Wiki Certification

[cingram]

Is it true that sometime in the next couple of years that healthcare facilites will have to have a certified coder?

 

[JG24]

While nothing has been mandated yet by any organization (CMS, HHS or OIG), I would not be surprised if they don't mandate certifications to code in any area. In light of the fact that we are seeing more audits from all insurance carriers, doctors who are audited and found to have compliance issues with billing matters may be forced to hire a certified coder as part of the Corporate Integrity Agreement if the Office of the Inspector General is involved. I realize that there are a lot of "self-trained" coders in the field now but as the laws get tougher and the insurance carriers perform more and more audits, it not only works to a physician's advantage to have a certified coder but it also helps the coder if they are questioned as to why something was billed the way it to have training and certification. Also with the coming transition to ICD-10, I believe that certification will be even more valuable.