AAPC Officer Duties

Founded in 1988, the American Association of Professional Coders is a trade association that provides education and accreditation to physician-based medical coders. Along with the American Health Information Management Association, AAPC credentials are the most highly respected certification in medical coding. Beginning in mid-January 2011, the organization offers certification for the position of certified professional compliance officer (CPCO). The AAPC articulates specific duties to be performed by this officer.

Federal Laws and Regulations

• The Patient Protection of Affordable Care Act of 2010 establishes many new requirements for compliance programs at hospitals and medical centers in order for them to be eligible for federal health care programs. The CPCO must understand how the act will affect practices in the workplace. He should also understand other federal laws and regulations that affect the field. The officer should demonstrate fluency in Office of Inspector General compliance guidelines for physician practices, clinical laboratories and third-party billing companies. In all of these areas, the CPCO should be able to communicate fluently with both internal and external legal counsel as well as senior management.

Policies and Procedures

• The CPCO must implement written policies, procedures and standards of conduct. These standards should be enforced through publicized disciplinary guidelines and a codified system to administer sanctions. The CPCO must ensure that managers and employees can report violations of the rules without fear of retaliation. On occasion, the CPCO should review current policies and procedures in light of changes in the medical organization.

Medical Fraud

• The AAPC compliance officer should have an understanding of medical fraud audits. A working knowledge of key health care fraud and abuse laws, such as the False Claims Act and the Stark Laws, are mandatory for CPCO certification. If she discovers illegal activity, the officer must respond promptly to the situation and report findings to the government.

Risk Areas

• The CPCO should monitor risk areas such as gifts, gratuities, beneficiary notices and any potential conflicts of interest. For instance, a pharmaceutical company that offers a doctor a free trip to Hawaii in return in return for prescribing a new drug to patients would present a clear ethical issue. Compliance officers should be able to communicate effectively with medical staff on these areas of concern and develop contingency plans if these problems occur. They also should be able to ensure that third parties adhere to these standards.