Frequently Asked Questions

PPEs

CEUs

CEUs

Certification/
CCHIIM

Accreditation/
CAHIIM

CourseShare

CourseShare

Curriculum
Maps

For more information on the PPE program, please go to our PPE page.

Q: Are PPEs a requirement for the medical coding certificate and HIT degree? We have had a number of students who want to submit what we call "credit by portfolio." This is where the student supplies documentation of the experiences that they already have and apply it to existing classes for credit. Is this allowed?

A: For HIT programs you must have a PPE field-based practicum (see PPE Guide II). For coding certificate programs you can either do field-based, virtual, or hybrid (see PPE Virtual). Credit by portfolio is an individual college decision that is typically used for coursework. You will need to contact CAHIIM for a determination of using personal experience in lieu of the PPE for the HIT program.

Q: I am a little confused on the amount of CEUs I can give a PPE participating site, is five or 10 the maximum per year? Also, if I have multiple credentialed employees that assist at the hospital sites, can I give CEUs to each employee?

A: Each PPE site mentor can qualify for up to five CEUs. How you determine that is by reviewing the student's site log. He/she should keep track of each person that aids them, the person's name/credential/e-mail, and how many hours the student spent one-on-one with this person. If a credentialed staff person has spent a total of 12 hours with Nancy Student, that person qualifies for a certificate from you for five CEUs for the year. If a staff person spends three hours with Nancy, that person would get three CEUs from you. A credentialed member can only count five CEUs per year (or 10 CEUs over a two-year certification cycle). No one can ever exceed five CEUs per year regardless of the actual hour count that they have donated to the PPE student. And finally, yes, each credentialed person who aids a PPE student with one-on-one time and assistance qualifies for the PPE CEU option.

Q: Regarding clinical sites, do they all have to have an RHIT or RHIA present?

A: There is no rule that the person needs to hold an AHIMA credential. However, there does need to be a dedicated person who is recognized as the site supervisor for the PPE student (and we recommend a backup in case of illness or being off site as well). Please see the PPE Guide II for more in-depth discussions on the site supervisor requirements.

Q: I have a coding certificate student who already has considerable experience in home care coding, who writes: “My work duties presently include providing medical coding for all new referrals that are received from hospitals, rehabs, and physician offices. I am approaching the end of my studies and still have to complete my Internship. My question to you is whether or not my present job duties can suffice the requirements for completing my Internship? I code on a daily basis, and I am continually utilizing my coding knowledge acquired from the coding program.”

A: The purpose of the PPE is to expose the student to new experiences. Getting credit for what she already knows isn’t adding to her skill sets. Consider these options: either place her in a setting where she has no experience, or have her carefully document what she does know for the benefit of other students. The old adage "the only way to know for sure if someone has knowledge is to observe them teach another," applies here.

Option 1: The student gets an internship (PPE) in an area that she doesn’t have any experience in, such as, compliance, code auditing, or CDM maintenance out of the finance office so that she is building a new skill set and has a chance to experience something other than home care coding.

Option2: The student creates a three-hour skills lab (that you could later use as three one-hour labs). She would pick a focus (i.e., home health coding). Each unit would have a theme:

Compare acute care coding to home care coding – what are the differences, and how are they the same
Understanding the regulations of home care coding
Home care coding as a career choice: how to get into the field, where are the jobs, what to focus on while in school

With option #2, you turn her into a guest lecturer for home care coding. The units need to be well designed with lots of detail, and she needs to provide at least five cases of de-identified medical records that highlight the unique conditions/requirements for home care coding. She should plan on dedicating at least 10 - 12 hours to the development of each unit, and the units should include deliverables such as slides, quizzes, and Web resources. Encourage the student to present one or all of the units either in class, or at her place of employment as a continuing education project. She may discover that she enjoys teaching; this could be the start of a future career in coding education!

Q: I have a student who is involved in an EHR project for her facility and is a co-project manager for another site. She will help this sister site with their EHR implementation. This is above and beyond her duties as director of HIM for this behavioral care facility. Can she use this project work as part of her practicum?

A: A best practice approach would be to accept the work done at the other site, but not what is done at her home campus. She should also be required to produce deliverables at the conclusion of the course with her work on these deliverables representing PPE hours, setting an hours value to each. Depending on the number of hours she owes, she could do one or all three of the activities listed below:

Create a three-unit (three-hour) learning packet for CourseShare on hands-on EHR project management. For the greater good of all students, the packet should contain:

PowerPoint lectures on three topics such as the selection process, negotiations, implementation, clean-up, training HIM staff, or training clinicians
Instructor notes for each lecture so that a teacher could use the materials in the classroom and understand them
Assignment materials for students such as RFP samples, memo samples, implementation plans—things that students could complete or perform as assignments (one for each lecture)

Write an article for the state association on her experiences with the EHR conversion. Behavioral health records have additional concerns regarding privacy and security. How did her organization deal with this? The article should be written based on her role as a PPE student to demonstrate the value for other facilities and encourage facilities to take on HIM students for PPE during a conversion process (e.g., more hands to help). The article can help raise awareness in the state for the need to place students for PPE. The program should provide a follow-up article for this purpose.
Present this experience as a speaker at the state meeting. If she does that, then she should also create a poster of the experience in addition to speaking.

This is a good example of stimulating an existing HIM director to feel as if the PPE is giving her new exposure. In this case, she is adding to the body of knowledge in her discipline, which is a good thing in its own right. In addition, if she already has an AHIMA credential (such as CCS), she will also earn CEUs: five for CourseShare, three for the article, and one for the speaking engagement.

Q: We find it very difficult to place distance education students who currently work in a non-acute healthcare position into the required acute care coding portion of the advanced comps. Have any of the accredited schools used the Virtual Lab yet for a portion of PPE? Would it be allowed? With coders working remotely that is getting more difficult. Are other programs utilizing the Virtual lab for hands-on experience in coding using the Quantim encoder, etc.?

A: The short answer to your question is yes, a number of schools have a virtual PPE portion to the PPE process. Although there are similarities between accredited CAHIIM HIM degree programs, and AHIMA-approved coding certificate programs there are also distinct differences. This advice is for the coding certificate program only:

For AHIMA approved coding certificate programs, a 100 percent virtual PPE is acceptable as long as the following conditions can be demonstrated:

The coding student completes a minimum of 40 hours of authentic coding (coding from real charts) in a variety of patient encounters.
The student uses a logic-based encoder that has both ICD-9 and ICD-10 coding choices (QuadraMed and 3M meet this requirement).
The student is exposed to professional coders from a variety of settings—guest speakers come into the classroom, or you record them and post on YouTube.
The coding program should have a collection of scanned authentic medical records, around 100-150 charts, to ensure that students are not all doing the same chart at same time, and to ensure the 40 hours is met. Programs will find about 50 charts in AHIMA CourseShare at https://courseshare.ahima.org, along with coding answer keys for each chart. These resources are available for free for any HIM or coding academic program. Subscribers to the AHIMA Virtual Lab will find additional scanned charts and additional answer keys through the Virtual Lab CoP.

For CAHIIM, a hybrid PPE is acceptable (part Virtual Lab, part field based), but a 100 percent virtual PPE is not acceptable for the HIM degree seeking student as their demonstrated skill sets require much more than coding experience.

Q: Does AHIMA outline what exactly needs to be in the patient records for use in a virtual externship for medical coders? I’m referring to the requirement of 40 hours of “authentic coding” of charts for AHIMA Approved Coding Certificate programs.

A: There are two aspects of the Coding Certificate Program Virtual PPE: number of charts (50 minimum) and number of authentic coding hours (40 hours minimum).

Regarding the charts: The definition calls for an “authentic” record, meaning it is an actual medical record from a facility that has been de-identified of personal information. There are 30 authentic records available for download from CourseShare which can get you started. The other 20 (a minimum of 50 is needed, and many programs have much more) would come from your Advisory Committee members and adjunct faculty who teach in community healthcare. Your collection should represent a broad spectrum of charts: inpatient, outpatient, ambulatory, etc.

The advantage of getting local records is that your students get to see how each major employer sets up the record (data structures are different for each hospital) and can become familiar with where to look in the chart to find information. This becomes a “selling point” in their résumé when they later become job seekers.

Some programs have asked if the charts must be distributed as hard copy. That isn’t necessary, but you might want to have the student print off several of the records to practice chart analysis and put the chart in a particular order in case they end up working in a paper driven department. For the most part, the student will access scanned or computer generated patient records in which the patient’s identifying information is protected. Coding work on authentic records should ONLY occur after the student has received thorough instruction on HIPAA regulations and the AHIMA Coding Ethics Guidelines.

Regarding the authentic hours: Students are expected to code at least 40 hours of authentic coding. Your faculty should determine how many records that translates to; outpatient and ER records can be coded much faster, while inpatient charts vary depending on something straightforward (pneumonia case) to complex (cardiology, oncology, etc.). The number of charts needed should reflect your “mix” so that you can achieve the 40 hours of authentic coding. Your coding faculty are the best source for estimating how much time is involved in coding a particular chart. We ask for at least 50 records in the program’s collection to make sure that you have a bare minimum, but in reality, you will likely need more than that. Some schools have more than 200 records because they don’t want students sharing coding answers, so students get different sets to code.

For more information about AHIMA certification, please go to the CCHIIM site.

Q: How do I educate admissions staff about the differences between RHIT and RHIA? Is there a video?

A: There is no video. However, the hicareers.com website does a nice job of highlighting the differences, and I have had faculty use this for internal training purposes. I recommend setting up a training session with your admissions staff and use hicareers site in this sequence:

1. http://www.hicareers.com/Toolbox/pathways.aspx: Use this page to demonstrate the various academic levels/and match credentials. Show the ones your program offers

2. http://www.hicareers.com/Pathways/baccalaureate_degree.aspx: Select the level you offer (this example is RHIA/Baccalaureate) and go through each of the links on the page

3. http://www.hicareers.com/Pathways/baccalaureate_degree.aspx: Show them the interactive pathfinder. They can either refer interested applicants to this link to explore on their own, or Admissions staff could send the link to the applicant and go over their choices with them in real time. In the end, with four academic levels, it is really up to the student to determinewhich is best for them.

4. Take questions: The best thing about a live session is that they can talk with you and get immediate feedback. Some of the questions that they may have or you could discuss include the following, and the correct answer changes from one campus to another:

1. How much does the program cost, and does it cost more for students who live in other states?

2. How many credits can you transfer in, and do you have an arrangement with any other programs to accept work done elsewhere?

3. Do I have to wait to start classes, and how soon can I begin?

4. Is a field-based practicum a requirement of graduation? (Yes, for CAHIIM sites)

5. What can I do with a RHIT/RHIA? Show some of the career studies and different jobs beyond the hospital setting. A variety of job settings and earnings potential is located on the Salary Study section of the site.

Q: We are a community college with an approved testing center. How can we become a site for CCA and additional testing for AHIMA credentials?

A: AHIMA plans to only utilize the Pearson Professional Centers for the CCHIIM exams. These are centers wholly owned and operated by Pearson VUE. While Pearson VUE does have what they call “PVTCs,” some of which are operated on college campuses, it is not our intention at this time to deliver exams to them.

For more information on accreditation standards, please go to the CAHIIM site.

Q: How many credits can be transferred in to the HIT program at our school? How many HIT courses?

A: The school registrar will determine what the state regulations are for accepting college credits from technical and vocational schools. Some states are generous while other states limit transfer credits from these types of programs, so your first stop is a meeting with your school’s registrar. If you get the green light to accept credits from a list of feeder schools, then you need to evaluate each program on its own merits (since they aren’t CAHIIM accredited or AHIMA approved). You need to ask yourself for each course, “Is this course an equivalent in subject matter and rigor for what I teach in my program?” To know the answer to that, you need to see a detailed syllabus from each school/each course – you can’t make this decision from a course description. You need to know how much time they spend on each topic, how many contact hours are in the course, what textbooks they use, and so on.

Once you have completed your analysis and have an approved list of courses and the school that offers them, determine if there will be stipulations for the transfer credit. For example, must be a grade of C or greater, must have been completed no more than three years ago, etc.. This final document should be shared with your registrar to get a decision over the types and number of credits and the conditions to confirm that you are still in agreement with your college transfer credit policy. Once that is done, you should work up an agreement of understanding between each feeder program as to what courses you can accept, and the stipulations (if any).

Q: What must we do to be compliant with CAHIIM accreditation standards regarding transfer credits?

A: CAHIIM standards are silent on transfer of credits since it is so variable from one state to another, and within the state; there are additional variables between institutions of higher learning. From an accrediting perspective you want to keep your focus on the viability of your program. If you accept credits from students that are poorly prepared, it can adversely affect your graduate’s pass rate which is monitored by CAHIIM. If you don’t accept any transfer credits you shut the door on potential new sources of students – it’s a balancing act, and one you will probably need to refine over time as you become more experienced with the process, the students, and the quality of the feeder programs.

Q: What are the requirements for faculty teaching in a CAHIIM-accredited program?

A: CAHIIM standards are specific regarding the qualifications of the program director, but are not specific regarding qualifications of the teaching faculty, other than the faculty should be knowledgeable in their subject matter and be current on their continuing education (CE) credits in their field.

In short, you can hire whomever you and the college approve of to teach in your online program. However, hiring faculty with a background in something other than HIM to teach the core HIM courses in an associate or baccalaureate program can create a credibility issue for the students. Faculty serves as role models to their students; they influence the habits of mind of their students (thinking like an HIM professional).

Over the last 10 years, HIM leaders and advocates have helped to shape much of the legislation that now drives the creation, collection, and distribution of health information (creating PHRs, defining the legal EHR, and insisting on rules to govern the release of genetic testing results, to name just a few). This rich history creates the fabric of who and what we are and what we stand for. Our discipline has a history, and it is important that our educators know it. When attracting educators from outside the traditional pathways (AHIMA credentialed) it is especially important to train these educators on the domains/subdomains/knowledge clusters from the model curriculum, and monitor their CE training—ensure that they select topics that support the courses they will be teaching (also a CAHIIM standard).