do the job. 
   In most jobs, you get hired and then the hands on training is what gets you familiar with what you have to do with your job on a day to day basis. In the past, coders were hired without any classes and then trained in this manner.
   I passed my classes with a 4.0 GPA, have a great recommendation from my extern site, and passed my CPC the first time with an 81. It amazes me that this is not enough to get me started in this field and the I have an A after my CPC. 
    My school is an AAPC acreditted school so I officially have 1 year experience and only need 1 more to get my A removed. 
    So, what company would like to hire me and give me experience. I have found that I love to learn and want to become a foremost authority in ICD-10. I have seen and it looks very interesting. The company that hires me will be more than happy to have me as I am an overachiever and always perfect anything that I do.
      I dont know what is going to happen to my "A" but, it sounds like I would have been better off is I hadnt taken the test which makes no sense as there are so many coders that are not certified as it is. 
        Can anyone explain how this industry came from hiring anyone without schooling, and training them to people with skills learned in school that are wanting to learn and further their learning for their job that cant get hired. This sounds like a step backwards, not forward.


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## ljohnson980

*The Scarlet “A” needs to be eliminated NOW.*

The Scarlet “A” needs to be eliminated NOW.
I come to the coding field from an IT background and hold numerous certifications within that field. Each certification test I passed provided me the privilege to add those letters to my resume demonstrating time in the field as well as focused study. It was my resume that let the employer know my experience and readiness for a posted position.

If I am lucky enough to gain employment, remember NO one wants to hire a CPC-Apprentice I will probably spend the year entering the same five codes listed on the superbill. My “A” is removed but I am less of a coder at the end of that year than when I passed the CPC exam.

I would drop the A designation right away for anyone who has passed the CPC exam and move to a graduated certification method.
The CPC certified professional coder would be the base line certification attained by all members of the coding field utilizing the current exam format. Some of the coders will be hired by an office that utilizes the superbill and so be it at least they will have initially learned the correct methods and understand the requirement of coding guidelines. Next level of certification and testing (questions and clinical sections) would be based on the type of treatment center you are interested in ie: inpatient-focusing on ICD-10, outpatient-focus on CPT, emergency room coding, home health care coding etc. The third tier would be the sub-specialties CPC-I, CCS-P, CCMA, CPCO and so on. Each tier requires more study and time in the field. The goal is with each additional certification attained after the CPC your earning potential goes up. Also as employers seek to provide education opportunities (HITECH meaningful use) for their staff the tier process provides that.  Please remember that with the HITECH act more and more of the medical process will be absorbed by the clinical support systems within the EHR's. The graduated certification method will keep coders relevant in the EHR process.


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## FTessaBartels

*Apprentice Status is "new"*

Have we all forgotten how "new" the apprentice status is?  It has only been in effect for a few years. 

When I took the CPC exam in 2005 the requirement to sit for the exam was two years of experience. In order to even register for the exam, I had to submit two letters from employers, on letterhead, at least one of which was from my current supervisor, attesting to two years of experience with coding.

I believe there was a "student membership" that was available to those without the requisite experience.  But those members also didn't sit for the exam.

In my opinion, the leaders of AAPC did a great disservice to the organization (and to legions of students) by allowing the apprentice status at all. It seems that the organization's leaders have realized this, and are now moving back to the previous system.  

I am in favor of limiting the CPC to those with a certain level of experience, and that experience should come BEFORE one is allowed to sit for the exam.

That being said, I do believe that it is grossly unfair to those who have already worked so hard to pass the test, to require anything additional AFTER they have passed the test before granting them the full CPC.  So, go ahead, eliminate the "A."  Return to a more stringent standard of experience for those seeking to sit for the exam ... going forward.  

AAPC should admit that the entire "apprentice" designation was a mistake.  Grant those who passed the test their full credential (they took and passed the same test anyone WITH the requisite experience took).  Their resumes will speak for themselves as they seek employment.  

The organization may be smaller for a time because some of those who cannot find employment will eventually drop their membership, and those newly graduated students won't be sitting for the exam.  But I believe it will be a positive step towards increased professionalism and a greater recognition of the worth of the CPC credential

Just my opinion. 

F Tessa Bartels, CPC, CEMC


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## SLeingang7572

FTessaBartels said:


> Have we all forgotten how "new" the apprentice status is?  It has only been in effect for a few years.
> 
> When I took the CPC exam in 2005 the requirement to sit for the exam was two years of experience. In order to even register for the exam, I had to submit two letters from employers, on letterhead, at least one of which was from my current supervisor, attesting to two years of experience with coding.
> 
> I believe there was a "student membership" that was available to those without the requisite experience.  But those members also didn't sit for the exam.
> 
> In my opinion, the leaders of AAPC did a great disservice to the organization (and to legions of students) by allowing the apprentice status at all. It seems that the organization's leaders have realized this, and are now moving back to the previous system.
> 
> I am in favor of limiting the CPC to those with a certain level of experience, and that experience should come BEFORE one is allowed to sit for the exam.
> 
> That being said, I do believe that it is grossly unfair to those who have already worked so hard to pass the test, to require anything additional AFTER they have passed the test before granting them the full CPC.  So, go ahead, eliminate the "A."  Return to a more stringent standard of experience for those seeking to sit for the exam ... going forward.
> 
> AAPC should admit that the entire "apprentice" designation was a mistake.  Grant those who passed the test their full credential (they took and passed the same test anyone WITH the requisite experience took).  Their resumes will speak for themselves as they seek employment.
> 
> The organization may be smaller for a time because some of those who cannot find employment will eventually drop their membership, and those newly graduated students won't be sitting for the exam.  But I believe it will be a positive step towards increased professionalism and a greater recognition of the worth of the CPC credential
> 
> Just my opinion.
> 
> F Tessa Bartels, CPC, CEMC



I feel that you have hit the nail on the head with your post. Very well said and to the point! Great insight to this issue and hopefully AAPC will consider what you have written.

Sharyl Leingang BS RDH CPC-A


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## TabithaCollins

I don't understand the designation of A anyways. I sat through one year of an accredited AAPC school with an externship. I also have 8 years in the business of being an insurance claims processor, a charge entry, medical billing, and payment poster. One would think my experience is all of these plus school and externship should amount to a CPC designation without an A. I've done everything regarding the process of billing and coding and completed my school with a 3.76 GPA. I don't understand why I cannot get an A designation removed. A simple employment search would verify my claims of jobs from my resume. Why can't that be enough? I've been in the industry for so long and I know what I'm doing. I've worked so hard for the last 2 years to get my license only to be told the work I've done still isn't enough. 

Can CEUs be used to have the A designation removed? Can I obtain a certain number of these and it would qualify?


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## roeslerje

This has certainly been an interesting thread to follow!  I have so many things to say...  The Apprenticeship program has actually been very helpful to me.  Maybe it is because I understood the whole process right at the beginning -- my instructors explained it all to us pretty early.  I had no illusions of starting out in a high-level coding position.  But if I didn't have the CPC-A, I doubt I would have been hired on with no experience to do insurance followup for a large practice.  If I hadn't put in my time at that job, I would _definitely_ never have gotten my current entry-level coding position.

This was a huge career change, and it was a ton of work and sacrifice.  $14-20?  I've been more like $10-13 for the last two years.  Low starting salaries aren't forever.  My "A" will be coming off very soon -- I am gathering my documents for submission within the next few days.  I guess I don't really care how they change the credentialling process from now on, but this program did work for me.  I think it was intended for people just like me who enter the field with great enthusiasm but without much experience.  

That being said, I know from reading the forums that CPC-A hasn't worked for everyone.  I think the market is rather saturated with inexperienced coders.  It sounds like AAPC is trying to move away from that, and the idea of letting one's resume speak for itself is a good one.

And if you can get a CPC credential without the A by coding 20 notes, that's a heck of a deal (even for $300).  Care to guess how many I'll have coded to earn that distinction?  

 Jennifer Reynard, CPC-A


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## pamps76@yahoo.com

At least they get "experience" through doing an externship! We go to school and get the credential and then what??  I agree that most people do not have experience as coders, but HOW DO YOU GET EXPERIENCE if no one will give you a chance??  I am not arrogant nor stupid enough to think that I could code all scenarios or inpatient coding, but you have to start somewhere and given all the resources, software, encoders....and dare I say seasoned coders or HIT professionals that remember what it was like for them as a new coder to perhaps offer some guidance and assist in the training process??  How about this....in order to preserve your credential, it should be required that you mentor newly-credentialed coders.  It's a win-win scenario.  You, being a "seasoned" coder can brush up on things that you may have let slack by helping/guiding a new coder.  This allows you to stay fresh and on point and helps a newbie at the same time!!


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## chshaffer41@gmail.com

*CShaffer, CPC-A*

Pamps76, 
      I think your idea for seasoned coders to help with training process,  for the new coders,  is a great idea.  I think if the AAPC continued to offer the Apprentice Program,  and offered the seasoned coders the ceus they need to maintain their credentials to help with the training and/or mentoring  process,  WOULD benefit all the way around!  I beleive there are probably a few that would get on board with that idea,  and it would be a great way to create the bond between those who "know their stuff",  and those who are eager to learn from them.  And it would definately give the new coders an insight on what is expected in "the real world".


----------



## bedwards

While this is a great thread with many good ideas and also valid concerns, please remember you all need to express these comments through the link provided in the article.


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## MnTwins29

*Coding Edge access here*



bedwards said:


> While this is a great thread with many good ideas and also valid concerns, please remember you all need to express these comments through the link provided in the article.



That is accessed from the home page, correct?  I will copy what I wrote here to that link, but I am still old school when it comes to journals - still prefer to read the paper copy and that is where I read it and made my comments.


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## bedwards

www.aapc.com/cpc-acomment is the link in the article.


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## SLeingang7572

bedwards said:


> While this is a great thread with many good ideas and also valid concerns, please remember you all need to express these comments through the link provided in the article.



Great to remind everyone again. I had mentioned this in a previous post to leave comments on the link provided in the article in the Coding Edge.


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## bamgirl1960@yahoo.com

I was certified over a year ago and I decided to code the 800 notes that the AAPC offered to remove my Apprentice status.  They shut down access to the notes due to complaints about how hard it was to code those notes.  I received an email explaining that and was told that it would be revamped and then would be up and running again.  When that did not happen in a timely manner I asked to be reimbursed and was sent a check.  I am still wondering how I will remove my A, but feel better that they did reimburse me.


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## jillainecouse

I too have a CPC-A, but reading all these comments is making me quite upset. Had I known that it would be this difficult to get a job in this field, then I would've stuck to my previous profession as a medical technologist with 10+ years of experience. Whether you have the experience before or after taking the exam really isn't the point to me: it's getting the experience in the first place. Doing a job search made me realize that nobody is hiring if 1: you're not certified; 2: you don't have at least 1 year of experience. People here are talking about having experience before you take the CPC exam.... HOW DO YOU DO THAT???? iT'S A CATCH-22. Another sore point is that there are no internship programs even remotely close to where I live. Another thing: most jobs want the AHIMA certification, not AAPC.

I couldn't even accept an internship right now because nobody is paying me even minimal wage to do it. I have 2 kids who would then require some daycare and after-school program; not to mention that I would need money for gas to get to the "job". How do I do that with no extra income?


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## rzink

I had the great privilege yesterday of calling a CPC-A into my office and watching the excitement on her face as I offered her a coding position. I hired this person only one month ago into an entry level position which she was eager to accept. After only a few weeks of recognizing her positive attitude, eagerness to learn, dependability and work ethic, I was thrilled to be able to place her into the position she had hoped she would eventually move into. I will reiterate what so many have said in this thread. Keep a positive attitude, be willing to accept an entry level position and then show your employer you possess all of the above mentioned traits. All of the "seasoned" coders can repeat stories of starting at the bottom up. And we will all tell you that no matter how many years of experience we have, we continue to be challenged and to learn on a daily basis. The AAPC certainly has the best interest of its members at heart. We all need to remember that they have the incredible responsibility of maintaining the integrity of our professional organization so our credentials continue to be worth all the effort each of us put into obtaining them.


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## ollielooya

*an encouraging thread in the midst of it all*

Robin, thanks for posting this day-brightener to many CPA-s who may be following this thread.  Not only that, but would have loved to see the look on her face as well.  Who knows?  Perhaps this same employee is numbered amongst us who read the forums regularly!   That must have given you immense satisfaction to bring tidings of good news!

---Suzanne E. Byrum CPC


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## Betty328

*signature for CPC A removal.*



w_burns said:


> I too am an "Apprentice", for sake of a better term.  I graduated from a one year AAPC accredited school with coding occurring throughout the course of the class.  I have been with a billing and coding company for 21 months, of which, 14 of them have been in the coding department.  My supervisor will not approve a letter from corporate for me, beacuse I do not code 'all' of the types of ASC cases that we code for.
> I was trained on how to properly look for and code for ANY type scenerio.  I have a "A" hanging over my head, and with the limited range of coding that I am doing, I am not certain that my employer would give me a good reccomendation should I choose to apply elsewhere as a coder.  It is frustrating to have to jump through so many hoops, when dependant upon your state, the carrier, and the contract, coding will NEVER be the same from one local to the next.  That is why we must continue with our CEU's and the "A" should not exist.
> I understand if your employer places restraints on your coding until such a time that he/she feels confident with your abilities as a coder, but what employer doesn't do that anyway, no matter what job your have?  And I too have 25+ years experience in the healthcare field and found that this test was challening, but rewarding.  I had one hour remaining when I completed my exam, and passed with an 83%, so WHY do I have to sit with an "A", when I can obviously code?



I work with two coders whom I encouraged to join the AAPC and take the CPC exam. I'm just their cowoeker and I wrote both their letters to have the A taken off their credentials. You do not necessary need it to come from your  boss. As for college coding, you can get your teacher to write a letter explaining what you have been doing for the time you were in school. It was not hard for me to get the A removed. I was lucky to have the letters from college and my current employer. I do understand that I'm lucky to be employeed and coding. Don't give up on your dreams.


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## vwash

*We have the ability to affect the outcome!!!!*

Dear Coding Community and Fellow CPC-As,

I have been following this thread daily with earnest interest.  I actually read this thread before reading the article on page 7 in the January Coding Edge issue.  If you haven't read the article for yourself, I highly recommend you read it in its entirety first.  Quite a few things were said and I am a CPC-A that could be affected by the resulting changes of this proposal. 

After reading the article for myself, I discovered *two* things.  

*1st)*- The very fact the AAPC is taking steps to potentially help the current CPC-A situation shows that we are a part of a great organization who is concerned about its members.  REALLY.  They are not unaware of the trials we are facing as a CPC-As and are looking for a way to change it.  

*2nd)*-  The very last paragraph of the article by Reed Pew states,
*“ As stated above, we would appreciate comments to this important change to our credentialing program THROUGH JAN. 31, 2012.  You may go to www.aapc.com/cpc-acomment to submit your comment.  From those comments we will either proceed ahead, make modifications that strengthen the change, or slow down the change due to legitimate concerns that AAPC has not properly considered.  Your friend, Reed E. Pew”*

If that doesn't show we are part of a great organization, then I don't know what does.  We have an opportunity to change the outcome of this proposal.  It is not written in stone yet, it is written in pencil and open for modifications which is GREAT news to me.  To all my CPC-As out there, we still have time to affect the outcome of this situation.  We have until *Jan 31, 2012* to submit legitimate concerns regarding this issue.  We have the ability to make modifications, or slow down the change based on the feedback WE provide.  Quite frankly, a lot of people have expressed legitimate concerns regarding this matter on this thread, but if they remain only on this thread, it will do no good in voicing your concerns.    

*Today, it is January 8, 2012.  We have until January 31, 2012* which is approximately 24 days from today.  I encourage *EVERYONE* who has posted a comment regarding this issue on this thread to send your comment to the comment link. I encourage *EVERYONE* who has read this thread and thought about posting a comment on this thread will do so at the appropriate link *BEFORE JANUARY 31, 2012*.  I definitely have a strong opinion on this matter, but will send it to the comment link because that is where it will count.

I love the AAPC!  I wouldn't trade my credentials for anything in the world because I worked my you know what off to get them!  And I know I am not the only one who has made great sacrifices and invested a small fortune in obtaining and maintaining these precious credentials.  I encourage *every* CPC-A to not throw that away and don't throw in the towel now.  Especially since collectively WE have an opportunity to affect the outcome of this proposed change.  

Honk if you love the AAPC.  HOOOOOOOOONK!!   Thank you to Reed Pew for even allowing us an opportunity to voice our concerns and thank you for taking our feedback into consideration.  Have a happy day everyone!


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## shakira

I think there is something dishonest here.  I have a bachelor's degree, and have worked in a hospital setting for over 20 years.  I took the online CPC course, passed the CPC exam the first time but was not issued a completion certificate due to a " technicality" and now, 3 years later, am working 4 hours per week " coding" on a very limited basis because I am still an " apprentice."  I am several thousand dollars " in the red" due to renewal fees for my " credential" , seminar fees, the cost of the course that I was never given credit for, plus books, etc.  Now I have to come up with another $1000 for ICD-10 bootcamp plus new books, etc.  I think if you already have a credential such as M.D., MBA, R.N. then the CPC is just the icing on the cake and you are given easier certification and rights to publishing articles in the Coding Edge or speaking at a seminar with an excellent salary.  Otherwise, if you just want to advance your current position or even obtain a coding position, it is short of impossible.  I am very disillusioned with the coding world.  I initially wanted to make a difference and bring honesty and integrity into the coding profession.  But it is virtually impossible to break into unless you already have a coding job and then go to get certified or you are already an R.N. or M.D. or have your MBA.  I am just glad that I didn't resign from my current evening job as a transcriptionist because if I had resigned to obtain a coding position I would be jobless.  This AAPC progran is very deceiving and I am looking to possibly file a complaint against this company.  I think AAPC is very biased and not very fair.  I am wondering if there is going to be an ICD-10-A after passing my exam which will be another "technicality" which will prevent me from qualifying me for a coding position.  And by reading the other comments that other "apprentices" have posted, I am seriously considering "throwing in the towel."   I hope that my opininion as well as the opinions of others are read and considered by the AAPC.  I have spoken with several coders who are certified from several years back and they never had to obtain years of experience or obtain references or take additional exams.  Once they passed the 5 1/2 hour coding exam, they were certified.  Period.  When did these "apprentice" requirements begin?  I feel this is unfair and biased and it also provides extra income for AAPC looking at all of the apprentices in the publication of AAPC Coding Edge each month.   I hope that these comments are read and considered.

From CPC-A 01092997


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## dclark7

I'm sorry you feel that the AAPC is unfair.  However as for previous coders not having to have experience, you are wrong.  When I became certified in 2000 you had to have two years of experience and two letters of recommendation before you could even take the CPC exam.  When you took the exam you only had 5 hours (not the 5 hrs & 40 minutes that is now allowed), there were three separate sections and you had to have a grade of 70% on EACH section to pass.  If you got below a 70 on even ONE section you failed the entire exam and had to retake it.  There were no "schools" you could go to the courses were offered by AAPC (the PMCC) and coding was not really considered a "career choice".  You were haned coding books and learned on the job.

Prior to 1988 the AAPC didn't even exist, the only credentialing body was AHIIMA (they offered the RRA and ART credentials which now are called RHIA and RHIT) and you were required to go to an accredited school before you you could take their exams.  AHIMA at that time was only for hospital based coders.  If you read the history of AAPC they were founded in 1988 to promote professionalism among physician based coders.  It has taken a long time for AAPc to gain the recognition it has.  I remember in the early 90's asking the physician I worked for if I should become certified and her response was "why would anybody need a certified coder?"  

Fast forward to today, the AAPC and CPCs are now recognized as Professionals with high standards.  Many of todays CPCs have been coding for a long time and we have worked hard to bring our profession to the spotlight.  Employers want experienced coders because they know that we (whether we've chosen to become certified or not) have fought the good fight and we by necessity have kept up with ever changing rules and regulations.  Are there older coders who don't really have a clue?  Yes, just as in every profession you have some who do not keep up and some who don't really care as long they get a paycheck.  But the majority of coders with experience have been where you are and started in the trenches.  I started as a "float clerk"  which means I did all the jobs know one else wanted to do.  The biggest problem I've seen on this and other posts is that MANY (not all but many) new coders want to start with their dream job.  The advise I see experienced coders giving over and over is to take any job you can, it could be front desk, it could be file clerk, it could be answering phones, take it, prove you want to work and learn and see what happens.  The other thing I've seen on this post is that the 800 chart coding was taken down because of complaints that the records were to hard to code.  What do you think the real world of coding is like?  The answers are NOT given to you and sometimes you have to do a LOT of research and sometimes you even get it wrong and have to make corrections.  So whoever was complaining about it being too hard didn't do anyone any favors.  As far as ICD-10, we are all in the same boat with learning something new, I see it as an opportunity to enhance my skills and become more knowledgeable in my field.  I actually fell into this field quite by accident, but I love what I do and I think that whatever AAPC has to do to keep the integrity of our credentials high then they should do it.

The last thing I would like to say is this, AAPC has grown from under 80,000 member a couple of years ago to over 111,000 now.  While growth is good, does anyone really think that over 31,000 new jobs have been created in this field during this time?  The answer is a resounding NO!  Hospital and practices have closed and companies have downsized and merged so there are actually fewer jobs available now.

Doreen Clark, CPC, CPMA


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## rthames052006

rzink said:


> I had the great privilege yesterday of calling a CPC-A into my office and watching the excitement on her face as I offered her a coding position. I hired this person only one month ago into an entry level position which she was eager to accept. After only a few weeks of recognizing her positive attitude, eagerness to learn, dependability and work ethic, I was thrilled to be able to place her into the position she had hoped she would eventually move into. I will reiterate what so many have said in this thread. Keep a positive attitude, be willing to accept an entry level position and then show your employer you possess all of the above mentioned traits. All of the "seasoned" coders can repeat stories of starting at the bottom up. And we will all tell you that no matter how many years of experience we have, we continue to be challenged and to learn on a daily basis. The AAPC certainly has the best interest of its members at heart. We all need to remember that they have the incredible responsibility of maintaining the integrity of our professional organization so our credentials continue to be worth all the effort each of us put into obtaining them.




Way to go Robin!!!! It's very refreshing to hear these types of stories and it just goes to show, it is possible....


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## coachlang3

Well stated Doreen.

Obviously the stress and frustration of finding a job in this horrible job-loss economy is taking a toll.

From my perspective (and in my opinion) the AAPC started out trying to give professionalism to the physician-based coder.  Then it saw a mass explosion and the AAPC wanted the cake and wanted to eat it too.  So to give those that wanted to be coders it instituted the apprentice program.  Then they made the exam easier, (heck I took it only 5 years ago and then it had ten sections and you had to pass each section or fail the entire exam, like Doreen stated), because people cried "it's too hard" and the AAPC got a little greedy and made it easier so they could have more members.

But then "career colleges" started to produce too many "coders" using the old "have a better and easier life" and "code from home" and people saw and heard life would be easier and I'd get paid better and they had dreams of grandeur.

And now, because the market is glutted and there are no jobs, people are crying out, blaming the AAPC for wanting to get back to it's roots and be a homing point for professional coders because it wants to make the certification mean something.

How's that bachelors doing for you?  Wait, was it a waste of money and time getting it? (Not trying to pinpoint you shakira, many have said "I have a degree in this thread").  Isn't your degree helping you get a position now?  

How about we go be doctors?  They have to go to school for 8+ years and then residency and all that junk.  Just to get their "certification" (license).  You think this one little change (which may or may not happen based on people letting the AAPC hear from them) is tough?  Try being that doctor and all the changes they have to keep up with or lose credentialling and possibly their license.

Things change and companies have to change to.  If the AAPC doesn't do something to make our certification truly mean something, then our cert will be worth less than the paper it's printed on.

So while I'm sorry for those that don't have a coding position, or are finding it hard to get a paid internship or think the exam is too hard or too long, I'm not sorry the AAPC is doing something to make my certification (and others) mean something.  And believe me I know how tough it is.  I have three kids, my wife doesn't work and I make well under 40K.

On the flip side of the argument though is those that have been through the ringer and are "apprentices".

How about I cry out about icd-10 and the AAPC making me take a new exam by a certain date and if I don't pass it by that date I lose my certification entirely and have to start over?

I didn't "sign up" for that back in 2006!!  lol, just kidding.

I embrace these changes to better myself and my fellow coders.

The AAPC is just changing with the times and the evolving requirements.


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## mitchellde

shakira said:


> I think there is something dishonest here.  I have a bachelor's degree, and have worked in a hospital setting for over 20 years.  I took the online CPC course, passed the CPC exam the first time but was not issued a completion certificate due to a " technicality" and now, 3 years later, am working 4 hours per week " coding" on a very limited basis because I am still an " apprentice."  I am several thousand dollars " in the red" due to renewal fees for my " credential" , seminar fees, the cost of the course that I was never given credit for, plus books, etc.  Now I have to come up with another $1000 for ICD-10 bootcamp plus new books, etc.  I think if you already have a credential such as M.D., MBA, R.N. then the CPC is just the icing on the cake and you are given easier certification and rights to publishing articles in the Coding Edge or speaking at a seminar with an excellent salary.  Otherwise, if you just want to advance your current position or even obtain a coding position, it is short of impossible.  I am very disillusioned with the coding world.  I initially wanted to make a difference and bring honesty and integrity into the coding profession.  But it is virtually impossible to break into unless you already have a coding job and then go to get certified or you are already an R.N. or M.D. or have your MBA.  I am just glad that I didn't resign from my current evening job as a transcriptionist because if I had resigned to obtain a coding position I would be jobless.  This AAPC progran is very deceiving and I am looking to possibly file a complaint against this company.  I think AAPC is very biased and not very fair.  I am wondering if there is going to be an ICD-10-A after passing my exam which will be another "technicality" which will prevent me from qualifying me for a coding position.  And by reading the other comments that other "apprentices" have posted, I am seriously considering "throwing in the towel."   I hope that my opininion as well as the opinions of others are read and considered by the AAPC.  I have spoken with several coders who are certified from several years back and they never had to obtain years of experience or obtain references or take additional exams.  Once they passed the 5 1/2 hour coding exam, they were certified.  Period.  When did these "apprentice" requirements begin?  I feel this is unfair and biased and it also provides extra income for AAPC looking at all of the apprentices in the publication of AAPC Coding Edge each month.   I hope that these comments are read and considered.
> 
> From CPC-A 01092997


I am not sure what your complaint is exactly.  I have had my certification for a long time now, since about 1999 I believe or it may have been before that, I have a Masters degree in Public Health and over 20 years of experience.  I am not sure what the technicality is that has kept the A on your certification.  Back when I became certified you had to apply to take the test, you had to submit your resume and have 2 or 3 letters of recommendation then the board decided if you had the necessary background to take the test, if not you had to work longer in the field or take some additional classes.  I know people that were turned down to take the test.  If you have 20 years experience and a degree that is relevant to the field then I am not sure why the A but if you talked to the AAPC whatever the technicality is it could be worked out.  BUT ... do not blame the AAPC because you cannot get a job.  You have experience and degree and the certification with or without the A, so there is nothing stopping you except you!
You do not have to spend money taking an ICD-10 CM class, you can learn this without classes, you just have take the time to figure it out, again the only thing stopping you is you. I do get weary of people pointing fingers at the AAPC everytime they do not get a job.. and to say there is something dishonest????? really!  This is a fine upstanding organization and in my opinion you have insulted them greatly.  I am ashamed of you.


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## Grintwig

shakira said:


> I think there is something dishonest here.  I have a bachelor's degree, and have worked in a hospital setting for over 20 years.  I took the online CPC course, passed the CPC exam the first time but was not issued a completion certificate due to a " technicality" and now, 3 years later, am working 4 hours per week " coding" on a very limited basis because I am still an " apprentice."  I am several thousand dollars " in the red" due to renewal fees for my " credential" , seminar fees, the cost of the course that I was never given credit for, plus books, etc.  Now I have to come up with another $1000 for ICD-10 bootcamp plus new books, etc.  I think if you already have a credential such as M.D., MBA, R.N. then the CPC is just the icing on the cake and you are given easier certification and rights to publishing articles in the Coding Edge or speaking at a seminar with an excellent salary.  Otherwise, if you just want to advance your current position or even obtain a coding position, it is short of impossible.  I am very disillusioned with the coding world.  I initially wanted to make a difference and bring honesty and integrity into the coding profession.  But it is virtually impossible to break into unless you already have a coding job and then go to get certified or you are already an R.N. or M.D. or have your MBA.  I am just glad that I didn't resign from my current evening job as a transcriptionist because if I had resigned to obtain a coding position I would be jobless.  This AAPC progran is very deceiving and I am looking to possibly file a complaint against this company.  I think AAPC is very biased and not very fair.  I am wondering if there is going to be an ICD-10-A after passing my exam which will be another "technicality" which will prevent me from qualifying me for a coding position.  And by reading the other comments that other "apprentices" have posted, I am seriously considering "throwing in the towel."   I hope that my opininion as well as the opinions of others are read and considered by the AAPC.  I have spoken with several coders who are certified from several years back and they never had to obtain years of experience or obtain references or take additional exams.  Once they passed the 5 1/2 hour coding exam, they were certified.  Period.  When did these "apprentice" requirements begin?  I feel this is unfair and biased and it also provides extra income for AAPC looking at all of the apprentices in the publication of AAPC Coding Edge each month.   I hope that these comments are read and considered.
> 
> From CPC-A 01092997



While I personally do not think an additional test would help someone with no experience get a job as a coder I DO NOT think the AAPC engages in fraudulant practices.
I went into this with absolutely NO experience in the medical field whatsoever. No "friends" in the industry to pave my way AND no other degree of any sort. I spent a year in a community college taking Medical Billing and Coding, Transcription, and Medical Terminology. I sat for the test three months after my classes ended and passed on the first try. I was awarded a CPC-A. Three months later I was hired as a coder in a local surgical practice. A year later the executive office manager wrote a brief letter stating that I had been coding for a year and my -A was dropped.
Prior to the -A designation a person had meet certain criteria before they could even take the test so the people you have spoken to did not give you all of the honest details.
Have you called the AAPC and discussed your issue? I have always found their employees to be friendly and helpful. No one involved with the organization,in my opinion, would purposefully deny you anything you were entitled to. Of course without any knowledge of your extenuating circumstances I can't really offer any concrete advice.


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## AnneM2

*Looking at this from a distance...*

The thing to remember, my fellow apprentices, is we don't really need the CPC or CPC-A credential to eventually succeed in coding. Nice to have, but not a necessity.   My school had a strange obsession with the CPC exam.  They promoted it every chance they got and rarely discussed AHIMA and other options.  It was like the Holy Grail of coding.  Must. Have. CPC.!!!!!   Must. Join. AAPC!!!!  I must have been brainwashed. 

  In my area, I've only seen one job ad asking for a CPC and that was for a billing only (not coding) position. They wanted someone, they said, who "understood coding" but would not be doing coding. I've never seen an ad for a CPC-A.   Most jobs have no requirement for a credential and the handful that do, require the CCS.  The working coders I know do not have credentials and look amused when I mention mine.  Just like the "overly optimistic exaggerations" we heard from the schools about the coding job market, the need for a CPC-A or CPC also seems to have been exaggerated as well.   

So why the heck our we stressing ourselves over (and spending money on)  something that is apparently not important???  

I am not bitter.  I am not angry.  Frustrated? a bit.  Mostly I am bemused at myself.  If anyone else came to me for advice about what to do in this situation, I'd tell them to cut their losses with the AAPC, concentrate on learning ICD-10, maintain their CCA (I have one) and move on.   But there was something so grueling about studying for and taking that exam, that I would rather crawl through hot coals and a pit of rattlesnakes than give it up.  LOL   I do, however, believe I'll get over this obsession.   When I do a cost/benefit analysis of my AAPC credential and membership, the costs clearly outweigh the benefits. 

So I am grateful the APPC put this in the January magazine since my membership is up for renewal in February.  I was already leaning towards leaving, this made it easier to do.


----------



## ajs

AnneM2 said:


> The thing to remember, my fellow apprentices, is we don't really need the CPC or CPC-A credential to eventually succeed in coding. Nice to have, but not a necessity.   My school had a strange obsession with the CPC exam.  They promoted it every chance they got and rarely discussed AHIMA and other options.  It was like the Holy Grail of coding.  Must. Have. CPC.!!!!!   Must. Join. AAPC!!!!  I must have been brainwashed.
> 
> In my area, I've only seen one job ad asking for a CPC and that was for a billing only (not coding) position. They wanted someone, they said, who "understood coding" but would not be doing coding. I've never seen an ad for a CPC-A.   Most jobs have no requirement for a credential and the handful that do, require the CCS.  The working coders I know do not have credentials and look amused when I mention mine.  Just like the "overly optimistic exaggerations" we heard from the schools about the coding job market, the need for a CPC-A or CPC also seems to have been exaggerated as well.
> 
> So why the heck our we stressing ourselves over (and spending money on)  something that is apparently not important???
> 
> I am not bitter.  I am not angry.  Frustrated? a bit.  Mostly I am bemused at myself.  If anyone else came to me for advice about what to do in this situation, I'd tell them to cut their losses with the AAPC, concentrate on learning ICD-10, maintain their CCA (I have one) and move on.   But there was something so grueling about studying for and taking that exam, that I would rather crawl through hot coals and a pit of rattlesnakes than give it up.  LOL   I do, however, believe I'll get over this obsession.   When I do a cost/benefit analysis of my AAPC credential and membership, the costs clearly outweigh the benefits.
> 
> So I am grateful the APPC put this in the January magazine since my membership is up for renewal in February.  I was already leaning towards leaving, this made it easier to do.



And it does depend on the area you live in.  Where I live a credential, either CPC or CCS-P, is essential if you want a job in coding.  Of course there are still people out there working in coding that have been doing it a long time that are not certified.   

What may happen is, as the long time non-certified coders retire or leave their jobs, the move will be for the new hires to be certified.  Also, all the mergers of smaller physician practices into larger medical corporations are going to push non-certified coders out the door.  I have seen it happen.  Some folks are getting certified with both AHIMA and AAPC, some are choosing one or the other.  AHIMA is a great place for those who want to get into hospital and facility coding as well as HIM stuff.  The advent of ICD-10 and the move to EHR are both going to impact medical coding in a big way.

There is a saturated market right now, I hope that changes in the certification and membership system will help to re-define things for coders.  I have been doing this for a long time and figure it will be the career I retire from in about 15 years!


----------



## CLS

Members, 

Many of you bring forth valid issues and concern and we value each of them. So that your voice may be heard, the AAPC generously granted a comment period on this issue, something that has never been done before in this organization. 

Please don't discard this opportunity to be heard. I encourge each of you to post your comments and concerns on the site provided and where each will be reviewed and possible alternatives offered may be considered.

www.aapc.com/CPC-acomment

Cyndi Stewart, CPC, CPMA, CPC-H, CPC-I
President, National Advisory Board of the AAPC


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## Lynn Hendrickson

*Virtual Experience: Apprentice Removal Program*

I am also one of the CPC-"A"s still in the process of testing in the Virtual Experience: Apprentice removal program (800 operative and office notes from 17 different specialities). I have been waiting for over a year to finish the testing program as last summer the program was put on hold for re-vamping. At that time I had completed close to 600 cases. I have since done the "Beta Testing" and am now waiting for the final version of the testing program so I can finish & get rid of the dreaded "A". I don't see how AAPC can drop this program as they need to up-hold their standards as a professional organization. I feel they will follow through.
No learning is wasted and I have enjoyed coding these notes but I guess I have to say I feel cheated if coding 20 notes in an exam to remove the "A" instead of the 800 we have been working on, seems unfair. That said; for my next job interview I will challenge HR to give me a coding test containing samples of their OP notes and office visits as I feel I'm up to it. I have learned so much doing this online program.
If this goes forward as now being considered, I hope AAPC will acknowledge in a meaningfull way, the effort and time those of doing the Virtual Experience: Apprentice Removal program have put in.
L. Hendrickson CPC-"A"


machshaffer@aol.com said:


> I'm a CPC-A and I am quite unsure of what I now may need to do to get the"A" lifted from my credential.  I have a particular concern with this change because I actually did sign up and work through, all but about 100 of the 800, doctor notes for the Online Apprentice Removal Program this past summer when the site went down and I was not able to complete it.  I am sure there are some of you who have read some of my posts since this all went down, and you are probably tired of hearing about it, but let me just share my story once more...
> 
> I decided last summer to take some time off from a job I had as a Medical Assistant,  which I had worked for 14 months.  I thought this was going to be my "foot-in-the-door",  but it was clear it was not going to happen with this practice due to nature of it being a small practice( one doctor),  no room to move up.  Anyway,  I decided to leave the practice-due to other unfortunate reasons as well,  to per sue the Online Apprentice Program.  I dedicated my ENTIRE summer to try and finish this with the hopes of finishing by fall,  so I could get back to work with this experience behind me. I literally worked all day, and night, every single day this past summer (from 8:00 am to at least 10:00 pm).  Unfortunately,  the site went down when I had about 100 to do in order to finish.  This was in Aug/Sept,  and I have been patiently waiting for the site to come back up so I could finish.  I even participated in helping with providing feedback to the AAPC during this time.  I want to say that having nearly finished this program,  it was very exhausting and every bit as grueling as the CPC exam. I feel I have worked extremely hard, and dedicated a large amount of time working on this progam,  only to possibly have it no longer be available as an option for removing my "A" status.  I signed up for this program because it allowed me to do it on my own time,  at my own pace,  and from home.  I think the idea of this program was a good one in that it teaches you not just what to code, but if you submit incorrectly, to do some research to find the correct codes, and understand why you may have an incorrect code.  I think a coder gets a better understanding of the process as a whole.  If you sit for a test consisting of only 20 notes,  and have a time limit how is this considered an apprentice program where a new coder is being prepared for real world?  Everyone needs to be trained for any job, and there aren't many employers willing to train a coder, so I think an apprentice program should be an option to train and further teach a new coder to prepare them for the real world.  New coders still need experience to get a job,  they cannot get a job and then sit for the test,  because they won't be hired without the credential either.  And it is another, additional expense.
> 
> All this being said,  there definately needs to be a change on how new coders can obtain the experience,  and the credential,  to help them gain the employment.  But from my point of view,  I am very upset about how this is potentially going to affect me.  I have spent a large amount of time,  AND money persuing this credential/education.  I am beginning to feel I have wasted alot of my time,  money,  AND energy trying to obtain this credential.  Maybe I should go back to Accounting,  where I DO have the experience,  in addition to a degree from a state college.  I love the medical feild and I have the compassion for this line of work,  and I thought I had found where I belonged,  but I have to say this has been a dissapointing experience.  I hope those at the AAPC will read my post and try to help me understand what exactly MY options are now....?


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## semaxwell1

*Todays it's an Employer's Market*

I've read many posts from many threads (not just AAPC) that are from one end of the spectrum: those who have coding experience and a credential yet still can't get a job, to reading posts on the other end of the spectrum: those who don't have coding experience and/or a credential yet still can't even get a non-coding related job just to get their foot in the door. 

In my opinion, I can summarize that it all boils down to the *“employer”.*
Due to the current economy, and other factors, this industry is the *“employer's market”*, and they have the upper hand and know it. So good networking these days seems to trump experience and education and credentials. 

Since there is such a saturation of those who want to get involved in coding, the employers are raising the bar and are going to be a lot more selective then before about whom they hire because they can. The requirements, for a particular position 10 years ago, have more likely been increased. What you currently have to bring to the table may have been considered ‘overqualified' many years ago, but now you are considered ‘underqualified'. 

I don't believe you can really point the finger at anyone in particular, it's just the nature of the business ‘beast' for now, and I'm sure there have been other types of industries that have gone through a similar situation.

I too am anxious to see what changes ICD10 and EHR, EMR, etc. will have in the medical coding industry the next couple of years. It seems the best thing to do for now is to get very familiar with ICD10 and continue to *network best you can through ALL avenues*.


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## marion

It has been my experience through 6 years of Teaching (as a licensed PMCC Instructor) and an Employer of CPC's for the past 26 years that passing the CPC exam is indicative of the knowledge base of the individual.  Most coders have limited experience in 1 specialty or limited to billing.  I have had many "fresh" Coder's who I would hire before someone who is "self taught".  Needless to say, having an individual take another exam, in my mind, is punishing the eager individual who has earned the CPC designation just as much as the "experienced coder".  I have many "experienced coders" who cannot pass the CPC exam....The exam is the same for everyone therefore the earned designation should be the same.  A person's resume details their experience....NO other certification or organization adds a designation to "taint" an individual.


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## SLeingang7572

marion said:


> It has been my experience through 6 years of Teaching (as a licensed PMCC Instructor) and an Employer of CPC's for the past 26 years that passing the CPC exam is indicative of the knowledge base of the individual.  Most coders have limited experience in 1 specialty or limited to billing.  I have had many "fresh" Coder's who I would hire before someone who is "self taught".  Needless to say, having an individual take another exam, in my mind, is punishing the eager individual who has earned the CPC designation just as much as the "experienced coder".  I have many "experienced coders" who cannot pass the CPC exam....The exam is the same for everyone therefore the earned designation should be the same.  A person's resume details their experience....NO other certification or organization adds a designation to "taint" an individual.



Marion very well said!


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## mimzmac

*Elimination of Apprentice*

I don't agree and I think it's ridiculous...There's a lot of students who spent a whole year taking coding like me. I took 2 tough exams and with me being apprentice is keeping me from getting a coding job coz of lack of coding experience. How are we going to get experience if nobody gives us a chance? And now, you want us to take another exam with extra $35 more? This is absolutely not right!! 
Offices should give us chances. And instead of helping us, this 'thing' is gonna make it even more harder for us to get a job and experience..smh


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## csheehy

Wow!!!
After reading all of these I am really second guessing  my  choice of careers as a medical coder. I have spent 20+ thousand dollars and now to find out that the dream my never come true is quit depressing. Did not think it was going to be this hard to get into something after obtaining a degree. Wonder if I can ask for a refund? and to think I just received my exam study guide too. 
Connie, just another newly graduated medical coder


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## jennylynh

Connie - I am probably going to get thrown under the bus for saying this, but first off why did you spend that much?  Second, did you do any research on the field before attending school?  If people would do the research they would find that it is tough out there right now for new graduates.  You need to be applying for entry-level positions that will work your way into coding such as receptionist, front desk, medical records, registration, admitting, etc.  And network as much as you can.  It might not be fair, but that's how it is right now.  I guess I'm getting kind of tired of new graduates expecting a coding job to be handed to them and didn't do any research in the field before going to school...


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## chshaffer41@gmail.com

Lynn Hendrickson said:


> I am also one of the CPC-"A"s still in the process of testing in the Virtual Experience: Apprentice removal program (800 operative and office notes from 17 different specialities). I have been waiting for over a year to finish the testing program as last summer the program was put on hold for re-vamping. At that time I had completed close to 600 cases. I have since done the "Beta Testing" and am now waiting for the final version of the testing program so I can finish & get rid of the dreaded "A". I don't see how AAPC can drop this program as they need to up-hold their standards as a professional organization. I feel they will follow through.
> No learning is wasted and I have enjoyed coding these notes but I guess I have to say I feel cheated if coding 20 notes in an exam to remove the "A" instead of the 800 we have been working on, seems unfair. That said; for my next job interview I will challenge HR to give me a coding test containing samples of their OP notes and office visits as I feel I'm up to it. I have learned so much doing this online program.
> If this goes forward as now being considered, I hope AAPC will acknowledge in a meaningfull way, the effort and time those of doing the Virtual Experience: Apprentice Removal program have put in.
> L. Hendrickson CPC-"A"


Lynn,  I was happy to see your post in reguards to the Apprentice Program.  It was a relief to see there was someone other than myself that is having this very same experience.  I also, was a beta tester for the program.  I was offered reimbursement when the site went down, but I am hanging in there and fighting for the program to continue because, like you, I really feel that I have learned sooo... much during this process.  I think once the AAPC gets the bugs worked out of it, it will be a GREAT experience for a "new" coder.  I also feel that it is a challenging program and , for those who want to per sue a job in this field, it ABSOLUTELY requires them to work through the cases as if they are working in the "real world".  I think this is the way the AAPC should help those with the "A" status get through this process.  I don't think making us sit and pay for another exam is the answer,  we passed the CPC exam the way it was offered, and the way it was offered was not our fault.  But having said that, I'm sure you would agree,  there are many of us who would support future changes to the CPC exam, by adding the clinical notes, as it would test the coders understanding of the process, and it is a very positive step for the future,  but something has to happen to now, for the apprentices, to make the transition.  I personally would rather pay the money for a program that would prepare me for the "real world", than take another test that would give me a "Status" change, and no real experience. After just doing approximately 700 of the 800 notes,  and now having been a beta tester,  I feel comfortable applying to a job, and being interviewed and/or tested by a potential employer as well.  I actually sent my comment to the web address offered by the AAPC, and proposed that the Apprentice Program be continued, and the changes for the future CPC test be implemented.  I also asked that the AAPC should consider continuing the "A" program for those who would like to have the additional experience/education, even after the changes have been made in the future. I believe this program will give future coders VERY strong skills in the field, and recognize the AAPC as VERY,(more than it already is), reputable organization.  I think it is important to recognize those of us who are working really hard to get our "A" lifted,  and it should be said that even though there are some who have "high" expectations of being "given" a job,  there are MANY, like you and myself, who are willing to work extremely hard, and do whatever it takes, to "work" for a job. Just hanging in there and wanting to work hard at a program, like the Apprentice Removal Program, just proves exactly that.  I encourage you to post your comment on the site that the AAPC provided, if you haven't already, to help those of us get the support we strongly desire.  Keep your chin up, fingers crossed, and hopefully there will be a resolution to this issue soon!


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## apache069

*Leave People Alone*

If someone can pass that CPC exam let them just be a CPC and leave them alone. Don't make them jump through hoops and drain their finances with another test. How ridiculous!
If you are determined enough and smart enough to pass that CPC exam congratulations to you. Let your resume speak for itself and pray that you are interviewing before a manager who will take a chance on a newbie. 
Stop trying to make it so hard to get into this field! Let the passing of the CPC exam be the 1st step onto a career in coding and LEAVE PEOPLE ALONE.


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## semaxwell1

I posted to the AAPC comments:

Having to pay for two exams and then sit for them separately, just to remove the apprentice status, seems a bit too much and unfair, compared to those who already have the alleged “experience” and are not labeled apprentice, yet who can't even pass the CPC exam.

Please continue with the “Virtual Experience: Apprentice Removal” 800 Note program. I believe this is the next best thing for those who have not been able to achieve any kind of real-world coding experience in order to remove the apprentice status. Also, I think one should have the choice of either completing this program or passing the 20 note “Clinical Exam” in order to remove the apprentice status.

However, I highly recommend adding a fill-in-the-blank section of medical records to the CPC exam similar to the CCS exam. This would be a great asset because it would show potential employers that those who pass the exam know more about coding than just choosing codes from multiple choice questions. 

Nonetheless, it all comes down to the potential employer deciding if all this is good enough to hire someone as a medical coder. *I seriously hope AAPC will heavily consult with as many coding employers across the country as they can to see if they will even “recognize” any of this as “coding experience” before AAPC implements any changes.* 

It would be futile for a member to shell out a lot of money and time towards this if an employer won't hire them because they don't acknowledge this as any kind of coding experience.​


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## chshaffer41@gmail.com

semaxwell1 said:


> I posted to the AAPC comments:
> 
> Having to pay for two exams and then sit for them separately, just to remove the apprentice status, seems a bit too much and unfair, compared to those who already have the alleged “experience” and are not labeled apprentice, yet who can't even pass the CPC exam.
> 
> Please continue with the “Virtual Experience: Apprentice Removal” 800 Note program. I believe this is the next best thing for those who have not been able to achieve any kind of real-world coding experience in order to remove the apprentice status. Also, I think one should have the choice of either completing this program or passing the 20 note “Clinical Exam” in order to remove the apprentice status.
> 
> However, I highly recommend adding a fill-in-the-blank section of medical records to the CPC exam similar to the CCS exam. This would be a great asset because it would show potential employers that those who pass the exam know more about coding than just choosing codes from multiple choice questions.
> 
> Nonetheless, it all comes down to the potential employer deciding if all this is good enough to hire someone as a medical coder. *I seriously hope AAPC will heavily consult with as many coding employers across the country as they can to see if they will even “recognize” any of this as “coding experience” before AAPC implements any changes.*
> 
> It would be futile for a member to shell out a lot of money and time towards this if an employer won't hire them because they don't acknowledge this as any kind of coding experience.​




     Thank you semaxwell, for your support of the 800 note Apprentice Program.  You are right though,  I would hope the AAPC would seriously try to appeal to the employers across the country that this program really DOES provide the experience, and is very closely simmulated to the "real world"; So it could be recognized, before too many purchase it, and there is yet another issue about what is acceptable to employers as "real world" experience,  and yet another debate on why someone would spend the money and not be able to gain employment.

      However, I have already purchased it and had almost completed it before the site went down. But I do have to say that I don't regret this purchase, because it really opened my eyes on just how much is expected of the coder in a real world job,  and I gained a great amount of information and experience that I was not going to get otherwise.  I am keeping my fingers crossed that with all the feedback the AAPC has been given,  they will get this program the recognition, (by potential employers, AND members) that I totally believe it deserves.

      Also, I am in favor of the AAPC changing the CPC exam to include op notes, to give the credential the the status IT deserves. All in all, I think this discussion was needed to move forward,  and as a CPC-A myself, I am gratefull for the opportunity to voice my concerns, along with those who are "seasoned" coders. Hopefully, there will be a resolution soon....


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## jmcpolin

csheehy said:


> Wow!!!
> After reading all of these I am really second guessing  my  choice of careers as a medical coder. I have spent 20+ thousand dollars and now to find out that the dream my never come true is quit depressing. Did not think it was going to be this hard to get into something after obtaining a degree. Wonder if I can ask for a refund? and to think I just received my exam study guide too.
> Connie, just another newly graduated medical coder
> 
> I started out as a medical receptionist in 1986 and worked in many different specialties and that was a big help for my medical terminolgy, working with physicians and nurses everyday.
> 
> I was a "self taught coder" back in 1994 due to the fact that we lost our main coder and then to polish my skills I took one basic coding class at the community college that was $534.00 other than that I bought an anatomy book and studied that night and day to learn that by myself. I passed my CPC in 2003.  What I am saying is there are cheaper ways to acheive the goals you want and I have never held anyone else responsible for me having or not having the career I want.  I have never had a problem finding a coding job and I do understand that every state is different.  But even after all of the years that I have been coding I still push myself to learn more and more, that is my own personal goal and not what is expected of my employer.


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## SuzanneLogan

*Do not punish CPC-As*

I am a recent CPC-A, 12-9-2011.

I completely disagree with the parameters AAPC proposes relative to removing the "A".

1)  To impose an "expiration date" on the additional exam or worst still "experience gained", in this jobless market would only punish those of us who have successfully passed the CPC exam hoping to break into the filed of coding as a viable career path on an entry level basis.  

That said, I respectfully request you remove all time limits imposed, or better still grandfather CPC-As into CPCs.  Our resumes can speak for themselves. 

If AAPC imposes these "sanctions" on CPC-As, all my efforts, financial and otherwise, will be *lost* if I am unable to secure a position before the *"expiration date".*
Thank you,
Suzanne M. Logan, CPC-A, CPhT.​


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## johnmeyer

For what it’s worth….

There are good and bad things I think with this change.

As most of us know, AHIMA strongly recommends a person have at least 3 years worth of coding experience before they take the CCS exam. This is because the exam is no joke. I’ve talked to coders with the CCS certification and they said it was harder than the CPC exam.

So why do I mention the CCS exam?

After doing some research and talking to coders, I’ve come to the conclusion that the AAPC’s CPC certification is more like something that a new coder would get, while AHIMA’s CCS is more like something a seasoned coder would attain.

Now don’t get me wrong…. I’m not trying to put down the CPC certification because I’ve got mine as a CPC-A. What I am trying to get at is that I see the CPC as a way for a new coder to break into coding and the CCS as something a seasoned coder gets to highlight their coding career. I see the CPC-A as a way for a new coder to show that they are sincere with their dream of becoming a professional coder.

I’ll buy into making a CPC-A code 20 OP/office notes with a 90% accuracy rating if we don’t have the year’s worth of experience. This would allow those of us who are new to coding to prove what we really know. I think this could be used by the medical community as a way to allow those of us who are really good a coding, but don’t have the experience yet, to be able to break into coding without having to take a “foot in the door job” before getting into coding. I also think this will allow the brightest of us to really shine when searching for a job. Imagine how good it would look on the individual who could say that they have their CPC without having a year’s worth of experience yet.

I don’t agree making a person either have a year’s worth of experience or pass the coding of 20 OP/office notes before they can be certified as a CPC. Why not leave the CPC-A where it is with the requirement of one year’s experience or coding 20 OP/office notes with a 90% accuracy to remove the “A”? This would allow those like me the ability to at least say we are certified and ready to break into coding.

Lastly…. If everyone is looking for certified coders, how does one attain the year’s worth of coding experience before taking the CPC? Not everyone will be able to pass that extra exam, after all.

I know that most say to volunteer for the experience, but there are many like me who can’t because of financial responsibilities. So what happens to us? Does this mean we should just give up on coding? Of course not!

What this means is that those who cannot pass the extra exam or volunteer for the experience need to find some other way to get into coding. This is where that “foot in the door” job comes into effect. Having said that, I think it was the CPC-A that got me my job because it showed that I wanted to be a coder and that I was willing to “grow” into it, for lack of a better term. I think this is what the CPC-A should show. I should show that a person is ready and willing to grow into coding and not the fact that the CPC-A has no experience in coding.

My $.02 for what’s it worth.


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## dej1918

Appreciate your comments and words of wisdom.  I am preparing for the CPC exam, and I have been
thinking  if this will be enough to get started in Medical Coding.  Will this get an entry-level position?  Is there any such position as "Entry-Level"?


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## johnmeyer

dej1918 said:


> Appreciate your comments and words of wisdom. I am preparing for the CPC exam, and I have been
> thinking if this will be enough to get started in Medical Coding. Will this get an entry-level position? Is there any such position as "Entry-Level"?


 
As far as I know....

The term "entry-level" really doesn't apply to coding all that much since everyone is looking for coders with experience. Entry-level in coding is more about a "foot in the door" job like receptionist or medical records or data entry. This allows a coder to grow into the medical community and eventually into coding. I'm a CPC-A, but I had to take a job as a receptionist just to get into the medical field. I told my employer I wanted to be a coder during my interview. She said that will come in time.


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## lmsmom2

*What will happen with current CPC-A's*

I have mixed emotions on the new proposal being put forth.  But being a CPC-A not working in the coding field, I agree with some of the other posts about working hard to put yourself through school and study, sit for the exam and to pass the exam and still struggle for months or years to find and oppportunity to work with in the field. It is extremely frustrating, to say the least.  My question is if you are currently a CPC-A, and choose to take the clinical exam and do not pass the exam and do not have a year's worth of expierence by December 2013, what happens to your designation do you loose your CPC credential altogether and have to start all over?


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## kevbshields

Let's all understand some basics on credentialing.

Unlike the clinical side of the house, coders are afforded choices in their credentials.  We are also allowed to "specialize" in a setting early on in our careers.  The CPC exam is designed for those pursuing physician-based coding; the CCS, on the other hand, is for hospital inpatient coders to demonstrate their qualification in that setting.  (Yes, I realize that AHIMA indicates that it covers both outpatient hospital and inpatient hospital and while I concur to some extent, the exam was or is heavily weighted toward the inpatient side.)

That being said, I have not found evidence that supports physician practices seeking a CCS for professional fee coding.  Likewise, I find that only a handful of inpatient coding jobs publicize that the CPC is an acceptable credential for that role.  The reasons are very simple:  a coding manager wants a candidate with credentials that match the setting in which that coder will be working.  This is why both AAPC and AHIMA created the CPC-H and CCS-P, respectively--to broaden the base of certifications covered by each organization.

If you are experiencing thoughts that other certifications are necessary, then add them.  However, if you are finding that all the jobs you apply for list qualifications outside your possession, then perhaps you are applying in the wrong setting.  Hospitals are not the only places that coders may work--thus the need to have physician, payer and many other credentials.  I do not consider the CPC as an entry-level certification and I believe most of my peers would express similar feelings.


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## patkimmel@yahoo.com

That is a good question. I have recently received my CPC-A. I can't find a position due to lack of experience. Not only do I have to fund my own training for the ICD-10 change, which is completely unaffordable, now I have the worry of losing everything I worked for because of the changes they are talking about now. I also have a huge loan hanging over my head for school. I feel sick with "what a  big mistake I made?" I would love an opportunity to prove myself, but apparently that is not to be. I find this so frustrating. I really thought I would enjoy this field. It is not easy, but that is part of what I enjoyed about it.


----------



## mmorningstarcpc

Very nicely said, Kevin!!!  KUDOs for another great explanation!

I think there is a lot of misunderstanding with some people in what the basics for each credential means.  You, hopefully, cleared up some of that confusion!


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## chshaffer41@gmail.com

*The 80 hrs of classroom and 1 yr exp. to lift "A"*

The initial (current), requirements of ways to get your "A" removed stated that you have to have 2 years experience OR 80 hrs classroom plus 1 year experience on the job.  I actually completely forgot that the 80 hrs of classroom, through an accredited school, was considered 1 of the years of experience needed.  I was recently e-mailing my previous proffessor where I received my certification for the Medical Billing and Coding program,  and she reminded me of this. I wanted to see if anyone could tell me what the other year of "on-the-job experience" should consist of??  Does it have to be a job specifically in coding, or can the experience be ANY job in the medical office?  For example,  would clinical experience, patient scheduling, receptionist, and medical insurance, be considered the experience needed for that 1 year plus the 80 hrs of schoolwork??  I am just wondering,  because ALL of these particular jobs have been mentioned as "foot-in-the-door" jobs that could lead to a possible coding position?


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## kseifert

Consider a new grad who has school loans.
AAPC membership $125
CPC test $300
Coding books $165 (approx)
totaling $590.00
PLUS
Clinical exam coding 20 operative/office notes price unknown

ALSO like one of the previous post, I too am a registered nurse, and with passing the state board exam was allowed to take care of sick people.

I found the CPC exam challenging, and feel passing it should allow you to practice as a full CPC.  Let employers decide if they want experience or not.

Thank you for the opportunity to voice my opinion.


----------



## cthompson1446

machshaffer@aol.com said:


> The initial (current), requirements of ways to get your "A" removed stated that you have to have 2 years experience OR 80 hrs classroom plus 1 year experience on the job.  I actually completely forgot that the 80 hrs of classroom, through an accredited school, was considered 1 of the years of experience needed.  I was recently e-mailing my previous proffessor where I received my certification for the Medical Billing and Coding program,  and she reminded me of this. I wanted to see if anyone could tell me what the other year of "on-the-job experience" should consist of??  Does it have to be a job specifically in coding, or can the experience be ANY job in the medical office?  For example,  would clinical experience, patient scheduling, receptionist, and medical insurance, be considered the experience needed for that 1 year plus the 80 hrs of schoolwork??  I am just wondering,  because ALL of these particular jobs have been mentioned as "foot-in-the-door" jobs that could lead to a possible coding position?



Hi,

I am pretty certian that the other year has to be in the area of coding, however, it can be done in any speciality that you choose.

Hope that Helps!

Christina, CPC


----------



## TracyHecox

*Removal of Apprentice*

I hope I understand this correctly.  Since I am a CPC-A right now, all I need is a year of experience and a letter from my employer stating that fact or do I still need 2 years of experience and 2 letters, one from the employer and one from a co worker.  I am going by removal of A guidelines listed on the AAPC site.  Any info would be most appreciated.
Thanks


----------



## ajs

TracyHecox said:


> I hope I understand this correctly.  Since I am a CPC-A right now, all I need is a year of experience and a letter from my employer stating that fact or do I still need 2 years of experience and 2 letters, one from the employer and one from a co worker.  I am going by removal of A guidelines listed on the AAPC site.  Any info would be most appreciated.
> Thanks



Currently there is no change in what it takes to remove the A from your credential.  There is a proposal being discussed to allow further testing to replace part of the requirement, but it is not yet official.  So as of now, you still need either two years experience validated by an employer or 80 hours of classroom work and one year experience.


----------



## Pam Brooks

kseifert said:


> I found the CPC exam challenging, and feel passing it should allow you to practice as a full CPC. Let employers decide if they want experience or not.


 
You are absolutely correct, and most employers consider experience very carefully when interviewing candidates for coding jobs. But remember......this whole initiative is coming down from the AAPC, who currently provides a credential to people who may (or may not) have taken a community-college course in billing or coding, who may never have set foot into a physician's billing office, and who have been, over the past few years, communicating to the AAPC that they feel they have been ripped off because they have this credential, but are unable to find work. The AAPC recognizes that it is not the apprentice designation, per se, that's holding the new coders back, but the lack of experience and practical, hands on knowledge. 

As a hiring manager, I can tell you that simply being able to "code" is only a small part of the picture for the coders that I supervise. I think that's a huge misconception on the part of coding apprentices. It's not just about being able to look up a diagnosis or CPT code. It's about understanding the various payer rules, being able to sort out CCI edits, knowing how to navigate the CMS website, understanding healthcare law, being able to communicate with physicians, understanding EOBs and knowing what questions to ask to decipher denials. It's about being in the middle of the revenue cycle and considering the many, many variations that our multiple-payer system imposes upon us with each claim we bill out. I could go on, but I think I've made my point. It's not the apprentice designation that is the issue....it's about having sufficient knowledge to do the day-to-day work so that hiring managers and existing staff can trust that any coder's work will be accurate and compliant. That's why I strongly believe, and have communicated to the AAPC, that there should be a two-year (at least) experience requirement in order to sit for the CPC examination.


----------



## chshaffer41@gmail.com

cthompson1446 said:


> Hi,
> 
> I am pretty certian that the other year has to be in the area of coding, however, it can be done in any speciality that you choose.
> 
> Hope that Helps!
> 
> Christina, CPC



 Christina, Thank you for your reply.  That is what I thought, I just needed to clarify that I was understanding it correctly.  Also, I had one more question you might be able to answer for me... What if someone has MORE than the 80hrs  of classroom required?  Does it count for anything?? Just curious...  I guess when I first completed the classes and took a job as a Medical Assistant, I didn't ask these questions because I was hoping to get the experience needed on the job....

Christine


----------



## medcoders

Pam Brooks said:


> You are absolutely correct, and most employers consider experience very carefully when interviewing candidates for coding jobs. But remember......this whole initiative is coming down from the AAPC, who currently provides a credential to people who may (or may not) have taken a community-college course in billing or coding, who may never have set foot into a physician's billing office, and who have been, over the past few years, communicating to the AAPC that they feel they have been ripped off because they have this credential, but are unable to find work. The AAPC recognizes that it is not the apprentice designation, per se, that's holding the new coders back, but the lack of experience and practical, hands on knowledge.
> 
> As a hiring manager, I can tell you that simply being able to "code" is only a small part of the picture for the coders that I supervise. I think that's a huge misconception on the part of coding apprentices. It's not just about being able to look up a diagnosis or CPT code. It's about understanding the various payer rules, being able to sort out CCI edits, knowing how to navigate the CMS website, understanding healthcare law, being able to communicate with physicians, understanding EOBs and knowing what questions to ask to decipher denials. It's about being in the middle of the revenue cycle and considering the many, many variations that our multiple-payer system imposes upon us with each claim we bill out. I could go on, but I think I've made my point. It's not the apprentice designation that is the issue....it's about having sufficient knowledge to do the day-to-day work so that hiring managers and existing staff can trust that any coder's work will be accurate and compliant. That's why I strongly believe, and have communicated to the AAPC, that there should be a two-year (at least) experience requirement in order to sit for the CPC examination.



How does a new coder obtain this experience when it is not in the coding classes? It is obtained with on the job training and experience. How is a new coder suppose to get this?


----------



## mimzmac

*Elimination of A*

I hear yeah Sis...Tell them.. 




pamps76@yahoo.com said:


> None of this really makes ANY sense to me.  I graduated from an AAPC- approved 1 yr. rigorous coding school 1 yr. ago.  At the same time, I was/am pursuing an A.S. degree in Health Information Technology (will graduate in May and then take the RHIT exam).  I passed the AAPC certification exam as a CPC-A. I have been very diligent trying to get any experience to get rid of the "A" on the end.  I have tried to participate in the Apprentice program that AAPC offers, with the closest office being 45 minutes away from me and they had nothing available for me.  My question to ALL seasoned coders, hiring managers, etc.. is how do we gain experience (and therefore get rid of the "A" on our credential) if no one is willing to hire non-experienced coders???  You can't get experience if you don't have any experience!!! It is highly FRUSTRATING!!!!!  Passing the CPC exam was grueling in and of its self only to be "awarded" with a credential that means nothing...and even less than nothing if you have the scarlet "A' attached. Woopee, now I get to pay more money, and take yet another test to get rid of the "A".....and guess what, still no experience, so still NO JOB!!!!!
> 
> I am  highly-motivated and generally possess a positive attitude, but this whole thing really rubs me the wrong way!!!  Any thoughts or suggestions would be greatly appreciated!!  Happy New Year!!


----------



## Pam Brooks

suziski said:


> How does a new coder obtain this experience when it is not in the coding classes? It is obtained with on the job training and experience. How is a new coder suppose to get this?


 
Revenue cycle, payer guidelines, CCI Edits, Healthcare law, communication skills, and denial management are all skills and concepts that can be replicated in a virtual office "lab" and taught in the community college level. What I'm seeing with entry-level coders are a whole lot of really earnest people who know how to look things up in the CPT and ICD-9 books, have a general understanding of medical terminology but don't know what the word "adjudicated" means, and who don't know how to use the CCI edits. It's just as frustrating to me as it is to people trying to get hired. 

Whose fault is that? Good question. The school, for not providing a comprehensive education? And for the 20K I've read that people are plunking down for this opportunity, I sure hope they got some of this training. Or do we blame the students for not researching coding job descriptions in advance of selecting coding coursework? 

But the bottom line is that without that knowledge, lately (with a bad economy and a strict budget) it's hard for me to bring anyone on that is going to require a lot of additional training outside the new-employee training like multiple software applications, company policies, and Joint Commission requirements.


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## chshaffer41@gmail.com

Ms. Brooks,

      My name is Christine,  and I would like to say that I have been following this post for a while now, and I have also posted a few comments as well, and I have been taking in everything you have said about this issue.  I want to say that I admire the fact that you are trying to explain to the CPC-A's, myself included, just how much more is involved to becoming a certified coder.  I totally understand your point of view, and I also appreciate the fact that you are seeing our frustrations as well.  I would like to know what you think should be done to help the apprentices that are "Stuck in limbo", and are willing to do whatever it takes to get the "A" removed?  Do you think we should sit for another test that just shows we have the ability to find the codes in the CPT and ICD-9 manuals? I don't know if you have seen any of the things I have posted, I'm sure you have though, and I was wondering how you feel about the Apprentice Removal Program that AAPC has attempted to implement??  I am just curious to what your opinion might be?


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## semaxwell1

Pam Brooks said:


> . . . That's why I strongly believe, and have communicated to the AAPC, that there should be a two-year (at least) experience requirement in order to sit for the CPC examination.



That sounds like a good idea, AHIMA set up the CCS exam that way as well.

However, if AAPC goes that route, than they need to switch things.
For those that are not able to achieve the two-year experience (coding that is), then you must EITHER pass the 20 note Clinical Exam or complete the 800 note Virtual Experience program BEFORE you can sit for the CPC exam.

If you are still unable to achieve a job (paid or not paid) that would allow you any kind of “coding experience” 12 months after passing the exam, then you should be able to EITHER retake a new 20 note Clinical Exam or complete another new 800 note Virtual Experience program. Since it appears that the Project Xtern is unfortunately not as widely available across the country, this seems the best route. I would hope this would show potential employers your dedication and persistence even if you lack "real-world experience".

As for other kinds of "experience", your resume should show that you have that. As Pam had stated in a previous post, there are many other types of experiences, besides just coding, that are involved in this industry. Read the job description carefully. IMO, if just extracting and looking up codes are at least 80% of the duties, than I believe the above mentioned should suffice as experience?


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## TracyHecox

ajs said:


> Currently there is no change in what it takes to remove the A from your credential.  There is a proposal being discussed to allow further testing to replace part of the requirement, but it is not yet official.  So as of now, you still need either two years experience validated by an employer or 80 hours of classroom work and one year experience.



Thanks, that helps


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## Pam Brooks

machshaffer@aol.com said:


> Ms. Brooks,
> 
> My name is Christine, and I would like to say that I have been following this post for a while now, and I have also posted a few comments as well, and I have been taking in everything you have said about this issue. I want to say that I admire the fact that you are trying to explain to the CPC-A's, myself included, just how much more is involved to becoming a certified coder. I totally understand your point of view, and I also appreciate the fact that you are seeing our frustrations as well. I would like to know what you think should be done to help the apprentices that are "Stuck in limbo", and are willing to do whatever it takes to get the "A" removed? Do you think we should sit for another test that just shows we have the ability to find the codes in the CPT and ICD-9 manuals? I don't know if you have seen any of the things I have posted, I'm sure you have though, and I was wondering how you feel about the Apprentice Removal Program that AAPC has attempted to implement?? I am just curious to what your opinion might be?


 
Hi, Christine. Thank you for your comments. 

There are many, many frustrations here. Even as recently as six or seven years ago, I would have given my right arm to have some entry level coders to help with the manual charge entry, filing, and administrative tasks, while they learned the ins and outs of coding and billing. With the rapid changes that my facility has seen...EHR, automatic coding/charge capture, paperless office, etc., I have so much less need for entry level staff that I can't even provide much of an opportunity for anyone who has less than a couple of years coding/billing experience. While all this was happening, the coding schools (and the AAPC) weren't quite paying attention, and provided me and other hiring managers with a great group of people that I can't reasonably employ! It's a major catch-22. The only suggestions I can make are repeats of the ones I've been listing for months....get your feet wet however you can.....front desk, registration, payment posting, customer service, or even dietary, housekeeping, and administrative assistant.

Personally, I'm not sure what an additional test would prove, unless it included some of the topics I outlined above, such as revenue cycle knowledge and denial management strategies. But that's not easily measurable in a multiple-choice test, so I see it as having to be an essay or presentation project. Imagine the AAPC having to manage that kind of examination venue, with 30,000 apprentice coders wanting that kind of opportunity? It boggles my mind, and certainly would be a logistics nightmare. It's not that I don't sympathize, but my loyalty lies with my employer, who trusts me to hire the very best people for the job, with the best return on investment. And these days I need experienced coders, that can hit the ground running. To hire an inexperienced (although willing) apprentice would be a bad business move. And after all, healthcare is a big, big business.


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## chshaffer41@gmail.com

Pam Brooks said:


> Hi, Christine. Thank you for your comments.
> 
> There are many, many frustrations here. Even as recently as six or seven years ago, I would have given my right arm to have some entry level coders to help with the manual charge entry, filing, and administrative tasks, while they learned the ins and outs of coding and billing. With the rapid changes that my facility has seen...EHR, automatic coding/charge capture, paperless office, etc., I have so much less need for entry level staff that I can't even provide much of an opportunity for anyone who has less than a couple of years coding/billing experience. While all this was happening, the coding schools (and the AAPC) weren't quite paying attention, and provided me and other hiring managers with a great group of people that I can't reasonably employ! It's a major catch-22. The only suggestions I can make are repeats of the ones I've been listing for months....get your feet wet however you can.....front desk, registration, payment posting, customer service, or even dietary, housekeeping, and administrative assistant.
> 
> Personally, I'm not sure what an additional test would prove, unless it included some of the topics I outlined above, such as revenue cycle knowledge and denial management strategies. But that's not easily measurable in a multiple-choice test, so I see it as having to be an essay or presentation project. Imagine the AAPC having to manage that kind of examination venue, with 30,000 apprentice coders wanting that kind of opportunity? It boggles my mind, and certainly would be a logistics nightmare. It's not that I don't sympathize, but my loyalty lies with my employer, who trusts me to hire the very best people for the job, with the best return on investment. And these days I need experienced coders, that can hit the ground running. To hire an inexperienced (although willing) apprentice would be a bad business move. And after all, healthcare is a big, big business.




Thank you Pam for your reply.  Believe it or not, I appreciate your honesty about the reality of the healthcare industry, and how it has grown.  I just wonder what can be done to get the word out to the colleges/technical schools to get them to maybe offer some detailed courses on the topics you mentioned above?  Do you think that might be something that would help to get the new coders a better understanding of the "real world" job??  Or maybe get the word to them, that an apprentice program at the college level is needed?  I just wonder...

I know all about the "hit the ground running" issue.  I actually took a job in a medical office in 2010,  just a few months after I passed the CPC exam.  It was a position as a Medical Assistant.  I had absolutely NO prior experience in a medical office, and definately none as a MA, I had to "learn on the job", "hit the ground running"!  I was able to obtain this job by basically going around town passing out my resume, talking to the people in the doctors' offices, and fell into it.  The doctor was a teaching physician so I suppose that is why she was able to hire someone like me??  Although it was a GREAT experience, it was not meant to be. I worked for 14 months before they replaced me with a nursing student.  Although I was quite upset at the time, I completely understood giving someone who was going to nursing school the opportunity.  I am very greatfull  for the experience that I received during my time there. Although my duties were mostly clinical, I did do some front desk work,(verifying insur., pt scheduling, A/R posts, etc.), and quite a bit of managing pt records in the EMR.  So, I do have some understanding of how the medical office works,  it just didn't lead to the Billing/Coding job I was hoping for.  I know I have much, much, more learning to do, and I plan on learnig as long as I can, I just wish I could get the chance to prove myself. I am definately NOT below taking a job, whatever it may be, I was kind of a "nurse" for a while, and I was actually good at it, who knew? 

Anyway, I am sorry to be so long winded,  but I am trying very hard to help, in any way I can, to find a solution to this issue for myself, as well as the other CPC-A's, who are willing to work for the recognition to a potential employer. I also realize the economy being what it is, is not helping in this situation.  So, I am going to a chapter meeting tomorrow for my FIRST time.  I am going to try the "face-to-face" networking, you never know what can come of it??!

Thanks again, and any information/advice you can offer is greatly appreciated!!


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## ASCOTT@HIGHLANDCLINIC.COM

*Cpc*

I just got my "A" removed the old fashioned way by going to school and getting my year of experience. I was very fortunate to be hired 6 months after I graduated as a coder for a multi-specialty clinic. I would be very frustrated if I already passed the CPC and I was working as a coder, but didn't have a full year under my belt and had to take the additional exam. Good luck to all the newbies on the new exam!!


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## ldpsam1

*Lori CPC-A*

I think this is just another way to squeeze more money form hard working people.  I took the coding course after becoming unemployed with 30+ years of medical office, I had done everything possible in the medical office except the coding piece.   So why not, it was the most difficult and stessful test I have ever taken and most people will agree with me.   I don't see the need for  the A at all.   Every position is different and you will always learn as you go along.  I did land a job in another medical facility, not in the coding or billing for that matter, (Clinical Clerk)  As it stands now,none of the people working in billing are certified and as of Jan.1,  the department is being replaced with our EMR  provider.  So, so much for advancement in this company!


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## hnriddle

I worked hard to pass the CPC exam. I passed it the first time while my friends who already had medical jobs didn't even pass it on the second time and just gave up. They still had a job and all I have is that stupid A. I don't have any on the job training and have tried the project xternship program and have gotten nowhere. I also want to know from all the hiring managers how I am supposed to get a job, any medical job coding or not, if no one will give me a chance. When I talked to the AAPC about doing the exam to get my A off, they said that I could but truthfully employers don't look at that as field work it is still just book work!


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## kmorandi

I so agree, I was not trained in school on how to code clinical notes. I have the AAPC workbook, which I haven't gone through yet because I didn't need to to get my CPC certification. However, I would like to see the schools add some "real" training to the curriculum. I also agree that on-the-job training would be best, but if we can't get hired even with certification without two years of experience, where are we going to get that experience? You say to work in the field for two years before getting the certification. You'd have to change how hospitals want their coders -- everyone in this area that still hires "newbies" wants some experience, and if they hire you without a certification, you get sixth months to get that certification.


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## gmuslimani

Most of the coders I have talked to do not even have any coding education much less a certification of any kind.  They are being hired as a general employee in a physician's office as a front desk receiptionist and being moved along as they learn the ropes.  So, I would suggest that we all try to begin wherever we can get our foot in the door.  The thing is they are not being paid what a CPC should be paid either.  So, we may even have to accept a lesser salary as well.  

Another issue with that may be the office is not being reimbursed as they should be, but I suppose you get what you pay for.

Good Luck to everyone and keep searching.


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## semaxwell1

Due to the mandate of medical records becoming digitized by 2014 and the increased usage of automated medical coding software, it seems the administrative healthcare employment demand might soon be in RHIA and RHIT? This link is from the Department of Labor Bureau of Labor Statistics. This mentions coding, but there seems to be heavier emphasis on RHIT.  I only pasted parts of what the web page says.

http://www.bls.gov/oco/ocos103.htm

Occupational Outlook Handbook, 2010-11 Edition 

Medical Records and Health Information Technicians

Significant Points
Employment is expected to grow much faster than the average.
Job prospects should be very good, particularly for technicians with strong computer software skills.
Entrants usually have an associate degree.
This is one of the few health-related occupations in which there is no direct hands-on patient care.

Training, Other Qualifications, and Advancement 
*Entry-level medical records and health information technicians usually have an associate degree. Many employers favor technicians who have a Registered Health Information Technicians (RHIT) credential.* 

Education and training. Medical records and health information technicians generally have an associate degree. Typical coursework in health information technology includes medical terminology, anatomy and physiology, health data requirements and standards, clinical classification and coding systems, data analysis, healthcare reimbursement methods, database security and management, and quality improvement methods. Applicants can improve their chances of admission into a postsecondary program by taking biology, math, chemistry, health, and computer science courses in high school.

Certification and other qualifications
*Most employers prefer to hire credentialed medical record and health information technicians.* A number of organizations offer credentials typically based on passing a credentialing exam. Most credentialing programs require regular recertification and continuing education to maintain the credential. Many coding credentials require an amount of time in coding experience in the work setting. 

The American Health Information Management Association (AHIMA) offers credentialing as a Registered Health Information Technicians (RHIT). To obtain the RHIT credential, an individual must graduate from a 2-year associate degree program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) and pass an AHIMA-administered written examination. In 2008, there were more than 200 CAHIIM-accredited health information technology colleges and universities programs.

The American Academy of Professional Coders (AAPC) offers coding credentials. The Board of Medical Specialty Coding (BMSC) and Professional Association of Health care Coding Specialists (PAHCS) both offer credentialing in specialty coding. The National Cancer Registrars Association (NCRA) offers a credential as a Certified Tumor Registrar (CTR). To learn more about the credentials available and their specific requirements, contact the credentialing organization.

Health information technicians and coders should possess good oral and written communication skills as they often serve as liaisons between healthcare facilities, insurance companies, and other establishments. *Candidates proficient with computer software and technology will be appealing to employers as healthcare facilities continue to adopt electronic health records.* Medical records and health information technicians should enjoy learning, as continuing education is important in the occupation.

Job Outlook 
Employment is expected to grow much faster than the average. Job prospects should be very good; *technicians with a strong understanding of technology and computer software will be in particularly high demand.*

Employment change
Employment of medical records and health information technicians is expected to increase by 20 percent, much faster than the average for all occupations through 2018. Employment growth will result from the increase in the number of medical tests, treatments, and procedures that will be performed. As the population continues to age, the occurrence of health-related problems will increase. Cancer registrars should experience job growth as the incidence of cancer increases from an aging population.

In addition, with the increasing use of electronic health records, more technicians will be needed to complete the new responsibilities associated with electronic data management.

Job prospects. Job prospects should be very good. *In addition to job growth, numerous openings will result from the need to replace medical record and health information technicians who retire or leave the occupation permanently.*


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## kevbshields

All of the demand issues depend on the following:
 * Setting
 * Desired position
 * Geographic location
 * Specialty
 * Organizational missions/initiatives

Please keep in mind that RHITs must now compete with folks who've completed the HITECH trainings related to electronic record training, process improvement and clinical leadership.  Although I do not have reports on how well employers are accepting that training or seeking those candidates, it is clear that employers are sending in-house employees to be trained and educated in this area.

All along I have suggested for Coders in small to medium sized practices to seek some of this HITECH training so they can grow into leadership positions for transition.  Additionally, all the training in implementation and training for EHR does not replace the knowledge or skill base of a certified coder, especially when we look at adopting new practice management tools and revenue cycle processes.


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## jtmatteson

*Cpc-a*

I also live in the Wilimington, NC area and attend AAPC chapter meetings on a regular basis. I am in agreement with everything you are saying. The CPC exam was absolutely the hardest test that I have ever taken, and I was extremely relived when I learned that I had passed. However, the euphoria has now worn off, and the reality of the situation has set in. And it is not a pretty picture.

When I attend the chapter meetings, I see a room full of well-intentioned, frustrated and unemployed people at a loss as to what they should do. Unfortunately, I believe that a lot of people who have already paid a substantial amount of money for education, joining AAPC and taking the CPC exam are now going to dole out more funds to take yet another ardous exam as they feel like they have no choice if they hope to become gainfully employeed only to be still left in the catch 22 position of no experience, no job. 

I was really excited about this aspect of the medical profession, and I was looking forward to being a part of something that offered career opportunities as well as professional comradery. In retrospect, perhaps these expectations were too high, and I know that the employment opportunities in this area are not that great. I have not given up all hope, but I am definetly brainstorming to try and come up with ideas that I can propose at the next chapter meeting. Thanks to all who have responded. It has been uplifting to realize that we are not in this quandry alone.           




lorig said:


> I have to agree with you.  I have worked in the medical field in various capacities for the last 20+ years.  I was offered an opportunity to participate in a class that was given to several employees in a local billing office by a certified instructor.  Although not a formal class, I participated for over a half a year, attended all but one of the weekly classes and did all of the required work.   I am proud to say that I passed the CPC exam on my first try, and,  I was the only one of eight students who passed on the first try.  The test was grueling, both mentally and physically.
> I now feel that my efforts may have been wasted since my passing that test will basically mean nothing unless I take and pass the new test.  I don't feel it's fair that I will have to sit for another 5 1/2 hour exam, which is what I will be required to do given the nature of job openings for coders in my town.  Most practices here don't even hire certified coders.  The few that do, require 5 years experience. Extern programs are all but non-existent. The ones I checked on require that an extern work during the day. Unfortunately, I have to work at my full-time job in order to pay my bills so this would be impossible. In addition, even if I pass the add-on exam, it will still not give me the coding 'experience' that is required to get a job.  I don't see how this is helping apprentices at all.  It appears to me that only the AAPC stands to gain since apprenticies will be required to pay additional money to take another exam.
> While I'm at it, I will also say that I know of serveral 'certified' coders who do not have the required experience, but still their employers were willing to write letters for them so they didn't have to have the "A".  If this "A" is so important that maybe ALL coders need to take both exams so that it will be a level playing field.
> I will carefully consider what to do since this will now become an issue for me and I'm sure for so many others.  I will also make sure to bring this up at my local chapter meeting, which I attend faithfully.
> Thanks so much for making my day!


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## jtmatteson

I also live in the Wilimington, NC area and attend AAPC chapter meetings on a regular basis. I am in agreement with everything you are saying. The CPC exam was absolutely the hardest test that I have ever taken, and I was extremely relived when I learned that I had passed. However, the euphoria has now worn off, and the reality of the situation has set in. And it is not a pretty picture.

When I attend the chapter meetings, I see a room full of well-intentioned, frustrated and unemployed people at a loss as to what they should do. Unfortunately, I believe that a lot of people who have already paid a substantial amount of money for education, joining AAPC and taking the CPC exam are now going to dole out more funds to take yet another ardous exam as they feel like they have no choice if they hope to become gainfully employeed only to be still left in the catch 22 position of no experience, no job. 

I was really excited about this aspect of the medical profession, and I was looking forward to being a part of something that offered career opportunities as well as professional comradery. In retrospect, perhaps these expectations were too high, and I know that the employment opportunities in this area are not that great. I have not given up all hope, but I am definetly brainstorming to try and come up with ideas that I can propose at the next chapter meeting. Thanks to all who have responded. It has been uplifting to realize that we are not in this quandry alone.


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## johnmeyer

*A black belt is a white belt that never gave up*



hnriddle said:


> I worked hard to pass the CPC exam. I passed it the first time while my friends who already had medical jobs didn't even pass it on the second time and just gave up. They still had a job and all I have is that stupid A. I don't have any on the job training and have tried the project xternship program and have gotten nowhere. I also want to know from all the hiring managers how I am supposed to get a job, any medical job coding or not, if no one will give me a chance. When I talked to the AAPC about doing the exam to get my A off, they said that I could but truthfully employers don't look at that as field work it is still just book work!


 
I'm not a manager of any kind. I'm just a CPC-A like yourself. Just like you, I couldn't find a job in billing or coding and for the same reason you can't. I graduated with a 4.0 GPA in billing and coding. I even got my CPC-A a few weeks after finishing school the first time up with an 88%. Even with all that, I couldn't get a job in billing and coding because of my severe lack of practical experience.

So I took a job in reception as a way to break into billing and coding. I think this is the only way most of us will be able to get into billing and coding. I've got a few friends that were able to get right into billing and coding, but that's because one was lucky enough to extern for a billing company looking for some new employees. She was able to get a job for some of our other friends.

I think the thing really is that most places want us to "grow" into billing and coding. What we are taught in school really is just the basics of billing and coding. I'm learning so much more than I did in school as a receptionist. There are so many goofy rules with the different insurance companies, it gives me a headache just thinking about them.

I will also say that if you are given an interview... make sure to tell them that you are a CPC-A and that you want to eventually get into billing and coding after having some real experience in whatever position they are interviewing you for. I think this is what put me over the edge and into my job.

At any rate.... I wish you the best of luck if you want to continue your search for a billing/coding job.


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## ElizKerr

*Cpc-a*

This was my comment to aapc.com/cpc-acomment...
I have a CPC-A.
I agree that the A should be eliminated. The resume speaks for itself.
We should not be required to take a clinical exam of coding 20 operative/office notes, because there was not enough emphasis at my Community College to do this (it was not part of the curriculum). So therefore we should be grandfathered in.  Moving forward there is a great need to communicate better with the College's. There should be a free pre-req. class explaining all that is required to obtain your CPC credential. 1. A person should already have work experience (unless see below my #4 comment if that was enacted - then you would not need the emphasis on already having work experience). 2. The complete cost and requirements (including joining AAPC to see your results). 3. I have heard good things about the Virtual Experience and perhaps AAPC could incorporate that with the Community College curriculum. That way you would be trained better for the clinical exam. 4. There are presently government grants available for people to start business's that can employee lots of people. With 30,000 CPC-A's out there trying to find work this would be a great area to obtain that grant. Schools, AAPC, Physicians and Hospitals need to work together to have a apprentice program that works to help us CPC-A's learn and accomplish the real world work of coding. (A little bit like the program they have for a dentist - where people can go have dental work done by the medical school students). The schools could set up special secure classrooms where CPC-A's can do real practical work (that a courier has brought in) like a clearinghouse. This would be a win-win situation. Work is done and students learn and get practical experience. Thank you for allowing my comments. Also, perhaps you might consider a "Chapter Meeting" round table discussion on this issue.


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## checkers454

I am really upset about the fact that I probably will never have the -A removed from my CPC.  I worked hard to pass the exam after taking an online course with UMA, an excellent school.  In addition, I have years of medical work experience, although not in coding.  I have taken a job working with Medicaid.  However, I will not be able to uitlize my coding skills.  It is very unfortunate that obtaining just one more year of working with codes is so hard to come by.  I am in my 50's and I believe the job I have now is where I will stay and the company will be fortunate to have me.  The ones that will be unfortunate are the ones that did not give me the chance to obtain that one year of working with medical codes.   And this is America?


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## lcashburn

I have mixed feelings about this change.  On the one hand, I know that for those newly certified coders with no previous medical experience the A is like a scarlet letter, as pamps76 stated, and it puts potential employers in a frame of mind to expect the worst.  On the other hand, I have tutored several people who failed the exam only to discover that they didn't have much beyond the most basic knowledge when they finally did pass.  Those people were smart and worked hard, they just hadn't had enough exposure.  There are so many things you won't learn until you are "in the field", things like revenue codes and condition codes and all of the other items that cross over from coding to billing.  But NO ONE is going to know it all.  So, I think the certification either has to be reworked, as ollielooya (love it!) suggested, or we have to just accept that the CPC is entry level and then experience adds to your "hire-ability".  

As for me, I had been doing specialty coding while working clinically and finally got my CPC because I kept running into conflicts with the hospital's coders that I couldn't resolve, and I needed to know how they thought and why our communication left us both frustrated.  The credential helped them to see me as someone who might know what I was doing, and I learned how to show them my side of the story in language they could relate to.  I was luckier than w_burns in that my boss and our doctor's practice manager, a CPC herself, wrote my letters so I never had to wear the dreaded "A".  But even after 8 years of doing the specialty coding and 20+ years of clinical background I am still learning new things so in some ways I will always be an apprentice.


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## karnmadding

*KMadding*

They are NOT discontinuing the Virtual Experience .  I just finshed beta testing.  The Virtual Experience can be done in your home at your own pace.  800 questions is a lot but I think the 20 being proposed in the Elimination of the A Designation is too few. Having done the beta for Virtual passing 20 qestions at 90% is going to be almost impossible.  I think they should compromise between 20 and 800 questions and lower the price of Virtual and keep it.
Has everyone forgotten about the testing we are going to have to do to KEEP certification after ICD-10 Its not going to do you an good to get the "A" removed in 2012 if you loose the entire cerification a few years later now is it.


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## Nawojcik@aol.com

I think that we need to get rid of the "A" all together.  I hear of so many people out there coding who aren't CPC's and yet they were able to get into an office because they knew somone who was willing to give them a job and train them on the job.  Then you have the people who took the time to learn coding, take and pass the grueling test and still can't get a job because they have that A after the CPC.


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## coderpj913

*Virtual Experience.*



karnmadding said:


> They are NOT discontinuing the Virtual Experience .  I just finshed beta testing.  The Virtual Experience can be done in your home at your own pace.  800 questions is a lot but I think the 20 being proposed in the Elimination of the A Designation is too few. Having done the beta for Virtual passing 20 qestions at 90% is going to be almost impossible.  I think they should compromise between 20 and 800 questions and lower the price of Virtual and keep it.
> Has everyone forgotten about the testing we are going to have to do to KEEP certification after ICD-10 Its not going to do you an good to get the "A" removed in 2012 if you loose the entire cerification a few years later now is it.



Was the beta testing done by AAPC, and when and where can you find the Virtual Experience in order to sign up for it?
I agree with you 100% and sent my response to AAPC.  I so hope that we are able to do the Virtual Experience as I feel it is a much better indication of a coder's abilities than a 20 question exam. If I can code 800 notes at 90% accuracy on my own, that shows I already know something about what it takes and can learn what is necessary to be sucessful to insure that claims are coded and billed correctly for whatever facility I am employed.


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## chshaffer41@gmail.com

karnmadding said:


> They are NOT discontinuing the Virtual Experience .  I just finshed beta testing.  The Virtual Experience can be done in your home at your own pace.  800 questions is a lot but I think the 20 being proposed in the Elimination of the A Designation is too few. Having done the beta for Virtual passing 20 qestions at 90% is going to be almost impossible.  I think they should compromise between 20 and 800 questions and lower the price of Virtual and keep it.
> Has everyone forgotten about the testing we are going to have to do to KEEP certification after ICD-10 Its not going to do you an good to get the "A" removed in 2012 if you loose the entire cerification a few years later now is it.



karnmadding,

     I just wanted get your thoughts on the beta testing. I, was also a beta tester for the Virtual Experience. What, if anything, did you find difficult about the notes? And what did you like about what was changed? How did you find out that the AAPC is keeping the program?? I just sent an e-mail out this morning, to my contact at the AAPC to inquire about the progress of the program. What have you heard about what they are planning to do?

      Also, I agree with you that 20 notes for the Elimination of the A Designation is too few as well, and passing with a 90%, with so few is going to be almost impossible.  Also, the issue that seems to be the major problem with aquiring a job, is not having the *experience*.  That is why I thought the idea of having an apprentice program was a good opportunity to get the much needed experience that is required.  However, I am not sure how to get a potential employer to recognize this as real experience... 

      I actually had about 700 of the notes done when the web site went down, and I'm sure you will agree, this is alot of work. I think anyone who goes through this program deserves to be recognized for their hard work. I also think this is a great way to prove they are willing to work hard to get the "A" removed, and to show they are serious about working in the field. I just felt that the AAPC should have had some way of actually providing a mentor to aid in the process, as if this was an internship. someone to go to for advice...


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## rmastalerz

Here is the problem that I see with this change; for those of us who went to school, passed the test and have been looking for a job-sometimes for YEARS-to have to pay to take another test, buy coding books because if you're not working you don't have up to date books...it's just frustrating! I have tried everything I can think of to break into this field and can't get any experience, I don't think I can afford to keep going on with it.


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## pjwils15

dclark7 said:


> Many moons ago when i took my exam you were required to have at least two years of experience (and a letter stating such fromyour employer).  Why the AAPC moved away from that I don't know.  Pam is right the AAPC can't leave alll those CPC-A's hanging out to dry, but in order for the credentials to be taken seriously (and for years they weren't) there has to be some sort of segue.  I like the idea of actually coding from the notes rather than a multiple choice test.  As difficult as people feel the test is, it doesn't begin to compare with abstracting information from a patient record where not everything is neatly in place for you.
> 
> As for other fields requiring apprentices, physican are not allowed to hang up a shingle once they complete medical school, they are required to go through both an internship and residency.  Plumbers, electricians and carpenters all have apprenticeships. And nurses are required to go through clinical rotations PRIOR to graduation.
> 
> Years ago before managed care, HIPAA, the ACA, CERTS, RACs and ZPICs it was easy to walk into a medical office and do any job.  Now all that has changed and from my experience, most of the coding courses do not adequately prepare new coders for the "real world".  People who have other experience in the medical field are more prepared, but most new coders have never set foot in a medical office except as a patient.  One thing the AAPC has accomplished with the apprentice designation is to over saturate the field with inexperienced coders.  What is the answer?  I'm not sure, but I agree with Pam, I think the AAPC is heading in the right direction.


I have a son who is now an E-1 Electrician and while yes had to do a specified number of hours for an apprenticeship it is a PAID apprenticeship with a company who is willing to hire apprentices and they are in our state subsidized for this. It is fine to designate one as an apprentice if once you have studied very diligently and passed the exam there is some way to GAIN that experience. I have years of experience in a different field, I also have a certificate as a Medical Secretary I obtained years ago, I am now a CPC-A and even if I were to take the exam you are talking about I don't think anyone would hire me as I have no experience.

The courses and program that I have taken was through my local College as an HIMT Coding Specialist. It was my choice to go on, become a member of AAPC and sit for the credentialing exam. The courses entailed everything you need to know from Medical Terminology to Anatomy and Physiology, including Health information Management courses, the legalities of HIPAA and medical documentation and more. It was very intensive and I am proud to say I graduated from the program with a GPA of 3.86. You would think with two certificates in the Medical Field, some experience in Medical Offices and years of experience with computers, litigation support and other areas someone would want to hire me on an entry level basis. It is not happening and I find it very discouraging. Maybe what is needed is to start within some of these facilities a real apprenticeship program where you can work through your apprenticeship and be paid reasonably for the skills that you have. 

What I really find aggravating is the fact that most of the ads ask for only a High School education with no formal training but a CPC with 2 or more years of experience. While it is nice to volunteer to work somewhere to gain experience I don't think anyone who has gone to school for this or has retrained to be in another profession can afford to volunteer for two years?


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## kevbshields

You've really hit the nail on the head:  our industry does not require certification or licensure.  Electricians are normally required to be licensed in their states.

If we (as an industry) could compel adoption of mandatory certification (and probably an associated licensure fee with repsective states), then the keys to the kingdom are there for the graduates and those seeking employment.  

Every certified coder I know would happily support efforts at more closely regulating workers in our end of the industry.  It's remarkable to note that our part of the health care field is more heavily regulated than many others, yet our practitioners are not required to demonstrate competence through professional affiliation and credentialing.  The hiring managers certainly lean that way in larger organizations, but it's an open field for the rest...

Just some thoughts for AAPC, readers here and credentialed coders who need their day in the sun.


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## msr1984

I also agree with Pam, I believe the AAPC is headed in a great direction. I have worked in this field for 10 years in billing, I started out as a receptionist that was required to do charge entry. I later went to a billing company as data entry rep and learned my way up through the ladder to coding. I took the exam and now I am a CPC, I have been coding under my boss for 4 years and I had a letter stating my abilities. I think that these "career schools" need to stop lying to people that they are going to come out here in the real world and make $25/hr as a CPC and then, they take the certification exam and find out they are a CPC-A and can't even get a job. I like the idea of doing away with the "A" and making people meet the work expreience requirement OR test their true knowledge of coding.


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## Grintwig

The real issue here for the employers I think is the fact that most of them (especially the smaller offices) do not hire people just to code. The "coder" they hire also has to be able to file the insurance, follow up, work the denials, work collections.....the list is endless and none of this is covered by the CPC exam. 
I agree that there should be a multiple choice section but I think to really give the certification true marketable value insurance issues should also be addressed. I know that would be a daunting prospect but in my opinion employers would have more confidence in hiring a CPC-A with no experience if they felt that the training a CPC goes through addressed the issues that affect their bottom line. 
As we go forward in this industry it is going to be more important than ever for claims to be filed cleanly (which involves a knowledge of LCDs/NCDs, Medicare guidelines, modifier usage, global packages, what constitutes a chargeable visit during the global period, ICD 9 guidelines, CPT guidelines, etc) and the RAs will need to be worked properly (which involves knowledge of redetermination filing, appeals filing, what you can and can not bill the patient for, the various rules of the various insurance companies, etc). Currently the CPC does not prepare coders for the "real" world that they are trying to step into and employers know it. Many of the smaller offices do not have the funds or time to train a person in all of the areas that the CPC lacks and so they will hire someone with no certification who has the experience they need to just jump right in and get the cash flowing.
How could this be addressed in the context of the CPC? I do not honestly know. Adding this to the exam would probably increase the cost to take the exam and the cost of creating it but I really do think that it would be a win-win for all concerned.


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## kevbshields

Perhaps the Advisory Board needs to look at the target markets for the CPC credential.  In most organizations that I've worked with, the assignments were generally not dumped on a single worker (though I recognize from my contact with health care offices, that is the practice at many).  

Your suggestions that a CPC does not prepare folks to be coders is not entirely correct.  However, the gaps between what needs done in a small physician practice is entirely different than what is accomplished by a CPC working in a corporate environment, where some of that suggested material will be unnecessary.


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## ghpkmp

dclark7 said:


> Ok, for all of you new coders who believed the hype that you can make over $40,000/yr AND/OR work from home.  YOU SHOULD HAVE DONE YOUR HOMEWORK!!!  If you check out the AAPC salary survey from 2010 which is when they broke it down by years of experience you'll see that most people with one year were making $16.61/hr,  coders didn't get to over $20 until they had 10 years of experience ($21.96).  So....if you who don't have any experience are not willing to accept jobs that are paying "$14-$20"/hr then you have no reason to complain.  If you actually read the salary survey report you'll find that the people making the most money are usually self employed, are consultants or are in managment positions.
> 
> Every post from experienced coders have adivsed the newbies to take any job they can get.  Yes jobs are hard to come by and if you take the front desk position you're NOT going to make $20/hr but you will be getting experience in the medical field and if you prove that you want to learn most employers will give you a chance.  However, if you go into an interview expecting that because you went to school and passed a multiple choice test they're going to look at you like you're the answer to they're prayers you are sadly mistaken.  Everyone has to start somewhere and most people are NOT going to start at the top.  So lower your expectations and get some experience.



Wow! Who said they weren't willing to take whatever job they can get? Who said they expect to make $40k a year? That's not what I've been reading here. I've been reading that people are afraid - afraid that they won't find a job that will give them the experience they need in the time-frame that the AAPC is proposing. I hear fear. And not a lot of empathy from many CPC's posting here. 

One of the smartest posts I've read here is from ljohnson980, at 1-5-2012 11:54AM.  It's worth reading if you haven't.  She holds several CPC certifications.

"If I am lucky enough to gain employment, remember NO one wants to hire a CPC-Apprentice I will probably spend the year entering the same five codes listed on the superbill. My “A” is removed but I am less of a coder at the end of that year than when I passed the CPC exam."

How many CPC's code the same codes day in and day out? How many of them were given full CPC certification when they completed the test, just because they were able to get the requisite letters from their employeers validating their experience, when, in fact, they don't do much coding at all?  The same could be said for the CPC's who were required to have those letters before they could sit for the test.  

From what I understand, even the externships are questionable.  One person can code for eight hours a day for three months and another for 4 hours a day for three months and they both get credit for three months of coding experience.  It's whatever the employer chooses to do.  

Maybe it's just time to level the playing field. 

Also from ljohnson980, at 1-5-2012 11:54AM (someone who is obviously not threatened by the idea of giving CPC-A's their full certification):

"I would drop the A designation right away for anyone who has passed the CPC exam and move to a graduated certification method."

THAT sounds like the best idea I've heard from anyone!


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## Grintwig

Entirely true kevbshields. I live in a small mostly rural area and the physician practices here are small. Many tend to hire experience over certification.
I was very lucky in that the office I work for wanted a certified coder and did not mind hiring someone with no real world experience. The previous coder was not certified (which is why the office was set on hiring certified) and it showed in the mounds of denials that was next to the mountains of uncoded charts in the office I was shown to. I was completely unprepared for dealing with the insurance world and could not understand some of the denials. I know I would have greatly appreciated a crash course in things like LCDs/NCDs, CCI Edits, Medicare guidelines, and the like.
I think it would add more prestige to the AAPC and the CPC itself if some of those things were added to the course and test. Newly "minted" CPCs would be a little more marketable than they are now and even better prepared than they currently are. But of course that is just my opinion


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## ghpkmp

karnmadding said:


> They are NOT discontinuing the Virtual Experience .  I just finshed beta testing.  The Virtual Experience can be done in your home at your own pace.  800 questions is a lot but I think the 20 being proposed in the Elimination of the A Designation is too few. Having done the beta for Virtual passing 20 qestions at 90% is going to be almost impossible.  I think they should compromise between 20 and 800 questions and lower the price of Virtual and keep it.
> Has everyone forgotten about the testing we are going to have to do to KEEP certification after ICD-10 Its not going to do you an good to get the "A" removed in 2012 if you loose the entire cerification a few years later now is it.



I spoke with the AAPC about the Virtual Experience and was told that they were discontinuing it indefinitely, (it's no longer on the website) because there were too many problems with it.

Also, I don't know how they could possibly add more than 20 notes to the exam they are proposing.  They will be allowing the same amount of time as they do for the CPC exam - five hours and 40 (?) minutes.  Can't imagine many people being willing to sit for an exam that's more than six hours long.


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## khbrower@yahoo.com

*Upset with the removal of A proposal from the AAP. One test like the CPC exam enough*



pamps76@yahoo.com said:


> None of this really makes ANY sense to me.  I graduated from an AAPC- approved 1 yr. rigorous coding school 1 yr. ago.  At the same time, I was/am pursuing an A.S. degree in Health Information Technology (will graduate in May and then take the RHIT exam).  I passed the AAPC certification exam as a CPC-A. I have been very diligent trying to get any experience to get rid of the "A" on the end.  I have tried to participate in the Apprentice program that AAPC offers, with the closest office being 45 minutes away from me and they had nothing available for me.  My question to ALL seasoned coders, hiring managers, etc.. is how do we gain experience (and therefore get rid of the "A" on our credential) if no one is willing to hire non-experienced coders???  You can't get experience if you don't have any experience!!! It is highly FRUSTRATING!!!!!  Passing the CPC exam was grueling in and of its self only to be "awarded" with a credential that means nothing...and even less than nothing if you have the scarlet "A' attached. Woopee, now I get to pay more money, and take yet another test to get rid of the "A".....and guess what, still no experience, so still NO JOB!!!!!
> 
> I am  highly-motivated and generally possess a positive attitude, but this whole thing really rubs me the wrong way!!!  Any thoughts or suggestions would be greatly appreciated!!  Happy New Year!!



I agree!
One exam like the CPC exam is more than enough!!!
We need a job to get experience!


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## khbrower@yahoo.com

*Removal of A*

I think the AAPC needs the leave things the way they were before this proposal.

Passing the CPC exam is more than ENOUGH!!!

I do NOT want to take another test and pay for another test!!


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## ghpkmp

Pam Brooks said:


> Bravo!
> 
> Although the CPC exam is challenging, it's not an absolute indicator of coding competency, and elevating the difficulty of the CPC examination will only improve the integrity of the certification. The apprentice certification, in my mind, was well-intentioned, but generated a huge glut of inexperienced (and unemployed) would-be coders, regardless of their abilities and willingness to work. I'm glad that the AAPC has recognized this, and is moving towards re-recognizing that we are setting a higher standard.
> 
> I'll never forget the words of one of my staff members, who was struggling early on to grasp the coding concepts in my department. He said, "I passed the CPC examination, but I had no idea that it would mean that I wouldn't just be able to sit down and do this work. There's a h$ll of a lot more to this coding stuff than just passing an exam".



Pam, you're assuming that everyone who took the CPC exam, before the AAPC added the apprentice designation somehow had more knowledge and experience.  How can that be true?  Some, to be sure, but, certainly, not all.  The only requirement before was experience, but that could have meant sitting in a job coding the same codes day in and day out.  And if you've read any of the comments here, you'd know that many people who have lots of experience coding have failed the exam!!!!!!  

Also, you seem to be under the impression that the test for CPC-A's is somehow different from the test for CPC's.  Well, it's not.  We all took the same test.  

Absolutely "elevate the difficulty of the CPC exam" and make everyone re-test.  That would be leveling the playing field.  And you'd certainly weed-out the "huge glut of inexperienced (and unemployed) would-be coders."


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## ghpkmp

machshaffer@aol.com said:


> Although I am an apprentice,  I am well aware of the fact that the CPC exam is multiple choice, and in the real world there are no multiple choices.  A coder DOES need to be able to read a note and pull the appropriate codes for the procedures and/or diagnoses,  and that truely IS a good measure of the ability the coder has. That is why I strongly suggest that the AAPC really take a look at continuing to offer the Apprentice Program, wether it be an online or on site program,  I feel that is a great way to get the "new" coders the experience and/or education that is needed in order to be a successful coder.  Since there are not many providers that have the time,  or the finances to train "on the job", it seems to me that someone appointed by the AAPC should lead an apprentice program (like the online program), to work with the new coders, and mentor them on the issues in a real world situation. I would rather pay for an apprentice program that's going to give me the "real world" information needed to be a certified coder,  than pay for yet another test that is timed, and does NOT offer any feedback on why a code would NOT be correct,  and WOULD get denied in an actual coding setting.
> 
> I am speaking from actually having attempted the on-line prgram.  Although it had some bugs that needed worked out,  I feel it was quite challenging and offered a very real picture of what it is truely like to be in a coding position.  The program consisted of 800 doctor's notes,  from EVERY specialty.  It is alot of hard work,  but I felt that it really showed how the real world looks and what is expected of the coder.  I REALLY hope that the program will become available again soon,  with the bugs worked out,  because I think the program, along with a mentor to guide the coder,  will make the "new" coder much more successful in understanding the field.  I also feel that it will better prepare them for the challenges they will face,  and how to do research in order to figure out what the proper codes may be.
> 
> One more thing about the CPC test....It is a very hard test and I don't think the fact that it IS  extremely challenging should be dissmissed.  But I do feel that there should be some actual,  fill-in-the-blank notes included in the future.  But the amount of time to complete it may need to be increased...just a thought.



What nobody seems to be addressing is the fact that the majority of coders out there do not code from EVERY specialty.  My guess is that if you had every CPC (not CPC-A) have to code those 800 notes, they wouldn't succeed with the accuracy the AAPC requires.  It's very unfair to expect CPC-A's to be able to do that.  

I inquired about it because I felt I'd gain valuable experience.  And certainly more experience than many CPC's.


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## jcroskery@gmail.com

*Removal of A*

If someone passes the bar exam that's it they are a lawyer.  Yes they have to participate in continuing education but as long as they do that they are still a lawyer.  If someone has passed the CPC exam then they should be considered a medical coder and as long as they fulfill their required continuing education obligations they should always be considered a qualified medical coder.  Nobody has to hire them but their certification should not be taken away.  As far as the A designation is concerned it should just be dropped.  If the AAPC wants to change the test that is fine but anyone who has already passed it should not be required to do anything more at this point other than do their necessary CU units.
As far as finding work goes some people will get lucky and find a good jobs as coders while others will struggle.  Those struggling should just try and get any job in the medical field and hope for the best.  There are too many CPC-A's (and CPC's for that matter) for the economy to accommodate.  What can be done about this?  Really nothing except wait for the economy to improve and let market forces work to bring supply and demand back into equilibrium.   Some many never find work as coders but hopefully their education/knowledge/certification will enable them to at least find some sort of employment in the medical field.


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## ealasaid76

*I think it is just making it harder for people to be certified or experienced...*

We all took the multiple choice test.  I don't believe that suddenly having a NON multiple choice test is going to change anything.  Having an entry level job that has office based coding would be experience enough to remove the stigma of the A.  Hopefully that will happen for me, since I am going for a lab billing/coding job right now.

I don't feel that those of us with the A should be just forgotten about, because the AAPC wants to make a change.  The 20 question exam wouldn't do much good either.  

Just my input.


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## semaxwell1

ghpkmp said:


> I spoke with the AAPC about the Virtual Experience and was told that they were discontinuing it indefinitely, (it's no longer on the website) because there were too many problems with it.
> 
> Also, I don't know how they could possibly add more than 20 notes to the exam they are proposing.  They will be allowing the same amount of time as they do for the CPC exam - five hours and 40 (?) minutes.  Can't imagine many people being willing to sit for an exam that's more than six hours long.



Okay, the 'Virtual Experience 800 Note' was for betatesting last year, and now AAPC has currently put in on hold because they realize there are too many problems with it. 

So...what does that mean for all those who signed up for it and coded the notes, whether they completed them or not before it was shut down? Is all the hard work and effort and many hours they put into this beta program going to even be recognized (at least as partial experience) by the AAPC, or are they just going to get a refund and nothing else?


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## dclark7

ghpkmp said:


> Pam, you're assuming that everyone who took the CPC exam, before the AAPC added the apprentice designation somehow had more knowledge and experience. How can that be true? Some, to be sure, but, certainly, not all. The only requirement before was experience, but that could have meant sitting in a job coding the same codes day in and day out. And if you've read any of the comments here, you'd know that many people who have lots of experience coding have failed the exam!!!!!!
> 
> Also, you seem to be under the impression that the test for CPC-A's is somehow different from the test for CPC's. Well, it's not. We all took the same test.
> 
> Absolutely "elevate the difficulty of the CPC exam" and make everyone re-test. That would be leveling the playing field. And you'd certainly weed-out the "huge glut of inexperienced (and unemployed) would-be coders."


 
Having read some of Pam's other posts, I know that she does not think the tests are different, everyone knows they're the same. What I have a problem with is people who say they had a 3.5 to 4.0 gpa in their classes but barely manage to squeak by with a 70% on the exam. This is after the AAPC made it easier to pass by making it an overall score and not requiring a 70% on EACH of the 3 sections. I'd be pretty upset with my son and his teachers if he was bringing home A's all year and then only got a 70 on his final exams. Learning should equate into knowledge about your chosen subject.

I don't think CPC-A's should lose their credentials, they did work for them. But going forward the AAPC definitely has to elevate the standards. As someone suggested, maybe CPCs should be licensed just like plumbers or electricians. Maybe all states need to require either AAPC or AHIMA credentials for anyone who works with records. There are no easy answers, but ironically (someone posted that once you pass the bar exam you are a lawyer in comparison to CPC-As), I read in my local paper today that newly graduated law student who've passed the bar exam can't find jobs. Guess this isn't just a coder problem after all.


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## lnapoles@bellsouth.net

*Elimination of "A"*

Unfortunately, I just read this post too late. However, to me the designation of an "A" to our CPC Certification is ridiculous. I have 20+ years in the medical field and passed the exam in December with a score of 82% and I finished the exam an hour earlier. I already had one year dropped off because of my many years of proven experience. Unfortunately, I was laid off at the beginning of the year but I cannot apply for a position as a CPC-A because employers think I am not qualified even though I have been coding and since I was laid off, my previous employer cannot attest to the fact that I was coding for the company. So, now I am stuck with an "A" classification I do not deserve and it is very discouraging. I then have asked myself, "Why become certified, if I will not be recognized as a CPC?"  Employers are NOT hiring CPC's unless they have 3 to 5 years of coding experience. What really upsets me is that having to take a Clinical Exam and still have to pay. Those of us that worked so hard to become certified should not have to pay for the so called Clinical Exam. I am more than willing to take such exam but would rather wait until a decision is made by the AAPC. The CPC exam in itself was really nerve racking and it covered all the necessary coding questions.  Since, I was not able to respond to the cpc-acomment link in the article, I would appreciate it if someone would advise their final decision. I most certainly need to have the "A" dropped just like most of us who took the exam to better qualify ourselves in the medical/healthcare field this is why we need to keep up with the CEU's to demonstrate our knowledge. What more do they want?


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## chshaffer41@gmail.com

ghpkmp said:


> What nobody seems to be addressing is the fact that the majority of coders out there do not code from EVERY specialty.  My guess is that if you had every CPC (not CPC-A) have to code those 800 notes, they wouldn't succeed with the accuracy the AAPC requires.  It's very unfair to expect CPC-A's to be able to do that.
> 
> I inquired about it because I felt I'd gain valuable experience.  And certainly more experience than many CPC's.



ghpkmp,

Maybe in order for this program to be valuable to the "new" coder looking for the *experience*, there shouldn't be a requirement to pass the Apprentice Virtual Program with a grade. Maybe it should just be what an apprenticeship is designed for, *Experience*, something to add to the resume to prove that they are willing to learn whatever specialty they may be presented with.  The way I understand it, anyone who does an apprentice program, in other professions, usually does it with little, or no pay at all for this time of learning.  All I am proposing is that the AAPC consider continuing on with the the program, (with some of the changes that need to be done). The *coder* has to pay for it, not *get* paid to do it, and if that is something they want to per sue to further educate themselves, and something to put on a resume, it should be available to them. This program should not be a basis for eliminating a "status" by how well they score, but a certificate of completion to show their desire to grow, and  how serious they are about working in the field. I still believe it gives the coder a great, all-around, view of what they may expect in the "real world", and the types of notes they may encounter. And I feel it is alot of work, and deserves some kind of recognition-but it shouldn't be a *requirement* to eliminate the "A" status; maybe an option if the coder chooses to add to thier education.

  If a person passes the CPC exam, give them the CPC, minus the"A", status as a credential to build on. Then offer more specialized credentials, CPC-"x", for whichever specialty they wish to per sue, as well as offer them the Apprentice program, to further expand their education and possibly help them pick the specialty they might feel they are most interested in. I agree, most coders are *not* going to use every specialty, and I thought that was the idea behind having the CPC-P, CPC-H, and the various other specialty certifications. I think a potential employer can decide for themselves, based on the resume, if the coder is a fit for their company, and if they think the coder is someone they feel they can, or want, to train.

After reading many of these posts, and posting some of my own opinions, I am now seeing the whole picture this issue has presented. I really hope the AAPC finds a resolution that everyone can accept, and one that addresses the many concerns of those in the profession, as well as those ,like myself, who are new, and would just love an opportunity to prove they are very serious about working in this profession. We are not *all* just looking for a quick way to get a job to be paid big money, some of us have made some very big sacrifices to per sue this, and would just love a chance to prove ourselves. I do have to admit though, I am becoming quite dissapointed that this issue is still not resolved. I have followed this post since it started, and some time before that. I am getting to a point where I may have to go find another organization, where I might be able to move forward. I really do not want to, but I have spent enough time worrying about this, there comes a point when you just have to make a decision on what you need to do. I'll keep my fingers crossed!!


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## Pam Brooks

ghpkmp said:


> Pam, you're assuming that everyone who took the CPC exam, before the AAPC added the apprentice designation somehow had more knowledge and experience. How can that be true? Some, to be sure, but, certainly, not all. The only requirement before was experience, but that could have meant sitting in a job coding the same codes day in and day out. And if you've read any of the comments here, you'd know that many people who have lots of experience coding have failed the exam!!!!!!
> 
> Also, you seem to be under the impression that the test for CPC-A's is somehow different from the test for CPC's. Well, it's not. We all took the same test.
> 
> Absolutely "elevate the difficulty of the CPC exam" and make everyone re-test. That would be leveling the playing field. And you'd certainly weed-out the "huge glut of inexperienced (and unemployed) would-be coders."


 
I certainly do understand that the examination is the same for CPC-As as it would be for a CPC. And I'm not assuming that coders prior to the 'A' designation had more knowledge and experience. They absolutely did have more experience. What you may not realize is that previously, in order to sit for the CPC exam, you had to have at least 2-3 years experience in the field, as a coder/biller along with two letters of recommendation from your management or administrators (on company letterhead) that indicated you had experience and knowledge of CPT, ICD-9 and HCPCS, and were well prepared to sit for the exam. And that would mean that you had to do more than just code the same codes day in and day out, as you suggest would have been sufficient experience. Irregardless, two years experience within the revenue cycle is better than no experience that I see with a lot of coding apprentices. Someone in management had to vouch for your ability to do the work before you could even take the exam. That's because it is well recognized that coding is not an entry level job, and in order to be deemed a certified coder, you had to have that experience first. And once you had the CPC after your name, you had both the credential and the experience. It was an unfair disadvantage to allow coding students to sit, and then expect them to be able to be hired.

I also know that people with coding experience have failed the exam. (and it makes you wonder about the vailidity of their coding to begin with). But from an employer's perspective, the only way to gauge a coders' broad knowledge and understanding of the field is to ask for credentials. We license nurses and doctors, and while they may be fabulous practitioners, without that license, they are not physicians or nurses, whether or not they "test well". 

I do read the comments (and post quite a few myself), so I understand where many of the coding apprentices are coming from. Please don't assume I'm clueless about the plight of the new coders, just because I'm telling it from the point of view of a hiring manager.


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## pjwils15

I have a Certificate as a Medical Secretary, some medical office experience, recent graduation and certificate as an HIMT Coding Specialist from my local community college and recently passed the credentialing exam and have the designation of CPC-A. I can't get my foot in the door at all in my area. I am dismayed that people are not hiring CPC-A's, as most in the past were not credentialed at all but just received on the job training and were paid. If you became a CPC or CCS or whatever after two years or more of experience in the medical administrative field who gave you that chance? Who hired you with no experience so that you could become experienced? This is the quandry, no one can afford to volunteer two years of training to a physicians office or hospital in order to gain experience. Most professionals who are required to to and internship or apprenticeship are paid while gaining the experience they need to remove the apprenticeship designation. Medical Assistants are hired right out of college or school in physicians offices, hospitals, no experience even asked for. But somehow, someone going through the schooling and credentialing process for this type of work is not considered experienced enough to do the job. As a newly credentialed coder I expect that I will have to learn alot ON THE JOB, it is a no brainer how important this is. Now you are telling me after I have paid and passed this test that unless I have the required experience before a certain date I will be required to take yet another test at my expense? And if I cannot find a job  in this field, I am going to get this money where? Will it guarantee me employment with still no experience?I have not seen a job description yet that has included hiring anyone with NO experience, or entry level accepted.


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## mmorningstarcpc

pjwils15,

I beg to differ with your comment about internships being paid.  Physicians may be paid as they do their intership and residency, but most other  professions are NOT paid for internships.  I did a 13 week internship that was a mandatory part of my curriculum (many moons ago).  Not only did I not receive pay, I had to pay for that semester of college (as it was part of my education), AND I had to support myself during that time, as my place of internship was two hours from home.  (We only had three choices at that time for the internship).  I worked three jobs while going to college full-time, had a car payment and supported myself, so I do understand the dilema some people have.  In the long run, it was well worth the time, effort and money spent!!

And in case you are thinking I am one example, I am not!  I volunteer at a facility (not work related) and they have interns from all over the country.  Those interns are there for a semester of their college program, do not get paid, and have to pay their expenses as well.  Also, some trades have apprentice programs, and they may be paid, but I know of a couple people that apprenticed and they made minimum wage until their apprentice hours were completed. So while they did get paid something, it probably wasn't enough to support them, much less the family they had.

Again, I go back to what has been commented on many times.  It is up to each person to know the requirements of the program they are taking, as well as what the local area requires to get hired.  Then you make an informed decision on what will or will not work for you.  Its rough out there, but we are each responsible to only our self!  I am extremely happy with the sacrifices I made (again, many moons ago) to get to where I am today.

*pardon any typing errors, I was on my iphone!


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## Pam Brooks

None of the externships I am aware of in this area (for coders) are paid. Do any of the instructors on this board offer paid externships to their students? 
Who pays the salaries? The school or the physician?

There definitely are entry level jobs available. I have one open now, and I had nearly 30 applicants; most of whom had their CPC-A. The ones I did not consider were excluded for reasons other than lack of experience.

If a CPC-A applies for a job that requires 5 years experience, they are most likely going to be deemed unqualified. I have another position open for a coder that requries several years of experience, and most of the candidates have been doing this work for 10+ years. There is no way I would consider a coder right out of school for this position. 

The reason medical assistants are hired right out of school is because the work is relatively unrelated to revenue. Most physicians prefer to train their MAs "their way", and they are more comfortable supervising another clinical person. When it comes to coding and billing, physicians break out into a sweat--it's way outside their comfort zone and they typically turf that to someone else. Actually, I've worked as an MA. Coding is way, way more complicated. 

I think that you'll find that everyone who is relatively far along in their coding careers started out in very entry-level positions.
I was hired at a mental health agency with no experience after receiving an AS in Medical Office Management to answer phones and schedule patients, and eventually post payments, because the pay was so poor and the neighborhood and clientele so sketchy, that nobody else applied for the job! That's how I got my foot in the door. More than ten years later, I was a CPC.


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## lincomores

Ok...

I took a one year Coding/Billing program approved by the AAPC for the CPC certification...let me rephrase that: The diploma course was geared toward the CPC certification. I took, and passed (first go) my AAPC CPC certification exam. I became a CPC-A
Here is the AAPC's requirement for dropping the -A. (and as it was when I graduated in 2010 and as currently posted on the website)  Btw, I have worked for over a year in the EHR field.



> "Apprentice Removal: On-the-Job Experience
> 
> To remove your apprentice designation via on-the-job experience, you must obtain and submit two letters of recommendation verifying at least two years of on-the-job experience (externships accepted) using the CPT®, ICD-9-CM, or HCPCS Level II code sets. One letter must be on letterhead from your employer*, the other may be from a co-worker. Both letters are required to be signed and will need to outline your coding experience and amount of time in that capacity. Download our Apprentice Removal Template for easier submission. Letterhead and signatures are still required when using this template.
> 
> OR
> 
> Submit proof showing completion of at least 80 hours of coding education AND one letter, on letterhead, signed from your employer verifying one year of on-the-job experience (externships accepted) using the CPT, ICD-9-CM, or HCPCS Level II code sets.
> 
> Send proof of education in the form of a letter from an instructor on school letterhead stating the 80 hour course has been completed, a certificate/diploma stating at least 80 contact hours, or a school transcript.



One new requirement option now for dropping the -A designation is:


> Effective July 1, 2012, the CPC-A credential will no longer be granted. All current CPC-As would have their “A” removed by doing one of the following:
> 1. Getting at least one year of on-the-job experience no later than 12/31/2013, (helpful to those with a job and currently working towards that end)



My minimum 80 hours of coding education was counted "as"  one year experience (in "lieu of" one year's experience) towards my Apprenticeship.
That was the arrangement when I became "certified."
So, all I need to do, after July 1st 2012, is to submit my letter from that Institution as proof of one year experience.
Correct?


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## semaxwell1

This seems very vague _"on-the-job experience (externships accepted) using the CPT®, ICD-9-CM, or HCPCS Level II code sets"._

For some, this could mean just filling out billing forms checking off the same codes every day (small private practice, small specialty clinics, etc) to others who extensively work with codes by extracting them from large reports/charts of a variety of specialties (hospitals, ASCs, etc).

However, your resume, and hopefully your interview, will display what type of "experience" you have. With that, the potential employer can decide if you have the "experience" they are looking for.

But from reading some of these posts (here and other forums), it seems as if some employers won't even bother reading the resume if they see the scarlet "A" on it. Then it's the employer's loss and ignorance for doing that.


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## espressoguy

lincomores said:


> Ok...
> 
> IMy minimum 80 hours of coding education was counted "as"  one year experience (in "lieu of" one year's experience) towards my Apprenticeship.
> That was the arrangement when I became "certified."
> So, all I need to do, after July 1st 2012, is to submit my letter from that Institution as proof of one year experience.
> Correct?



The part you quoted about what happens after July 1st is just a proposal at this time. To the best of my knowledge nothing official has been stated. Based on the comments here and elsewhere, I would be surprised if the proposal goes into effect exactly as it was outlined in the January Coding Edge.

Even if it did, the new proposal makes no mention of substituting classroom for on the job experience, as is the case currently.


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## lincomores

espressoguy said:


> The part you quoted about what happens after July 1st is just a proposal at this time. To the best of my knowledge nothing official has been stated. Based on the comments here and elsewhere, I would be surprised if the proposal goes into effect exactly as it was outlined in the January Coding Edge.
> 
> Even if it did, the new proposal makes no mention of substituting classroom for on the job experience, as is the case currently.



The issue that I take is that the requirements now being considered are game changers for some of us.
We only needed one year of verified employment in the field.
The education was counted as satisfactory enough to constitute one of the two years of "experience" necessary.
If only one year is necessary at the possible July date, then those who have those minimum 80 hours should receive the benefit of that education"as advertised."
In other words, if the education is still being considered as constituting one year of experience today, why should that change in July?

Mind you, I've got my time in.
To consider those who have obtained the educational requirements and successfully passed the CPC Certification Exam as now needing to pass another exam and discounting their education is a tad unfair.


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## terrahbooks@yahoo.com

*Help*

I have been in a catch 22 for about a year. I passed my CPC at first attempt because I did go to school and study hard. I am not financially able to pay for yet another exam that will not gaurantee me employment. I have been out of work for some time so just renewing my certification was costly for me, but what choice did I have? Let my hard earned credential lapse and lose all that time and money already spent? I sent letters out to all medical offices and hospitals in my area asking to intern just for the experience but have had no bites. People want experience. I have the credential and schooling, but no on the job experience so no one wants to give me a chance even for free due to "liability" reasons. I can't help but feel scammed by a system designed to protect the veterans with job security. What do I do now? Can some experienced coders please offer some advise as to how to break into the field? I am one of those people on assistance that desperately wants my life back. I not only need employment, I want one so I no longer feel like a charity case. I am capable of working and should be. HELP!


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## simply_me1971

I'm not paying to renew my membership. I'm not paying to take another test. This is ridiculous. I passes this exam on the first try, not only this test, but also the NCICS (National certified insurance and coding specialist) test on the first try. Am I working in my field of study? NO!! With that being said, I am done!!


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## dfortner

*Credential Loss*

As others, I am a little distressed over the A elimination.  I have felt that it is not the "A" that has kept me from employment consideration, but rather the lack of experience.  I have applied for employment stringently since passing the CPC exam with minimal success.  I just do not have the "hands-on" experience.  Passing a 20 question exam is not going to give me this experience either.  Not to say that the exam would not be a beneficial experience, but to use it as a criteria for A removal and charge money for it, denigrates the credential.   In other words, fee for a service which does not expand time-in-grade or experience.

My biggest concern - losing my credential.  I worked very hard completing the AAPC independent study course, additional studying for and passing the exam.  Does this mean that if I don't complete one year and/or sit for exam, I will lose my credential?

Concerned


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## crhunt78

Has anyone thought about those students who graduate with a Bachelor's degree and then go on to get a Master's degree? Most students will graduate only to find out that they cannot find a job after they've completed 6-8 years of college and also have the tremendous burden of student loan repayments staring them in the face.  I think that, as coders, we have it easy.  We don't even have to have a college education to get a job yet we work with many professionals who have high level college educations.  I think the AAPC must hold us to a higher standard and if that means working as a coder for a year or taking two tests, then so be it!  Coders MUST be knowledgeable about the medical field and if a newly credentialed CPC goes into a medical office with no experience, they are going to be totally lost.  Especially if they went through a terrible program like I did.  I learned how to code on the job and through my own research and experience, not in class.  Real life is nothing like the AAPC certified classes that I have heard of or experienced myself.  Ask a newly credentialed CPC with no experience how to explain a consult clearly to a physician who has been practicing for 30 years.  I believe that we have to hold ourselves to a higher standard because of the field we work in.  We affect patients medical records for the rest of their lives and can potentially cost physcians their jobs if we teach them to code incorrectly.  I had to have a year of coding experience after I received my CPC-A and I think that was totally fair.  I worked hard to find a job and I worked hard to learn as much as I could while on the job.  I feel very strongly that we have to look at our careers just like any other student would look at a career.  When you are just starting out, you may have to start at the bottom and work your way up.  That's life!


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## mmorningstarcpc

terrahbooks@yahoo.com said:


> I have been in a catch 22 for about a year. I passed my CPC at first attempt because I did go to school and study hard. I am not financially able to pay for yet another exam that will not gaurantee me employment. I have been out of work for some time so just renewing my certification was costly for me, but what choice did I have? Let my hard earned credential lapse and lose all that time and money already spent? I sent letters out to all medical offices and hospitals in my area asking to intern just for the experience but have had no bites. People want experience. I have the credential and schooling, but no on the job experience so no one wants to give me a chance even for free due to "liability" reasons. I can't help but feel scammed by a system designed to protect the veterans with job security. What do I do now? Can some experienced coders please offer some advise as to how to break into the field? I am one of those people on assistance that desperately wants my life back. I not only need employment, I want one so I no longer feel like a charity case. I am capable of working and should be. HELP!



terrahbooks,

While I sincerely applaud your schooling and certification, I take issue with your comment about feeling scammed to protect veterans with job security.  Who scammed you?  Who promised you a job, was it the "veterans" or was it the school that wanted your money?  I think your anger and/or frustration is misplaced.  Many veteran coders have given advice for seeking jobs in previous posts, if you and the others would care to search for those posts.  I hesitate to offer advice again, as I think a lot of senior coders do, not because we don't want to help, but because we got tired of being trashed ALL the time for being "condescending, patronizing, etc."  We offered good, solid advice, but because a lot of newbies didn't seem to want to start at the bottom, or work for a billing service, or any of the other suggestions we offered (the same things that many of us "veterans" started with), we were continuously told that we were offensive, patronizing and condescending, demeening, among other things, some of them very rude as well.  I know many veteran coders and we have all worked very hard to get where we are.  There also seems to be a lot of newbies saying that with ICD-10, it will level the playing field.  This also is not entirely correct, as the veterans have the additional knowledge that most schools don't teach, and that is how the insurance and billing process works, how rule-making at CMS works, and many other things that won't change with ICD-10.  Yes, there will be some adjustments to some of those rules and practices, but for the most part, that kind of knowledge is learned on the job and by experience.  I don't want to start another debate here, but I personally think someone should have to have two years experience prior to sitting for your certification.  I believe many schools and courses have done many people a disservice (maybe not all) by "promising" you a job, working from home and making boocoo bucks.  Its really not fair.  I also know many veterans on here that have tried to offer the advice to check with some physician offices in your area and see if what the schools are promising is correct.  Talk to other coders (or those in any other profession you may be interested in) and find out from them what it takes to get hired in your area.  Also, not all veteran coders are able to assist newbies.  I have mentored several newbies in the past when I was able to, and my current employer has internship, but not everyone is in that position.  And just to let you know, I remember where I came from, I remember how hard I worked to jump to the next level!!

Again, Kudos on your education and initative!


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## nrichard

pamps76@yahoo.com said:


> None of this really makes ANY sense to me.  I graduated from an AAPC- approved 1 yr. rigorous coding school 1 yr. ago.  At the same time, I was/am pursuing an A.S. degree in Health Information Technology (will graduate in May and then take the RHIT exam).  I passed the AAPC certification exam as a CPC-A. I have been very diligent trying to get any experience to get rid of the "A" on the end.  I have tried to participate in the Apprentice program that AAPC offers, with the closest office being 45 minutes away from me and they had nothing available for me.  My question to ALL seasoned coders, hiring managers, etc.. is how do we gain experience (and therefore get rid of the "A" on our credential) if no one is willing to hire non-experienced coders???  You can't get experience if you don't have any experience!!! It is highly FRUSTRATING!!!!!  Passing the CPC exam was grueling in and of its self only to be "awarded" with a credential that means nothing...and even less than nothing if you have the scarlet "A' attached. Woopee, now I get to pay more money, and take yet another test to get rid of the "A".....and guess what, still no experience, so still NO JOB!!!!!
> 
> I am  highly-motivated and generally possess a positive attitude, but this whole thing really rubs me the wrong way!!!  Any thoughts or suggestions would be greatly appreciated!!  Happy New Year!!



You may want to check with AAPC and see if your degree class for RHIT can be counted as time towards your experiance. Back in "06" mine did. I didn't want to get the CPC-A
so I used my school (AAS HIM) they gave me one year of time for this (because of my class structure) and one year for my fist year of employment after finishing school.


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## rthames052006

*Well said my friend *



mmorningstarcpc said:


> terrahbooks,
> 
> While I sincerely applaud your schooling and certification, I take issue with your comment about feeling scammed to protect veterans with job security.  Who scammed you?  Who promised you a job, was it the "veterans" or was it the school that wanted your money?  I think your anger and/or frustration is misplaced.  Many veteran coders have given advice for seeking jobs in previous posts, if you and the others would care to search for those posts.  I hesitate to offer advice again, as I think a lot of senior coders do, not because we don't want to help, but because we got tired of being trashed ALL the time for being "condescending, patronizing, etc."  We offered good, solid advice, but because a lot of newbies didn't seem to want to start at the bottom, or work for a billing service, or any of the other suggestions we offered (the same things that many of us "veterans" started with), we were continuously told that we were offensive, patronizing and condescending, demeening, among other things, some of them very rude as well.  I know many veteran coders and we have all worked very hard to get where we are.  There also seems to be a lot of newbies saying that with ICD-10, it will level the playing field.  This also is not entirely correct, as the veterans have the additional knowledge that most schools don't teach, and that is how the insurance and billing process works, how rule-making at CMS works, and many other things that won't change with ICD-10.  Yes, there will be some adjustments to some of those rules and practices, but for the most part, that kind of knowledge is learned on the job and by experience.  I don't want to start another debate here, but I personally think someone should have to have two years experience prior to sitting for your certification.  I believe many schools and courses have done many people a disservice (maybe not all) by "promising" you a job, working from home and making boocoo bucks.  Its really not fair.  I also know many veterans on here that have tried to offer the advice to check with some physician offices in your area and see if what the schools are promising is correct.  Talk to other coders (or those in any other profession you may be interested in) and find out from them what it takes to get hired in your area.  Also, not all veteran coders are able to assist newbies.  I have mentored several newbies in the past when I was able to, and my current employer has internship, but not everyone is in that position.  And just to let you know, I remember where I came from, I remember how hard I worked to jump to the next level!!
> 
> Again, Kudos on your education and initative!



Very well put Machelle! I do believe you speak for the vast majority of us "seasoned/veteran" coders.  

Kudos to you for speaking up!


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## krisfelty

I really am apprehensive to chime in on this thread/subject however, I will. I was in the field for about 10 years before I was interested in coding. It was not until then that I decided to go and become certified. That is the way it should be. You have to learn all aspects of the medical field and insurance and laws, regulations, etc. before just "taking a test" to become a credentialed coder. Most of the people who cannot break into the field are those who decided to get into this field thinking they would make quick, lucrative cash. You have to love a profession/field or calling before you go into it and call it your own or make a living from it. This, I believe, is where the difference is. How do you know you want something that you have never done before? Just because you MAY get to work from home (which is not always what is is cracked up to be) or to make 50,000.00 a year. It takes many , many years of blood, sweat and tears to get where you want to be, not just three little letters after your name. 
Those who are certified, even with the A after it, Don't give up! Keep looking, learning and by all means, do not let your credential go. 

Sincerely, 

Kristin Felty CPC, CCC, CCVTC


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## Dabzzy

*CPC-A designation*

I've had my "A" for almost 3 years. I went back to school in the Health Information Technology program at my college because there weren't any coding jobs, they were outsourcing, or they wanted 2-3 years experience. (Although, I think passing the certification exam should count as partial experience.)
I had planned on taking the 800 question online exam when I finished my classes. But after learning about this exam, I was thrilled. I realize that a 90 percent will be required to pass, but I feel I have a better chance of doing so now then when I took the certification exam. The first coding classes I took weren't nearly as detailed as the ones I'm taking now. I hope this goes through.


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## tracy.ellington@yahoo.com

*What word of encouragement could AAPC forum offer to CPC-A's in the meantime....*

until I/we get a job? Keep taking the online CEU requirement courses, taking classes like Medical Terminology, Anatomy, Billing and list them on my resume when I/we pass the exams/tests as I/we go along? Would that help potential employers to see my/our effort in continually training myself as well as showing them that I/we will continue to do what it takes to get a job in the healthcare field? I've browsed through alot of earlier responses and can understand the frustrations as I've been looking for and applied for some jobs, even entry level positions and have yet to get one phone call from anyone. Seems like a lost cause when I've emailed externship program contacts listed on AAPC, actually one email came back as ''invalid email address'' and sent an email to another and got no response since Jan, to get some advice on where I should start. I tried to do some online research for billing service agencies in Ark and not much found on Google. Just a constant search with no results. Not sure if local hospitals or clinics offer ''unpaid'' training for someone like myself who have no experience in a healthcare setting. Almost feel like giving up but my only support is from my family who continue to encourage me. I work/drive 30 min from home M-F and by the time I get home most hosp/clinic offices are closed for the day. What to do, what to do? Huh, just need some encouraging word and an ''it's gonna be okay!''


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## nicholasjwolf

*Status?*

Is the July 1st date, and set requirements for apprentice status removal, still set to take place? What is the status of this issue? Thank you in advance for any information. -Nick



semaxwell1 said:


> The following is a shortened version of an article from the AAPC Coding Edge magazine January 2012 issue written by Reed E. Pew, AAPC Chairman and CEO.
> 
> Effective July 1, 2012, the CPC-A credential will no longer be granted. All current CPC-As would have their “A” removed  by doing one of the following:
> 1.  Getting at least one year of on-the-job experience no later than 12/31/2013, (helpful to those with a job and currently working towards that end)
> 2.  Successfully passing a clinical exam consisting of coding 20 operative/office notes.
> 3.  No current CPC-A would be grandfathered into the CPC credential.
> 
> Those taking the CPC exam after July 1, 2012 will have two ways to get their CPC credential:
> 1.  Have one year of coding experience prior to taking the CPC exam with proof given at the time of the exam, and then pass the CPC exam or
> 2.  Pass both the CPC exam and a clinical exam by coding 20 operative/office notes.
> On the job experience after taking the CPC exam will not be required. It does not matter in which order the two exams are taken.
> 
> The clinical exam will include a sampling of office visits, surgical notes, E/M coding, ancillary services, modifier usage, and diagnosis coding. A 90% pass rate on the clinical exam will be required and will be determined by correctly coding 18 of the 20 notes. The clinical exam will not be multiple choice, it will be free form and hand graded. The same 5 hours and 40 minutes time restriction and code books will be allowed, and the clinical exam can be taken at any AAPC proctored exam site.
> 
> Both exams will be paid for at the same time and the cost for both exams will increase by $35. Applicants may still take each exam twice to pass it. If the examinee already has one year experience, then he or she would pay only the CPC exam price. If one exam is passed after two attempts, but not the other, then the fee for the exam not passed would be paid to retake it.
> 
> Of course, current CPCs are not affected by this change. We would appreciate comments to this important change to our credentialing program through 1/31/2012. You may go to www.aapc.com/cpc-acomment to submit your comment. From those comments, we will either proceed ahead, make modifications that strengthen the change, or slow down the change due to legitimate concerns that AAPC has not properly considered.​
> 
> To me this sounds promising. Though I'm not looking forward to spending a total of over 11 hours of testing time and paying for two exams, but whatever it takes and hopefully it'll better help me reach my goals. I'm not fond of the $35 increase of the CPC exam price, and they don't mention how much the clinical exam will be, either.
> 
> I'm presuming AAPC has terminated the "Virtual Experience: Apprentice Removal" program. I was seriously thinking of signing up for that, but now am glad I didn't. I feel badly for those that started that program and were unable to complete it because AAPC brought the program's website down sometime last year. I would hope AAPC would recognize those that started it and give them some sort of credit towards this new clinical exam, at least financially.


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## espressoguy

The AAPC has decided to not make a change at this time.


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## cingram

Just keep with it everyone. I just got my "A" removed this past week. I took my CPC right out of school then took me 5 months to find a job. 1 of them that I landed required 5 years expierence. once you get the interview you really have to nail it. There are jobs out there even if you have the "A" most seasoned coders want more than the employer is willing to pay.


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## bedwards

Reed's message in the most recent Coding Edge will answer your questions.


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## semaxwell1

nicholasjwolf said:


> Is the July 1st date, and set requirements for apprentice status removal, still set to take place? What is the status of this issue? Thank you in advance for any information. -Nick



The answer was from the March 2012 Coding Edge. Here's the thread.

"CPC-A Elimination?" from March 2012 Coding Edge 
https://www.aapc.com/memberarea/forums/showthread.php?t=69065


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## PVAzCPC

I got an email on 3/15/12 from AAPC's News & Updates, explaining that no changes would be made to the current CPC-A policy...this is the article:

CPC-A® Designation to Continue... For Now
At the recommendation of the National Advisory Board (NAB), AAPC leadership released a proposal in January to eliminate the "A" designation. As a result, we received hundreds of comments from members and spent a good deal of time carefully reviewing each of them.
67% did not agree with the proposal, surprisingly including many CPC-As. Of the 33% that did agree, a large percentage wanted to see modifications to the proposal made first, yet many of those recommendations conflicted strongly with other comments. Notably, there appeared to be little appetite for an additional exam of operative note coding.

While we still believe a resume indicating the experience level of an individual should speak for itself, AAPC expects CPC® coders to be able to perform not only in an exam setting but also demonstrate coding experience (or an ability to code real-world cases) before receiving the full CPC® credential.

Consequently, until an alternative solution can be developed to eliminate the "A" designation, yet still preserve the standards the CPC® represents, the CPC-A® designation will continue... for now.


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## nicholasjwolf

*Thank you.*

Thank you for the replies on the current status of the issue. Personally, I had hoped for some kind of exam that simulated real-life coding challenges to remove my "A", but I now realize that you really can't substitute for real life experience. ICD-10 is coming, the demand for our skills isn't going anywhere.


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## JeMc1258

I am right there with everybody else -- options for experience are hard to come by.  I still have 6 months to prove to AAPC headquarters despite possible already having put in the time.

Stuck working for free as a Hospital Volunteer as everybody seems to want the full CPC or higher.  If not CPC, AHIMA certification seems to be requested along with previous experience doing the same exact job function.

Front Desk positions  -- no such luck there.

-----------------------------------------------
RE: Virtual Experience

I was working on that until I ran into some snags with regard to not enough information to even figure out the correct code(s) to use.  Would have been nice to have been able to submit each case separately.  

Anyway -- I suppose now I will just forge ahead until something opens up.


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## JeMc1258

You did not miss anything by not attempting the Virtual Experience.

I had started it but was struggling with some of the categories prior to the option being removed.

------------------------------------------------
I also decided to go back to school -- *DeVry / Keller online, Health Services Management:  Certificate* and maybe a full Master's Degree.  My "A" was removed right before I started classes in July of 2012.

Keep Volunteering and Networking!  It will pay off in the long-run.
---------------------------------------------------------------------------
Now I have to prove to the Department of Labor that I am still eligible for Unemployment.


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## gared111

Personally, I like the Apprentice indicator.  As someone who has trained my fair share of CPC-A's right out of school, I feel it is warranted.  Someone right out of school who has passed the test may have the basics, may have passed the test with flying colors, but real life experience is the most important factor in my experience.   I understand the quandry Apprentices are in trying to find jobs, but coders without practical experience aren't anywhere near as effective or accurate as experienced coders.  I'm sorry, but that's a fact.  

Rather then having the Apprentice indicator, I think 2 years experience should be required prior to obtaining the certification.  I've been certified for going on 10 years now, so I don't recall exactly what was required of me, but it seems to me I recall needing my employer to verify that I had two years coding experience.  I feel that needs to remain in effect if you're getting rid of the Apprentice indicator.

The most successful coders I know have started off as billers so that's where I would recommend getting your start if you're having a difficult time finding a coding job.  That billing knowledge really helps with the coding in my opinion, and having that coding base helps greatly when doing billing.  I've hired a ton of billers with no experience, and they generally do fairly well, and several have gone on to become sucessful coders.

I want my CPC designation to mean something.  As it is now, the AAPC has so many certifications that it's becoming somewhat of a joke.   The AAPC needs to consolidate them.


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## bedwards

I agree with the majority of your post and would like to clarify one thing.

The specialty credentials are in place to show advanced knowledge as indicated on the website:

Designed for experienced coders, the AAPC's specialty credentials enable coders to demonstrate superior levels of expertise in their respective specialty disciplines. These specialty credentials are stand-alone certifications with no requirement to hold the CPC® credential. They allow coders to validate their knowledge in a specialty with unique coding, reimbursement and compliance challenges. 

I also agree with you that my credentials mean something-this is my career, my profession and I take it very seriously.  I  don't believe the specialty are taking anything away from our core credentials.

Have a great weekend!


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## coderbert

You would make a good AAPC pres.


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## a.floyd@att.net

I couldn't agree more. I took this exam in 2004 and passed but due to financial issues couldn't maintain the fees and CEU's and subsequently lost my credentials. This was an extremely HUGE blow after working so hard to obtain it. After many years in the industry/field, and dreaded to sit for the exam again I decided to get back what I know I had earned even if it meant being drug through the mud again. I took the exam and passed only to now have an "A" attached to my credentials. It certainly seems there could be a better merit system for basing ones expertise..... I know maybe a 5 1/2 hour, rigorous exam.


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## CodingKing

a.floyd@att.net said:


> I couldn't agree more. I took this exam in 2004 and passed but due to financial issues couldn't maintain the fees and CEU's and subsequently lost my credentials. This was an extremely HUGE blow after working so hard to obtain it. After many years in the industry/field, and dreaded to sit for the exam again I decided to get back what I know I had earned even if it meant being drug through the mud again. I took the exam and passed only to now have an "A" attached to my credentials. It certainly seems there could be a better merit system for basing ones expertise..... I know maybe a 5 1/2 hour, rigorous exam.



You automatically get the A after the test is passed. You just need to send in the documentation showing the 2 years work experience and it will be removed. You have the experience its just a formality once you re-certify. It takes a couple weeks for them to remove the A

PS. the 5.5 hour exam isn't enough as its not real world coding. That's why AAPC wants the real world experience to back it up. There are many professions where you become an "apprentice" first. You know, kind of like a doctor and their residency, of course its not a letter after their credential but its pretty much the same process?


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