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Study Map offers guide to paraoptometric coding certification

May 7, 2013
Kraemer

Kraemer

Coding and claim errors are an area of mounting concern for optometric practices, as they can affect the practice’s bottom line. Optometric office staff can help avoid needless reimbursement delays and audits by training to become a Certified Paraoptometric Coder™ (CPOC) through the Commission on Paraoptometric Certification (CPC).

The CPC’s CPOC Candidate Handbook, CPOC Study Map and other recently developed materials are available to assist office staff, according to Amy Kraemer, CPOT, chair of the CPOC Examination Development Committee.

“Medicare and other public and private insurance programs continue to step up audit and claim review programs. Securing prompt payment by avoiding claim errors is a growing concern for practicing optometrists,” said Kraemer. “Medicare reports confirm that claim rejections, denials, and audits are generally the result of common coding errors, failure to provide all of the necessary documentation, or simple clerical errors such as failing to sign forms.”

The CPC’s Certified Paraoptometric Coder examination and related educational materials, such as the CPOC Study Guide and Study Map, are designed to ensure paroptometrics have the know-how to avoid such common claim-filing errors, Kraemer continued.

The commission offers its CPOC examination five times each year, including the only opportunity for in-person testing at Optometry’s Meeting®.

The CPOC Study Guide and Study Map are included in the registration package.

The CPC’s Certified Paroptometric Coder™ is centered around providing paraoptometrists the practical knowledge necessary to help ensure steady practice cash flow by making sure claims are coded and filed correctly.

“Paraoptometric coders are responsible for ensuring that all of the information about diagnoses and procedures for patients is accurate and complete,” Kraemer said. “A certified paraoptometric coder can be the first line of defense against non-compliance and improper coding for the practitioner. Beyond helping to ensure prompt payment of claims, a certified coder can help to maintain compliance with state and federal laws. This is especially important since the government has started focusing on identifying and fining or prosecuting for fraudulent claims.”

The CPOC program centers on mastery of common health care billing code systems – the American Medical Association’s (AMA) Current Procedural Terminology® (CPT), the International Classification of Diseases, Ninth Revision (ICD-9), and the U.S. Department of Health & Human Services’ Healthcare Common Procedure Coding System (HCPCS) – and the two major reference volumes optometric office staff use to find billing codes and claim-filing rules – the AMA’s “CPT Standard Edition” coding manual and the AOA’s “Codes for Optometry.” In addition to the coding systems, the program covers anatomy and physiology, medical terminology, medical records, claim filing, and compliance matters.

The coding examination covers both CPT procedure codes and CPT Evaluation & Management (E&M) codes, as well as rules for reporting the proper levels of E&M services on claims.

The CPC’s CPOC Handbook for Candidates outlines a course of study on coding and billing. The CPOC Study Map provides a list of study resources, links to online materials, and suggested references according to the subject matter.

Other materials paraoptomerics may find helpful include the AOA Paraoptometric Section’s “Introduction to Insurance Processing Study Flash Cards” and a series of live webinars for billing and coding beginners.

“The examination is designed not just to test specific knowledge but to make you think about the code book and say: Now where would I find that?” said Kraemer.

In addition to Optometry’s Meeting® testing, PSI centers offer computer-based exams. A list of PSI Test Centers can be accessed at http://tinyurl.com/PSIlocations.

Applicants must have a minimum of a high school diploma or equivalent, and should have a minimum of two years’ employment in the medical coding and billing field.

The examination fee is $265, and certification is renewable every three years.

The 2013 edition of “Codes for Optometry” and the “CPT Standard Edition” are both available from the AOA Marketplace online store (www.aoa.org/ x12590.xml).

For additional information, visit www.aoa.org/x4989.xml.

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