CCS Requirement/encouragement?

ggoodman@virginiahospitalcenter.com

All,

Just out of curiosity I was wondering if there are any CDI programs out there that require/encourage staff to get the CCS Credential through AHIMA?
I have been thinking about taking it for years and feel like I should at least attempt it before ICD-10 goes live.

This is something I am doing on my own, my hospital encouraged me to get the CCDS but whether I have a CCS doesn't matter one way or the other.
There is a good chance they won't reimburse the cost of test, renewal fees, etc.
So it would just be something I do for my own personal benefit.

I feel like having a CCS would help to support my expertise in the CDI field.
I was just wondering if any facilities were encouraging their CDI staff to get the CCS or if they prefer you just get the CCDS and that's it.
Do you agree that a CCS is relevant to our field and a valuable asset to have?
I'd like to be able to build a case towards showing my facility that while I am not a coder the CCS is still a benefit to have as a CDI.
Thoughts?

Thanks!
Greta

Greta Goodman, CCDS
Clinical Documentation Improvement Specialist
Health Information Management
Virginia Hospital Center
1701 North George Mason Drive
Arlington, VA 22205
703-558-5336
ggoodman@virginiahospitalcenter.com


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evanspx@sutterhealth.org

Hi, Greta

I have both, and I think the CCDS is most pertinent for CDI practice. However, if you wish to dive deeper into coding, the CCS is a credential you may wish to obtain. The downside is that you will be then pay dues to both ACDIS and AHIMA, and this is a factor to consider.

As a hiring mgr, I require either RHIT, RHIA, or RN. Our site does give special consideration to either CCDS or CDIP. I would also, as a decision-maker, consider the CCS as further evidence of professional accomplishment pertinent for this profession.

PE

Paul Evans, RHIA, CCS, CCS-P, CCDS

Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421

evanspx@sutterhealth.org

deanne_wilk

One thing I can provide is that the new requirements for AHIMA ICD10 trainers is that they must have a CCS credential in order to renew their trainer certificate.


Deanne Wilk, BSN, RN, CCDS, CCS
AHIMA approved ICD-10-CM/PCS Trainer

Clinical Documentation Improvement and Inpatient Coding Manager
HIMS Department
Good Samaritan Health System
4th & Walnut Sts
Lebanon, PA 17042
dwilk@gshleb.org

Phone: 717-270-7582
Cell: 717-580-1436

sharon.cooper@owensborohealth.org

Hey Greta,

I obtained my CCS several years ago, for the reasons you listed below, and because my department writes all of the appeal letters, so I thought having the CCS behind my name would carry a little more weight when fighting DRG change denials. I obtained my CCA initially & then decided to go for the CCS a short time later.

Our CDS's are all RN's and are required to either obtain the CCDS or CDIP credential (when eligible); they are not required to obtain a coding certificate, but it is encouraged. So far only one has obtained a CCA. I have 2 CDS's that obtained their ICD-10-CM/PCS Trainer status thru AHIMA - although according to the new Trainer criteria that becomes effective June 2016, they will lose this unless they choose to pursue a coding certificate (So, of course, I'm hoping they opt to obtain their CCS). The hospital pays for our certification and recertification.

I also think it makes you more marketable if you ever chose to pursue other employment.

Sharon

Sharon Cooper, RN-BC, CCS, CCDS, CDIP, CHTS-CP
AHIMA-Approved ICD-10-CM/PCS Trainer/Ambassador
Manager Clinical Documentation/Appeals

sharon.cooper@owensborohealth.org
(270) 417-4612 Office
(270) 316-9088 Cell
(270) 417-4609 Fax

Owensboro Health Regional Hospital
P.O. Box 20007
Owensboro, KY 42304-0007

katysuegood@gmail.com

I also have both, tested for my CCS a couple weeks before my CCDS. I agree that a CCS is not necessary and a CCDS is more specific to work as a CDI. Our program supports CDI's getting their CCDS. We will pay for the exam and in our job description we set it as an expectation to obtain after 2 years. I would be thrilled if any of our CDI's took the initiative to get their CCS but it will not be paid for. I do find that my CCS is helpful. Of course preparing for it advanced by coding knowledge which has been helpful for me but more than anything it adds credibility when I am discussing cases with coders. Right or wrong, I have found that my CCS helps them feel like 'we are on the same team' with a similar knowledge base where sometimes they dismiss some of the other CDI's as simply not understanding coding. This of course could certainly have to do with the fact that I actually do likely know more about coding than our other CDI's ;-). I also assume that my CCS would help me in future endeavers if I chose to make a significant career move in the future.

I do find it annoying to have to pay dues for both and track CEU's for both, so that's a bit of a pain....

Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404

renmeyer@sbcglobal.net

How did you prepare for the CCS? Could you recommend any books/training/courses? I'm interested in doing it but not sure where to start. I did my CCDS a year ago and feel the CCS will be a 'nice to have' addition in my job as a CDI.

Thanks
Renee

katysuegood@gmail.com

Renee,

I have been asked this question before and this was my response:

I took the exam in 2012. It was definitely the hardest exam I have taken though I was a relatively new CDI with only a year in this field and no exposure to coding prior to this job. I did NOT take a prep course. That being said, I had spent the last year getting a lot of one-on-one coding instruction with our coding manager because at that time we were reviewing every death chart together (we did this for a year). She basically was performing a coding audit and I was looking for documentation opportunities so I think my coding knowledge was pretty decent for a CDI considering the amount of time I had been doing it. Right after the exam, I posted my retrospective advice on CDITalk on this thread http://list.hcpro.com/read/messages?id=260107#260107

This was my advice:
The test is split in domains. I had no problem (100%) on compliance, privacy/ethics, Data quality management, Documentation and the inpatient regulatory/reporting guidelines. I did fine on the information/communication technology as well. I struggled a little more with the outpatient regulation/reporting guidelines (probably because I have no background in outpatient).
But, what really threw me was the actual diagnosis and procedure coding. It was BRUTAL! Prior to beginning to study I had never opened a CPT book so the outpatient procedure coding was exceedingly difficult. I also don't ever look at V-codes, so I needed to learn those as well.
The exam has roughly 100 mult choice/mult select. That was the easy part for me. Then there are 12 cases that you have to code. Time is really the issue. I realized that I was only on case #7 with 30 minutes left in the exam (and I am a fast reader)! I had read somewhere that you get points for each correct dx/procedure but you get extra point for having the correct Pdx. When I realized there was no way I would complete every case I began flipping though, assigning the principle dx and any easy dx I saw in the D/C summery (HTN, DM, hyperlipemia) and just entering 0000 for the other blanks (you have to enter something to move on). This worked for me. In retrospect, I shouldn't have wasted so much time searching for one missing dx (you know how many codes you should have based on the blanks) and should have focused on just getting the easy dx. I also likely should have skipped the CPT procedure entirely and moved on to the ones I was more likely to get right. I am positive my score would have been higher this way. You actually can miss a lot of the coding questions and still pass when you do well on the other portions.

I did use the AHIMA study guide. I would also suggest memorizing as much as possible of the "Guidelines" in the book. You have the book but you do not have time look that stuff up. I would not waste my time (although I did) on reviewing coding clinics.

Good luck!

Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404

evanspx@sutterhealth.org

Let me first state I took the exam over a decade ago, some of the parameters may have changed since that time.

Here is what I advise candidates:


1. Most importantly, do purchase the AHIMA CCS Study Guide...I assume this is still in print.

2. Review and read ALL of the Official Guidelines for Inpatient Coding

3. Read the last 2-3 years of AHA Coding Clinic....I'd also mention that Coding Clinic, 2nd Quarter of 1990, has pertinent advice still valid today regarding key concepts

4. You will be asked to code inpatient cases and some outpatient cases - at least, this was true when I took the exam

5. For outpatient coding, you will need to assign CPT codes for those types of procedure commonly performed in the Ambulatory Setting..so, study the CPT coding for procedures such as colonoscopies, excision of lesions of skin, procedures of the feet (bunions), and other types of procedures typically not performed in the Acute Inpatient Setting. Personally, this was the most difficult portion of the exam for me because CPT is coding is not the same as ICD-9 Coding.

Again, I'd refer to the AHIMA publication for greater details.....my advice is strictly from my recollection of the topics covered when I took the exam.

Paul Evans, RHIA, CCS, CCS-P, CCDS

Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421

evanspx@sutterhealth.org

evanspx@sutterhealth.org

Edit:

For Coding Guidelines, you must also read (and know) those pertaining to Outpatient Coding.

Paul Evans, RHIA, CCS, CCS-P, CCDS

Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421

evanspx@sutterhealth.org

catladyrn

I read Katy's advice when she first posted it and that was the incentive for me to take the exam. I didn't think I could pass it until I read how she approached it, but I thought, "I can do that," so I registered for the test and of course I did pass. So her advice is solid.

However, I took the test before they changed the eligibility requirements. Now you must either have completed a coding training program (which I have not done) or have two years of coding experience (which I do not have), if you don't already have an RHIA, RHIT, or other coding credential (which I do not have). So I would not be eligible to take the exam now.

I normally never prep for exams (didn't prep for CCDS or CDIP), but for CCS, I prepped for three solid weeks. I prepared by marking up the coding books with tons and tons of notes and reminders (like writing "modifiers" on every page in the CPT book where a modifier would apply, and "V27.0" on all the OB pages to remember to code the normal newborn, since I knew I'd forget). I grouped similar procedures together in CPT with notes as to what they meant. I put tabs on all the sections so I could find them more quickly. I also used the Professional Review Guide for the CCS examination and did all the practice exercises, and found another book at a used book store with practice coding exercises. I actually finished the test about 1 1/2 hours early because I had prepped so well. I did better on the theory than the coding, but well enough to pass.

I'll never have the skill set of a coder, but I learned a tremendous amount (especially about CPT) just through the preparation process.

Renee

Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
Director, Clinical Documentation
Tanner Health System

katysuegood@gmail.com

Renee,

I am so glad to hear that my advice helped! I also would not meet the current requirements....

Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404