Resolved About the risk adjustment field

[PaulD_81673]

Hi folks,

I was watching this amazing introduction to risk adjustment coding video by Alicia and Chandra located here, , and I have a concern about the field. I heard some not-so-good things from a YouTube channel called Medical Coding with Bleu. She said that RA coding is only good to START with if you're a brand new coder, and she urged not to stay in it long-term. Her reasoning is that only coding for diagnoses using ICD-10-CM stunts your growth since you're not using CPT and PCS, and some employers don't count RA coding as work experience for that reason. Also, since you're not working with CPT and PCS, she said that you'll have to study that over again. A further point she made is that RA coding "gets boring" after a while. What do you think about this? I figure since Alicia and Chandra are both CRC-certified, they could chime in here if possible. From what I heard in their video above, they seem very enthusiastic about RA coding, which makes it seem like Bleu is wrong.

 

[Alicia]

I don't know who Bleu is so I can not speak to her background or comments she has made other than what you have posted here. I disagree on several levels. Although I understand some of the points she is trying to make however RA coding is the basis of almost all reimbursement now since the change in E/M. Everything is based on MDM and that is validated by the diagnoses of the patient, thus translated into ICD-10-CM codes. On top of that any payer getting federal funding (all of them now) will use the risk adjustment model in various forms.
A. RA coding is a way to get your foot in the door.
1. Most entities will hire new coders because they give extensive training after onboarding.
a. My first RA coding job I was trained for 6 weeks after hire. I still use what I learned during that time.
2. I mastered reading documenation from a multitude of formats from all over the US.
a. You could pull at chart with 30 pages or 1,000 and get to abstract for all sorts of diagnoses.
b. You get to read documentaiton from providers in all specialties across the US.
c. I often got to see how those encounters were coded out with CPT.
d. I got to read inpatient and outpatient records which raised my skill set and gave me a foundation in CPT and PCS.
3. RA coding is very competitive and has a high standard.
a. 99% accuracy is standard not 95%
b. My first RA coding job started with 100+ and ended nine months later with 14. (they gave me the tools to succeed)
4. Boring!?!
a. To be fair I think CPT is boring. Same old codes over and over again and the code set is outdated and not expandable.
b. PCS is brilliant and will take over CPT in the near future. Especially since E/M is not based on what you do to the pt but what is wrong with them. PCS is expanable. At this time PCS is ONLY used for Inpatient coding and no one would hire a new coder InPt.
5. RA coding is more like auditing.
a. Teaches you how to abstract and increase your speed.
b. I used to say RA coding was the wave of the future but that is old news. It is growing and now not just MA plans hire CRCs but doctors offices, ACO, MA plans etc...
In conclusion note that this person is not look at the entire picture. RA coding used to be a niche arena. It no longer is. At this time you are able to get an RA coding job without being a CRC but that is about to end. RA coding is everywhere and in high demand. Even if you only work in the role for a short time you will gain vast experience and I would definintly hire a person who has worked in RA coding. In my opinion a person should get the CPC and then the CRC. That is the start of an excellent future.

 

[PaulD_81673]

I don't know who Bleu is so I can not speak to her background or comments she has made other than what you have posted here. I disagree on several levels. Although I understand some of the points she is trying to make however RA coding is the basis of almost all reimbursement now since the change in E/M. Everything is based on MDM and that is validated by the diagnoses of the patient, thus translated into ICD-10-CM codes. On top of that any payer getting federal funding (all of them now) will use the risk adjustment model in various forms.
A. RA coding is a way to get your foot in the door.
1. Most entities will hire new coders because they give extensive training after onboarding.
a. My first RA coding job I was trained for 6 weeks after hire. I still use what I learned during that time.
2. I mastered reading documenation from a multitude of formats from all over the US.
a. You could pull at chart with 30 pages or 1,000 and get to abstract for all sorts of diagnoses.
b. You get to read documentaiton from providers in all specialties across the US.
c. I often got to see how those encounters were coded out with CPT.
d. I got to read inpatient and outpatient records which raised my skill set and gave me a foundation in CPT and PCS.
3. RA coding is very competitive and has a high standard.
a. 99% accuracy is standard not 95%
b. My first RA coding job started with 100+ and ended nine months later with 14. (they gave me the tools to succeed)
4. Boring!?!
a. To be fair I think CPT is boring. Same old codes over and over again and the code set is outdated and not expandable.
b. PCS is brilliant and will take over CPT in the near future. Especially since E/M is not based on what you do to the pt but what is wrong with them. PCS is expanable. At this time PCS is ONLY used for Inpatient coding and no one would hire a new coder InPt.
5. RA coding is more like auditing.
a. Teaches you how to abstract and increase your speed.
b. I used to say RA coding was the wave of the future but that is old news. It is growing and now not just MA plans hire CRCs but doctors offices, ACO, MA plans etc...
In conclusion note that this person is not look at the entire picture. RA coding used to be a niche arena. It no longer is. At this time you are able to get an RA coding job without being a CRC but that is about to end. RA coding is everywhere and in high demand. Even if you only work in the role for a short time you will gain vast experience and I would definintly hire a person who has worked in RA coding. In my opinion a person should get the CPC and then the CRC. That is the start of an excellent future.

Thank you so much for such an in-depth reply! So many people need to read this about RA coding if that's what they want to get into.

 

[JamiaW_80513]

I agree with Alicia...Bleu has no CRC background neither. I watch her on Youtube and I disagree with what she mentioned about CRC