What Are the Medical Coding Certification Requirements?

By exploring medical coding certification requirements, you have already taken the first step toward pursuing a satisfying and successful career. Employers today are looking for applicants with a solid education and relevant experience as this field becomes more demanding, complex, and competitive. Medical coding certification will give you a distinct advantage in reaching your goals. Further in this article, we also provide guidance for medical billing certification for those who want information on that distinct career as well.

Coding Certification

You can choose from several national organizations that offer certification:

American Health Information Management Association

The American Health Information Management Association (AHIMA) offers various medical coding certifications, including the Certified Coding Associate (CCA), Certified Coding Specialist (CCS), and Certified Coding Specialist – Physician-based (CCS-P) credentials.

The only requirement for the CCA exam, in addition to AHIMA membership and an application fee, is a high school diploma or an equivalent educational background. To pass the exam, AHIMA recommends that you have at least six months of experience applying coding at a healthcare organization, have attended an AHIMA-approved coding certificate program, or have completed another formal coding training program.

If you are interested in the more specialized CCS or CCS-P exams, AHIMA strongly recommends that you obtain at least three years of experience in a hospital or other physician-based setting where you can apply coding systems to various cases. They also recommend that you complete coursework in anatomy and physiology, pathophysiology, and pharmacology, or be able to demonstrate proficiency in those areas.

You can visit AHIMA’s website for detailed information on medical coding certification requirements.

American Academy of Professional Coders

Getting certified through the AAPC requires an organizational membership and examination fee. The AAPC recommends applicants first earn an associate degree. However, unless you have at least two years of medical coding experience, you will be designated as an apprentice upon passing your exam. Once you’ve completed the required two years, AAPC will remove this designation.

You can find out more about AAPC and its medical coding certification requirements on its website.

Board of Medical Specialty Coding and Compliance

The Board of Medical Specialty Coding and Compliance (BMSC) offers these coding credentials:

  • Specialty Coding Professional (SCP)
  • Advanced Coding Specialist (ACS)
  • Home Care Coding Specialist ñ Diagnosis (HCS-D)

The only requirements for certification through BMSC are a high school diploma or equivalent educational background and a registration fee, which includes the cost of the exam. BMSC notes, however, that its most successful candidates have had at least three years of coding experience in their specialty or two years in home-care coding. You can visit the BMSC website for more information on medical coding certification requirements.

Billing Certification

Two organizations offer certification specifically in medical billing, and they include the following:

AAPC

Recently, the AAPC launched its new medical billing credential — the Certified Professional Biller (CPB), which is nationally recognized. The credential is separate from a certified coding credential, but it teaches some coding basics, with a core focus on medical billing on the provider side of health care. A bonus of this new certification is that it also qualifies for college credits for students who attend the University of Phoenix.

The AAPC course for billers is a total of 80 hours and can be completed at the student’s pace, within a four-month period or less — for those that are able to do so. A student’s enrollment starts from the date of purchase and they are able to log in whenever they want to start. The AAPC recommends taking courses in anatomy, physiology, and medical terminology in advance of signing up for the course in order to have a better comprehension of course materials.

The AAPC recommends that a student complete a minimum of one module per week in order to stay on schedule. The AAPC also allows students to email course-related questions to professional coaching staff.

American Medical Billing Association

Additionally, the American Medical Billing Association (AMBA) offers a medical billing certification course and exam that are nationally recognized.

AMBA requires membership in order to be eligible to sit for the Certified Medical Reimbursement Specialist (CMRS) certification exam. Similar to the AAPC, annual membership renewal is required to maintain certification. Members are required to renew annually to keep CMRS credentials. Members who are certified are required to submit 15 Continuing Education Units (CEUs) to AMBA on their CMRS anniversary date. Of note, AMBA requires that 50% of the required annual CEUs come from any combination of AMBA training, local chapter meetings, courses and/ or the annual conference and from the pre-approved CEU list.

AMBA does not have any prerequisites they require in order to take the CMRS Exam, nor are there required courses or training. AMBA does, however, recommend against sitting for the certification exam without any prior billing and/or coding training of some type.

You can visit AMBA’s website for more information regarding certification.

Final Thoughts

If you have targeted a hospital or other health care setting where you’d like to work, contact the human resources department to ask about what credentials they look for when selecting candidates. You might also consider seeking advice from a local college if it offers an associate degree in medical coding.