Questions about Medical Coding/Billing Certification

My wife asked me to pose a couple of questions to the SDMB regarding certification for medical coding/billing, so here goes. I would love to hear your thoughts, and especially from those of you who work in the medical administration field in the USA.

My wife has done medical coding/billing in the past, but has been out of that world about 15 years or so. She is looking at trying to get back into it, especially if she could work from home. However, most of the positions she has seen require medical coding or billing certification. She is exploring the possibility of signing up for a certification program, but the cost seemed rather high to me. The online school she was looking at has a cost of $27,000. (I am hoping that this was a typo, and that the cost is closer to $2,700; I will be double-checking with her to make sure that I didn’t misread something.)

From those of you with experience in this field, is $27,000 excessive for an online course for certification? It seems really expensive to me. I tried to spot-check certification costs for other online schools as well as looking at the costs for other certifications such as the Microsoft Certified Software Developer, and the costs appear to be much, much less (closer to $2,000 – $4,000). What did it cost you to get the medical coding/billing certification?

I have used the term “medical coding/billing”, although I believe they are actually two separate certifications. Is one preferred over the other? If she only gets one to begin with, which would be the best one to get before getting the other one?

If certification is really necessary (which it appears to be since it is being used as a weeding-out factor), what online schools would be recommended? I am trying to make sure she isn’t getting scammed by an online for-profit “university” that exists solely to get students to keep taking classes.

For those of you who have such certifications, did having the certification help you find a job in the field? I realize that merely having the certification is not a
guarantee for finding a job, but I am trying to help her do the cost/benefit analysis.

Also, how often will she need to be re-certified?

First, that’s a ridiculous price and I would only consider it for someone totally new to the field. The AAPC offers a CPC Test Prep Boot Camp for around $1K. Have her look around on the AAPC website – I’m sure she can find a better deal.

ICD-10 and HIPAA will be the biggest things for her to review, since they are new since she was in the field. ICD-10 is a huge change, the structure is totally different to ICD-9. That said, I can’t see a reason for her to do a full new course. You don’t forget how HCPCS work – no huge changes. She should buy the current HCPCS and CPT books, and the ICD-10, and do some practice tests. What she does not do well on will tell her what she needs to review.

You can also find a CPC test reviews and lectures/demos on youtube.

Background: I have been working with CPT, HCPCS, ICD, and revenue codes for 20+ years, but never got my certification. I’m getting it so we have a second CPC in my division. The only thing I’ve really had to do is to learn ICD-10 better.

Good luck to your wife!

ETA: you have to take CEUs annually to retain your CPC designation. She can also expand her billing/coding background into practice management and auditing, which you can also read up on at the AAPC website.

GrumpyBunny, thank you for the details. I will pass this post on to milady.

Yes, the price is absolutely ridiculous. A friend of mine took the courses last winter and was certified this summer; there is no way in bloody blue hell she could have afforded that kind of tuition.

She took her courses through a local hospital that is constantly offering them and hiring the best of each crop straight away. It is a small, independent hospital, not a mega-medical conglomerate, but look into your local health providers to see if anyone near you does something similar.