Medical Billing and Coding Certification ā Overview
Medical billing and coding certifications are in high demand in the US and in the global healthcare industry.
Those aspiring to be medical billing professionals can fully expect a fruitful and satisfying career ahead of them.
Employers in the healthcare industry seek highly certified professionals. Those with a solid education and relevant experience are most sought-after by employers.
Medical Billing and Coding Certification
According to the US Bureau of Labor Statistics, the employment of medical records specialists, including medical billing and coding professionals, is projected to grow 7% from 2024 to 2034. (BLS)
Medical coding and billing professionals are required in almost every healthcare practice, clinic and hospital.
Once you gain significant and relevant experience in this field, you can also work from home. Medical billing and coding certification requires knowledge of several coding systems, including but not limited to CPT, HCPCS Level II, and ICD-10-CM.
- CPT (Current Procedural Terminology)
- HCPCS (Healthcare Common Procedure Coding System) Level II
- ICD-10-CM
Getting an additional medical certification in medical billing will give you an extra edge over your peers.
Several organizations offer three of the most common medical coding and billing certifications in the US. Aspiring medical billing coding professionals can choose from:
- Certified Professional Coder (CPC)
- Certified Coding Specialist (CCS)
- Certified Medical Coder (CMC)
In this article, we have detailed everything you should know about medical billing and medical certification.
This includes details of becoming a certified professional coder, a certified coding specialist and a certified medical coder.
How to get Certified Professional Coder (CPC) Certification?
The Certified Professional Coder certification is ideal for working in outpatient departments. CPC professionals are usually employed by outpatient clinics or physicianās offices.
This is the most popular certification exam in the medical billing coding field.
The CPC certification is provided by the AAPC (formerly the American Academy of Professional Coders). This is the largest such organization, with over 250,000 members.
The AAPC suggests those with a minimum associateās degree from an accredited institution should appear for the CPC exam.
Usually, candidates with significant experience in the medical coding field choose to take the CPC exam.
It is important to remember that completing the CPC exam does not guarantee you a Certified Professional Coder certificate.
Newbies to the field are initially awarded the CPC-A (Certified Professional Coder ā Apprentice) certificate.
These candidates will also need to gain a minimum of 2 years of on-the-job coding experience and submit employer verification letters to the AAPC. Alternative pathways include 1 year of experience combined with completion of an 80-hour coding course, or completion of an 80-hour coding course plus AAPCās Practicode program.
As stated by the AAPC, CPC-certified professionals are required to complete 36 Continuing Education Units (CEUs) within a two-year renewal cycle. You can earn CEUs by attending online courses, conferences, and similarly approved events.
To learn additional details on eligibility criteria and the application process, you can visit the official AAPC website at https://www.aapc.com/.
How to get a Certified Coding Specialist (CCS) Certification?
Certified Coding Specialist (CCS) professionals are usually employed at inpatient medical facilities. The AHIMA (American Health Information Management Association) organizes and holds the CCS exam.
AHIMA recommends (but does not require) that candidates meet at least one of the following criteria before appearing for this exam:
- Completion of coursework in anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, and ICD/CPT/HCPCS coding, plus 1 year of coding experience directly applying codes.
- Two years of relevant experience in medical coding
- A current medical coding certification with 1 year of experience in medical coding
Unlike the CPC exam which requires AAPC membership, AHIMA membership is not required to take the CCS exam, though members receive a discounted exam fee.
AHIMA cost for exam is:
Non-member price: $399
Member price: $299.
The CCS exam covers 5 domains (per the exam content outline effective 05/01/2024):
1. Coding Knowledge and Skills (39ā41%)
2. Coding Documentation (18ā22%)
3. Provider Queries (9ā11%)
4. Regulatory Compliance (18ā22%)
5. Information Technologies (9ā11%)
CCS-certified professionals must complete 20 Continuing Education Units (CEUs) per two-year recertification cycle to maintain their certification, as per AHIMAās standards. This is part of their commitment to ongoing professional development.
For additional details on CCS eligibility criteria, application process, and exam details, you can visit the official AHIMA website at https://www.ahima.org/.
How to get Certified Medical Coder (CMC) Certification?
Although the Certified Medical Coder (CMC) certification is not as popular as the CCS and CPC, it is recognized as a significant certification for becoming a professional medical billing and coding expert.
In effect, the CMC exam format is considered more difficult than CCS and CPC.
The Practice Management Institute (PMI) organizes the certified medical coder examination every year.
Aspiring candidates should have at least 1 year of work experience as an outpatient medical coder, or successful completion of foundational coding training courses (included with enrollment).
Newbies can also choose to take the Principles of Coding course. However, these preparatory courses are not mandatory for appearing for the CMC exam.
The CMC exam differs from CPC and CCS because it does not follow the multiple-choice-question format. Thus, candidates need to assess coding scenarios and fill in the blanks accordingly.
The CMC exam is also held in a live, proctored setting and includes around 133 questions. Candidates with more than 70% marks are considered for CMC certification.
If you want to remain certified as a CMC professional, you will need to earn a minimum of 12 Continuing Education Units (CEUs) every year.
In addition, you will also need to submit proof of completion to the PMI.
To learn further details of eligibility criteria, application process and other queries, you can simply visit the official PMI website at https://www.pmimd.com/onlinetraining/
Conclusion
Certified medical billing and coding certifications boost your career. They are also incredibly useful for staying ahead of the competition and increasing your employment value.
Feel free to visit the official websites of the above-given organizations for additional information on the CPC, CMC, and CCS exams.
See Also
Medical Billing and CodingĀ Salary
How to Apply Medical Billing and Coding Schools
Medical Billing and Coding Grants
