The American economy has weathered some rough waters throughout the last few years. While medical coders are not immune to the effects of a turbulent economy, these professionals fared pretty well compared to other occupations. According to the U.S. Bureau of Labor Statistics (BLS), the seasonally adjusted unemployment rate reached a high of 10.1% in September 2009.(1) In comparison, the American Academy of Professional Coders (AAPC) 2010 Salary Survey revealed that only 6.8% of medical coders with Certified Professional Coder (CPC®) certification were unemployed in the previous year.

What Is Employment Like for Medical Coders?

As you learn more about the medical coder field, you may be looking for more detailed insight, such as the top method used to find a job and what types of employment benefits are offered. The following statistics provide a closer look at medical coding employment as reported in the AAPC 2010 Salary Survey:

The BLS reports that job prospects for medical records and health information technicians, which include medical coders, appear to be good in the coming years. Employment rates for this field are actually expected to increase 20% between 2008 and 2018, which is much faster than the average for all occupations.(5) Even in this slowly recovering economy, the job outlook and employment benefits for medical coders with relevant training and certification still seems to be positive.

1 U.S. Bureau of Labor Statistics. Databases, Tables & Calculators by Subject. “Labor Force Statistics from the Current Population Survey: Seasonally Adjusted Unemployment Rate”; data extracted October 31, 2011. < http://data.bls.gov/timeseries/LNS14000000>.
2 U.S. Bureau of Labor Statistics. Occupational Outlook Handbook, 2010-2011 Edition. “Medical Records and Health Information Technicians.” <http://www.bls.gov/oco/ocos103.htm>.

Medical Billing and Coding Blog is sponsored by Ultimate Medical Academy (UMA), a leading healthcare career school. UMA has campus locations in Tampa and Clearwater, Florida, as well as online programs available to students nationwide. For more information, including details on UMA’s medical billing and coding training and degree programs and medical office and billing specialist diploma program, please visit http://www.ultimatemedical.edu.

On the one year anniversary of President Obama’s milestone healthcare bill (Patient Protection and Affordable Care Act), House Minority Leader, Nancy Pelosi, shares her thoughts on the positive impact the bill has made and will continue to make on job growth, job opportunities and overall quality of life for middle class Americans:

What are your thoughts on the healthcare reform act now that it has been in place for a year? What is your hope for the future of healthcare and the impacts it’ll make on your career and in your life?

As a rule, medical biller and coders spend a lot of time researching codes, coding regulations, and ways to continue their billing and coding education in order to stay current and relevant in the field.

With that in mind, we’ve created a list of TOP 5 sites for billing and coding professionals. Even as a student, you may want to familiarize yourself with these sites – eventually, you may need them once you start working in the field!

Make sure to let us know what you think of our list. Are we missing an important link? Is one of these links one of your most useful resources? Your input could help your fellow biller and coders.

1. Centers for Medicaid/Medicare Services (CMS) | http://www.cms.gov
From this link you can find information on the CERT program, a glossary of MBC terms, information on ICD10, the Medicare claims processing manual, and other helpful information.

2. American Academy of Professional Coders | http://www.aapc.com
AAPC is the nation’s largest training and credentialing organization for the MBC professionals. Here you can find information on getting certified, becoming involved in regional groups, completing continuing education requirements, and more. If you want to be certified, start here.

3. Codapedia | http://www.codapedia.com
In a “Wikipedia” like effort, Codapedia is a free resource of coding and reimbursement information collected and organized by the volunteer efforts of professional practice administrators, physicians, consultants, coders, health professionals, and dedicated individuals.

4. The Coding Institute | http://www.codinginstitute.com
This is a great site for continuing education and professional resources. You’ll definitely want to check out the “SuperCoder” section where you can access code look-up tools, books, and print and electronic newsletters.

5. BC Advantage Magazine | http://www.billing-coding.com
Although you cannot access all the features of the site without a paid subscription, it may be worth the expense. Here you can find CEUs, discussion forums, job postings, workshops, articles and more.

MBC Blog Editor’s Note: We are happy to introduce our newest contributor, Merrilee Severino, CPC, CMM. She is a member of the Ultimate Medical Academy advisory board and is considered an MBC expert with over 20 years of experience in varying fields and specialties. We feel excited and privileged to have her contribute her professional opinions and experiences to our blog. Look for more blog posts from her in the coming weeks.

An Introduction to Prolonged Services

Lack of understanding and fear of the prolonged service codes is the main cause of improper billing of them.

I am certain that after reading this series of articles, my tips will provide you a clear understanding of how and when to use these codes and that you will begin to utilize them when applicable. This is part 1 of 2; check back in two weeks for part 2.

Defining Prolonged Services

A service becomes eligible as a “prolonged service” when a provider spends 30 minutes or more beyond the AMA’s average time with a patient for a given E/M (evaluation & management) service. The prolonged service code range is 99354 – 99357.

Documentation Is Key

Prolonged service codes are all add-on codes. This means that you cannot bill these codes without a documented E/M service and without documenting time spent with the patient. Documentation and reporting problems are the main reasons physicians fail to capture prolonged services revenue. So be meticulous in your documentation of time and necessity.
Proof of your time is integral to billing prolonged services. Without an actual minute value recorded in the patient’s record, you cannot code prolonged services no matter how much time is spent with the patient.

It is important to note that only physician face-to-face time spent with the patient qualifies; staff time does not count toward it, waiting for results does not qualify, but the time can be cumulative. A physician, a nurse practitioner or a physician assistant can bill for prolonged service.

Prolonged services documentation should be kept in the medical record as it does not need to be submitted to the insurer unless requested for review.

Documentation requirements for E/M services can be located and downloaded from the CMS website here.

Because documentation of time spent and context is so important, you may need to educate your provider of service on these issues as well on how and why you utilize these codes.

For specific examples on using the Prolonged Services codes and for a table of Prolonged Services CPT codes, check back in for part 2 of this series.

Merrilee Severino, CPC, CMM

Merrilee Severino, CPC, CMM is the CEO of MS Physician Practice Management and Revenue Consulting in Florida. She has over 20 years of experience in varying fields and specialties and is on the board of directors at Central Florida College. She can be contacted via email mimi2331@earthlink.net.

The Bureau of Labor Statistics has some pretty exciting statistics for medical billing and coding professionals: they’re earning about $3.00 more than the national hourly average for healthcare support occupations and about $7,000 over the national average for yearly salary within the same category¹.

Medical billing and coding also stacks up well against other careers in the allied health field:

Growth in the Medical billing and coding career is also strong, expected to grow by 20% in the next eight years².

The Bureau of Labor statistics remains the definitive source for an accurate snapshot of employment and earning in the U.S. today, but for our working biller and coders: how do these numbers compare to what you’re currently experiencing in your workplace?

¹ U.S. Bureau of Labor Statistics: National Occupational Employment and Wage Estimates
United States, May 2009 Edition: http://www.bls.gov/oes/current/oes_nat.htm#29-0000

² U.S. Bureau of Labor Statistics: Occupational Outlook Handbook, 2010-11 Edition: http://www.bls.gov/oco/ocos103.htm

When Healthcare Management Consultants was founded in Ohio back in 1949, it was one of very few healthcare management consulting companies in America. Today, members of two professional organizations for healthcare consultants (The American Association of Healthcare Consultants and The National Society of Certified Healthcare Business Consultants) can be found in every state in the nation.

Why has the business of medical practice consulting grown? There are a few reasons:

Running a medical practice has become more complicated. There are many reasons, including:  the increasing complication of filing insurance claims, the need to manage accounts receivable, the need to comply with OSHA and other regulations, and the necessity of keeping liability insurance coverage in place.

It has become more difficult to focus on the quality of patient care. Medical practice consultants can help busy medical offices preserve the quality of the relationship between caregiver and patient.

Physicians have learned that they can earn more money when their practices deliver care to more patients. This can involve: hiring additional front-desk staff, adding additional care rooms, and hiring support specialists to take blood pressure, do cardiograms, and perform other functions that may not require direct physician care. Medical practice consultants can analyze a medical practice and recommend which of these changes to apply.

And medical practice consultants can review office operations in other ways too. Here’s a list of services offered today by Healthcare Management Consultants Inc. (partial listing):

-  Billing Systems

-  Front Office Training

-  Interim Management

-  Managed Care Systems

-  Management Reorganization

-  Medical Practice Development and Management

-  Operational and Quality Improvement

-  Organization, Administration, Management, and Governance

-  Patient Care Delivery Systems Development

-  Patient Safety Training

-  Regulatory Compliance

-  Revenue Cycle Management

-  Strategic Planning and Marketing

So, where do medical billers and coders fit in the delivery of those services?  The answer is, just about everywhere. As medical offices become more efficient, the demand for billers and coders seems sure to rise. It’s another reason why the outlook for the profession looks so strong today.

When Healthcare Management Consultants was founded in Ohio back in 1949, it was one of very few healthcare management consulting companies in America. Today, members of two professional organizations for healthcare consultants (The American Association of Healthcare Consultants and The National Society of Certified Healthcare Business Consultants) can be found in every state in the nation.

Why has the business of medical practice consulting grown? There are a few reasons:

Running a medical practice has become more complicated. There are many reasons, including: the increasing complication of filing insurance claims, the need to manage accounts receivable, the need to comply with OSHA and other regulations, and the necessity of keeping liability insurance coverage in place.

It has become more difficult to focus on the quality of patient care. Medical practice consultants can help busy medical offices preserve the quality of the relationship between caregiver and patient.

Physicians have learned that they can earn more money when their practices deliver care to more patients. This can involve: hiring additional front-desk staff, adding additional care rooms, and hiring support specialists to take blood pressure, do cardiograms, and perform other functions that may not require direct physician care. Medical practice consultants can analyze a medical practice and recommend which of these changes to apply.

And medical practice consultants can review office operations in other ways too. Here’s a list of services offered today by Healthcare Management Consultants Inc. (partial listing):

• · Billing Systems
• · Front Office Training
• · Interim Management
• · Managed Care Systems
• · Management Reorganization
• · Medical Practice Development and Management
• · Operational and Quality Improvement
• · Organization, Administration, Management, and Governance
• · Patient Care Delivery Systems Development
• · Patient Safety Training
• · Regulatory Compliance
• · Revenue Cycle Management
• · Staff Recruitment
• · Strategic Planning and Marketing
• · Team Building

So, where do medical administrative assistants fit in the delivery of those services? The answer is, just about everywhere. As medical offices become more efficient, the demand for medical assistants seems sure to rise. It’s another reason why the outlook for the profession looks so strong today.



When Healthcare Management Consultants was founded in Ohio back in 1949, it was one of very few healthcare management consulting companies in America. Today, members of two professional organizations for healthcare consultants (The American Association of Healthcare Consultants and The National Society of Certified Healthcare Business Consultants) can be found in every state in the nation.

Why has the business of medical practice consulting grown? There are a few reasons:

Running a medical practice has become more complicated. There are many reasons, including: the increasing complication of filing insurance claims, the need to manage accounts receivable, the need to comply with OSHA and other regulations, and the necessity of keeping liability insurance coverage in place.

It has become more difficult to focus on the quality of patient care. Medical practice consultants can help busy medical offices preserve the quality of the relationship between caregiver and patient.

Physicians have learned that they can earn more money when their practices deliver care to more patients. This can involve: hiring additional front-desk staff, adding additional care rooms, and hiring support specialists to take blood pressure, do cardiograms, and perform other functions that may not require direct physician care. Medical practice consultants can analyze a medical practice and recommend which of these changes to apply.

And medical practice consultants can review office operations in other ways too. Here’s a list of services offered today by Healthcare Management Consultants Inc. (partial listing):

• · Billing Systems
• · Front Office Training
• · Interim Management
• · Managed Care Systems
• · Management Reorganization
• · Medical Practice Development and Management
• · Operational and Quality Improvement
• · Organization, Administration, Management, and Governance
• · Patient Care Delivery Systems Development
• · Patient Safety Training
• · Regulatory Compliance
• · Revenue Cycle Management
• · Staff Recruitment
• · Strategic Planning and Marketing
• · Team Building

So, where do medical administrative assistants fit in the delivery of those services? The answer is, just about everywhere. As medical offices become more efficient, the demand for medical assistants seems sure to rise. It’s another reason why the outlook for the profession looks so strong today.

In Getting to Yes, his classic book on negotiating, Roger Fisher writes: “Like it or not, you are a negotiator. Negotiation is a fact of life. You discuss a raise with your boss. You try to agree with a stranger on a price for his house. . . . Everyone negotiates something every day.”

Fisher, who founded the Harvard Negotiation Project, was right. When you stop and think about it, you realize that you are probably negotiating for something every day . . .

-     Can you work on a flextime basis, instead of logging in and logging out at regular hours?

-     Would your company consider setting up an in-house daycare center for employees’ children?

-     Will your husband or wife cook dinner for your family tonight, so you can go to the gym on the way home?

-     Can you take on a bigger job – the one that a departing colleague just vacated?

When you are about to discuss questions like those, it is tempting to think that you are about to enter into conflict, not into conversation. According to Fisher, that is a mistake. He writes that it is better to practice something that he calls Principled Negotiation – an approach in which both parties look for areas of mutual gain.

Here are the four principles of Fisher’s approach . . .

-     Separate the people from the problem. For example, set aside the fact that you don’t like your office manager and that you want to score a win against her. Remember that when you negotiate, you will come to a better agreement if you focus on issues, not personalities.

-     Focus on interests, not positions. Instead of saying, “I need flextime, period,” discuss your underlying reasons for needing it and invite the other side to express its interests too. When you strive to make a situation better for both sides, you are more likely to make progress toward your goals.

-     Generate a variety of options before coming to an agreement. Yes, it is tempting to seize upon the first agreement that you and the other party find. But is it really the best solution? According to Fisher, you need to do the hard work to develop several solutions to any negotiating problem – and then pick the best of them. After all, it is possible that the third solution you hit upon will be the best.

-     Make sure that your agreement is based on objective criteria. You will stick with your flextime schedule after a month of evaluation to make sure your productivity remains strong, for example. Or your promotion will become permanent if you improve your department’s output by 10 percent. When you develop objective ways to evaluate the results of your agreement, you make it more attractive for the other side to agree to what you want – and you keep the door open for later negotiations of the agreement does now work out as well as you hoped it would.

Medical Billing and Coding Blog is sponsored by Ultimate Medical Academy (UMA), a leading healthcare career school. UMA has campus locations in Tampa and Clearwater, Florida, as well as a national online program.  For more information about UMA please visit our website at www.ultimatemedical.edu

You have to get down to work. You have to sit down to study. But instead, you make another a cup of tea, chat with a friend, or shop online.

We all do it, because procrastination is one of life’s guilty little pleasures. But if procrastination becomes a habitual pattern, it can add a lot of stress to our lives.

So, do you procrastinate? According to the book Good Stress, Bad Stress, these could be the underlying reasons:

Cumulative procrastination – If you’ve let your work pile up, it becomes harder and harder to attack it.

Perfectionism – If you’re worried that you cannot handle certain tasks well, you tend to avoid them.

Conflict avoidance – If you fear that tacking a certain project will trigger disagreement with your boss or a colleague, you tend to avoid it.

Here are some procrastination-fighting techniques for medical billers and coders recommended by Barry Lenson, author of Good Stress, Bad Stress:

Tackle unpleasant tasks first thing in the morning. If you’ve been delaying a touchy conversation with your boss or a colleague, have it as soon as you arrive at work. Tackling dreaded tasks first gives you energy that can boost your productivity through the day.

Say, “I’ll work on it for just five minutes.” This tactic works especially well if you have let work pile up. When you make just a small commitment to start on a backlog of work, you break the logjam and get going.

Work with a partner. Take a batch of coding work, divide it up with a colleague, and get started. (And offer to share his or her work in the same way.) When you cooperate on a body of work, you stand a better chance of whittling a pile of work down to size. Cooperation is fun and energizing.

Have you found strategies for fighting procrastination? If so, why not take a moment and share them here with other readers of Medical Billing and Coding Blog?

What’s the best way to project a completely professional image in job interviews? According to Debra Benton, one of America’s leading executive coaches, you need to pay close attention to all the small things that add up to create your image.

“Little things mean a lot when it comes to making important impressions,” Benton tells Medical Billing and Coding Blog. “A traditionally professional bearing shows respect to people in the company and the organization as a whole.”

Debra Benton’s advice for interviewing women . . .

-     Dress in a dress, slacks or a jacketed skirt.

-     Don’t wear jeans, even designer ones.

-     Wear close-toed, low-heeled shoes or flats, not today’s sexy, popular platforms.

-     Pull your hair off your face and out of your eyes, and don’t play with it during the interview.

-     Show no cleavage or upper thighs, because your clothes shouldn’t be more interesting than you are.

-     Don’t wear noisy bracelets or distractingly dangly earrings, despite today’s fashions.

-     Cross your legs at the ankle rather than at your knee to avoid a nervous or a flirty-looking swinging of the leg.

-     Laugh, but don’t girlishly giggle.

Debra Benton’s advice for interviewing men . . .

-     Wear a collared sport jacket, suit jacket, or suit.

-     Wear a collared shirt.

-     Don’t wear jeans, even designer ones.

-     Wear close-toed shoes, not sandals or sneakers.

-     Your shoes and belt color should match.

-     Have a reasonable hair cut.

-     Be well groomed, which means checking out your fingernails, nose and ear hair too.

Debra Benton’s advice for both men and women . . .

-     Arrive with an attitude that says, “I really want to be here!”

-     Sport no tattoos – unless you’re part of the Maori tribe.

-     Show no visible body piercing – your ear lobe is okay, but pass on nose, lip, and eyebrow.

-     Stand up straight and carry yourself with control.

-     Firmly shake hands.

-     Slow down your walk, talk, and gestures, so that you will look more confident.

-     Refrain from using sexual expressions like “we’re screwed” or, “turned on.”

-     Keep a game face, with a relaxed expression of lips apart and corner of the mouth turned up.

-     Never drink alcoholic beverages before interviews.

-     Be good-humored – it makes the interview pleasant for you and your interviewer.

-     Speak in complete sentences.

-     Turn off your cell phone – don’t text, talk or have it buzzing in your pocket.

-     Don’t smoke before the interview. You might think you can hide it with Altoids – but you can’t!

Medical Billing and Coding Blog interviewed Debra Benton, who has been called “America’s top executive coach.” Ms. Benton is author of the new book, CEO Material: How to Be a Leader in Any Organization (McGraw-Hill, 2009). Her client list reads like a “Who’s Who” of top executives from such companies as Campbell’s Soup, Dell Computer, McDonald’s and Time Warner. She has been featured in Business Week, Fortune, the New York Times and Time, and has appeared on Today, Good Morning America, and CNN. Her other bestselling books include Executive Charisma and How to Think Like a CEO. She is founder and CEO of Benton Management Resources in Livermore, Colorado.

Medical Billing and Coding Blog is sponsored by Ultimate Medical Academy (UMA), a healthcare career school. UMA has campus locations in Tampa and Clearwater, Florida, as well as a national online program.  For more information about UMA please visit our website at www.ultimatemedical.edu

There are times when we all could use a good motivational book – one that energizes us to move ahead in our careers, land a new job, or simply attack a backlog of paperwork on the job.

If you’re looking for a book to get you moving, here’s a list of 10 of today’s self-help bestsellers on Amazon.com, with quick descriptions. (If you click on the books’ titles, you’ll be taken to their full listings on Amazon.com.)

Lift by Kelly Corrigan

From the publisher’s description of this book: “In Lift, Corrigan weaves together three true and unforgettable stories of adults willing to experience emotional hazards in exchange for the gratifications of raising children.” (Voice Publications; $16.99)

Women Food and God: An Unexpected Path to Almost Everything by Geneen Roth

From the publisher’s description of this book: “If you suffer about your relationship with food – you eat too much or too little, think about what you will eat constantly or try not to think about it at all – you can be free.” (Scribner Books; $24.00)

Life! By Design: 6 Steps to an Extraordinary You by Tom Ferry

From the author’s statement: “Writing this book is the culmination of 20,000 hours of coaching clients on choosing to have a life – By Design . . . I’ve been given unprecedented insight about what kills performance or what stops people from truly living a life that they really, and I mean really, love.” (Ballantine Books; $16.50)

The Secret by Rhonda Byrne

From the publisher’s description of this book: “In this book, you’ll . . . begin to understand the hidden, untapped power that’s within you, and this revelation can bring joy to every aspect of your life.” (Atria Books; $24.95)

Drive: The Surprising Truth About What Motivates Us by Daniel H. Pink

From Publishers Weekly’s review of this book: “According to Pink . . . everything we think we know about what motivates us is wrong. He pits the latest scientific discoveries about the mind against the outmoded wisdom that claims people can only be motivated by the hope of gain and the fear of loss.”  (Riverhead; $26.95)

The 7 Habits of Highly Effective People by Stephen R. Covey

From amazon.com’s review of this book: “The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change was a groundbreaker when it was first published in 1990, and it continues to be a business bestseller with more than 10 million copies sold.” (Free Press; $15.95)

Getting Things Done: The Art of Stress-Free Productivity by David Allen

From Booklist’s review of this book: “Allen, a management consultant and executive coach, provides insights into attaining maximum efficiency and at the same time relaxing whenever one needs or wants to.”  (Penguin Books; $16.00)

The Book of Awesome: Snow Days, Bakery Air, Finding Money in Your Pocket, and Other Simple, Brilliant Things by Neil Pasricha

From Publishers Weekly’s review of this book: “Though tongue-in-cheek, Pasricha emerges a committed but inviting optimist, combating life’s unending stream of bad news by identifying opportunities to `share a universal high five with humanity.’ Readers looking for simple, unsentimental pick-me-ups should find this happy browsing.” (Putnam Books; $22.95)

Blink: The Power of Thinking Without Thinking by Malcolm Gladwell.

From Amazon.com’s review of this book: “The key is to rely on our `adaptive unconscious’ – a 24/7 mental valet – that provides us with instant and sophisticated information to warn of danger, read a stranger, or react to a new idea.” (Back Bay Books; $15.99)

If You Have to Cry, Go Outside: And Other Things Your Mother Never Told You by Kelly Cutrone and Meredith Bryan.

From the publisher’s description of this book: “With chapters on how to find your tribe (those like-minded souls who make your heart sing), how sometimes a breakdown is really a breakthrough, and how there is no such thing as perfection, Kelly also shares practical advice, such as how to create a personal brand and how sometimes you have to fake it to make it.” (HarperOne Books; $22.99)

Medical Billing and Coding Blog is sponsored by Ultimate Medical Academy (UMA), a leading healthcare career school. UMA has campus locations in Tampa and Clearwater, Florida, as well as a national online program.  For more information about UMA please visit our website at www.ultimatemedical.edu