Medical coding certification
Elsewhere in this guide, I’ve shared with you ways to get started in medical billing and coding even if you have no work experience, but the one thing that helps the most to get you a job in the field is medical coding certification. Via certification you make it abundantly clear to prospective employers that you have precisely what it takes to do medical coding jobs in an accurate way.
Medical coding is highly detailed work requiring analytical skills and knowledge of medicine, and having credentials or even simply being in the process of pursuing certification from one of the certifying bodies in the field will help you immensely both in getting your initial job as well as in getting promoted down the line.
You can get hired without certification, and most newcomers to the field do because most certifications have a work experience requirement that must be met before certification is granted. However, it is certainly easier to get hired once you’re credentialed. It’s ultimately a personal decision whether you choose to go for this type of credential prior to starting your medical billing or coding career, but it is highly recommended if you want to ensure that you get a great job as a biller or coder that pays well and helps you afford the lifestyle you want to live.
Medical coding certification: What it is and why you need it
All of the certification programs that I have looked into are designed to ensure that you provide the best possible coding skills regardless of setting, whether a physician’s office, hospital, inpatient or outpatient facility or medical specialization. Every one of these situations requires different knowledge, so the coursework for certification prepares you to handle the specific situations that arise within each of those medical scenarios.
Because medical coding and billing require such precision and specialized knowledge, there are 2 organizations that offer medical coding certification in which you can enroll from your location; there are testing facilities available across the US.
Both the American Association of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA) offer various types of certification, which I will outline in brief below:
The AAPC (American Association of Professional Coders) offers the following certifications:
- CPC: Certified Professional Coder
- CPC-H: Certified Professional Coder – Hospital Outpatient
- CPC-P: Certified Professional Coder-Payer (for insurance employees)
- CIRCC: Certified Interventional Radiology Cardiovascular Coder
In addition there are also specialty certifications in such fields as pediatrics, emergency medicine and urology available on the AAPC site.
AHIMA offers the following certifications, among others:
- CCS: Certified Coding Specialist
- CCS-P: Certified Coding Specialist-Physician Based
(AHIMA does have quite a number of other certifications, but they are less important to worry about initially, so I am sharing with you the medical coding certification options that are most worthy of consideration at first when you launch your new career.)
Looking over this list, what you need to know first of all is that the AAPC coding certifications (CPC and the like) focus mainly on doctor’s offices and outpatient facilities, while the AHIMA CCS certifications focus mostly on hospitalization, though there is overlap, and you can choose certain certification options from both AAPC and AHIMA that will help you in both scenarios. As you can see, though, you do need to choose a direction in your career when you start looking into getting certified because there is a significant time and financial investment for each one of the certifications.
You can easily go to AAPC.com or and learn more about the requirements for each of these programs. I am going to walk you through one of the choices, though, just to illustrate what is involved so that you can better understand the overall commitment of these certifications.
To become a Certified Professional Coder (CPC), you need to pick up an application for the certification from the organization that gives the exam (the AAPC in this case) and submit it and any necessary fees and required references at least 6-7 weeks prior to sitting for the exam, depending on the current requirements published by the AAPC. (Online registration is possible for some credentialing exams.) What that means is that, for example, if you wanted to sit for an exam that is scheduled for December 5, you would need to get in your registration form at least 6 weeks prior to that date so that they can add you to their list. You also need to become a member of the AAPC to sit for the CPC exam, and I recommend that you do so a few weeks before submitting your application just to make sure that you’re already in their database and can be easily added to the exam roster.
There are preparation materials that you can use to get ready for the exam, and the CPC test itself has 150 questions on a variety of subjects related to medical coding. You also have to have 2 years of experience in the field to get the CPC distinction, but if you have 1 year of coding experience, you may be able to get a CPC-A (Apprentice) designation and then get the full CPC credential once you have worked another year and submit the right information to the AAPC. You can waive some of the experience requirements if you attend a couple different types of coding courses that have certain hours of training involved, but I am not going to get into those specifics here because how this works varies by certification type, and I am only seeking to give you a basic idea of how the process works.
Most certification exams are open book, but only certain materials are allowed as reference during the exams. For the CPC exam, you can take in CPT, HCPCS and ICD-9-CM manuals from the year you are taking the exam, but other exam prep materials are not allowed because they might assist you unfairly during the test. You are not required to take any courses before sitting for the CPC exam, but it may help you.
Now, that’s an overview of how the CPC test works, and it’s up to you to decide which type of certification you need based on the type of medical billing and coding work that you wish to get into or that you’ve already been hired to do. At this point, I recommend a thorough read-through of the details on the different certifications on the main websites for those tests if you are in need of certification right now. If you are just thinking about what will be required for your career in the future, rest assured that there are plenty of medical coding certification options that will help you get ahead.