The Certified Rheumatology Coder credential is awarded to candidates who pass the certification exam. CRHC holders are professionals skilled in classifying medical data from patient records, generally in the rheumatology outpatient office setting. The coding specialists review patient records and assign numeric codes for each diagnosis and procedure. To perform this task, they must possess expertise in the understanding and application of coding conventions and guidelines as outlined in the ICD-10-CM (Volumes I, II) classification systems as well as the CPT manual. In addition, the CRHC credential holder is knowledgeable in medical terminology, anatomy/physiology, disease processes, and procedural coding. The CRHC certification examinations assess proficiency in rheumatology diagnostic and E/M coding. Professionals experienced in E/M coding should consider obtaining this certification.
CRHC certified coders are considered leaders in the industry because they:
- Utilize their specialty knowledge and experience to better interact with clinicians and providers
- Understand basic and more advanced coding principles and guidelines
- Ensure their providers receive appropriate reimbursement
- Provide direction and instruction to less experienced coders in the workplace
- Demonstrate coding skills daily
As the importance of accurate and specific diagnosis coding increases in physician practices, it is important for coders to validate their knowledge in coding to ensure proper reimbursements; comply with federal and commercial guidelines; and stay compliant with the various state, federal, and commercial regulations.
As staff become more experienced in the practical requirements of diagnostic and CPT coding, the CRHC certification will provide additional professional and personal recognition and reward.
CRHC™ examinees will be tested on:
- Reading and abstracting physician office and procedure notes to apply correct ICD-10-CM, CPT®, HCPCS Level II and modifier coding assignments
- Evaluation and management (both the 1995 and 1997 Documentation Guidelines)
- Rules and regulations of Medicare billing including, but not limited to, incident to, teaching situations, shared visits, consultations, and global surgery
- Coding of surgical procedures commonly performed by rheumatologists, such as trigger point injections, joint injections, etc.
- Anatomy and physiology
- Medical terminology