Thursday, March 31, 2011

Medical Assistant Students Frustrated Over Medical Billing and Coding Expectations

Medical assistant students enrolled in medical assistant courses often have difficulties understanding the medical billing claim form and have problems understanding evaluation and management codes.

We often hear from frustrated students on our active online forums; many wind up venting.

One medical assistant student recently posted into the forum that her instructor wasn't very helpful; she felt the instructor apparently wasn't well versed in the medical billing and coding process herself and therefore was unable to explain the process in a manner that made it clear to the class. The students are frustrated and overwhelmed.

Another person posted a request for help:
I work for a Cardiologist. We are trying to get clarification on:
·        CPT 93454  (Catheter place in coronary arterty(s) for coronary angiography, imaging supervision, and interpretation
·        CPT 93458 (with left heart catherization including intraprocedural injection(s) for left ventriculogy, when performed

QUESTION: Can these two codes be billed together if both of these services are performed?

Medical Coding and Billing Questions in the Certification Exams

We receive many, many, many similar forum discussions from frustrated medical assistant certificants. Some posted right after taking the medical assistant certification exam where they stated that they were totally stumped over the amount of medical coding questions in the exam. The questions were multiple choice and asked about specific numeric codes, or modifiers, for a given specific diagnoses or procedures. Now, ask any medical assistant to cite a specific code without any reference book/manual; he/she would be hard-pressed to give the right one, since there are so many, not to mention specific modifiers.
Agnes told us:Hi, I just took the RMA exam today and I have to tell you that from the 206 questions none of them were in the AMT study book. I passed the test so I feel very lucky because it was very difficult. I was very disappointed because I felt the RMA test was not fair; they focused too much on the administrative area and I felt like it has nothing to do with the MA profession.
We also heard from a physical therapy instructor who teaches the basics of medical coding and billing as it pertains to PT because the majority of his students do their own billing and coding. One question this has raised is why do medical assistant students have to learn medical coding and billing and why is is such an extensive part of the medical assistant certification exams? Rather, shouldn't students who want to learn about it sign up for medical coding and billing classes?

Should Medical Assistants Learn Coding and Billing?

We can see where medical assistants (MA) need to have an idea of medical practice financial management, such as banking deposits, accounting and bookkeeping, dishonored check processing, payroll - and even that is nowadays often outsourced. Nevertheless, in any profession you should get a picture of how the whole kit and caboodle functions to make it run.

In our opinion, as far as medical assistant students being introduced to the billing and collections process in GENERAL is okay--only to give them a well-rounded understanding of the practice and how things work. This way, they can better address patient questions and communicate with the medical billing and coding staff efficiently should certain issues arise.

However, as far as actual billing and coding responsibilities in my role as a Certified Medical Assistant (CMA),  I was NEVER involved in the actual billing and coding process, neither were any of my medical assistant colleagues, with the exception of one medical office manager, who had worked her way up through the ranks as a medical assistant in a small single-physician office.

Many believe medical assistant programs who focus too much and dive too deep into the medical coding and billing process as part of their teaching curruculum are wasting their time. Most medical assistant students feel this time would be better spent drawing up injections, or drawing blood.


Anonymous said...

A friend of the family is an MA and is studying to take her State Board test for her licensing. While at her house, she asked me a ton of coding questions as I am a certified coder. I looked at her study guide and many answers for the study questions were incorrect. An MA is NOT a coder nor is an MA a medical biller. Practices put the MA, receptionist or spouse in the position to code and bill for the practice. Coding and billing is highly complex and specialized and must be done by a Certified Coder or Certified Biller with the proper training. Putting an MA, receptionist or spouse as the practice coder or biller is a formula for financial and professional disaster.
Coding questions asked on a forum are being answered less and less due to the possibility of a lawsuit or involvement in a fraud investigation.

Steven M. Verno
Certified Medical Billing Specialist
Certified Medical Billing Specialist Instructor
Certified Emergency Medicine Coding Specialist
Certified Multispecialty Coding Specialist
Certified Practice Manager-Medical Coding Specialist
Professor, Medical Coding and Medical Billing Instruction, Florida Metropolitan University (Medical Leave)


Every healthcare provider should switch to an EMR solution. Paper based records and prescriptions are a thing of the past now and it would be best for both doctors and patients to take advantage of their features and accessibility.

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