Medical Coding Certification

By Rachel Schneider

The medical billing and coding field features several certification opportunities through medical billing and coding schools and medical coder classes. Employers across industries typically require candidates to hold medical coding certification to demonstrate their competencies, skills, and abilities in the discipline. Credentials also show commitment to a chosen career path.

Certifications equip candidates with the high-level knowledge they need to thrive in a given field. Depending on the specific credential, students encounter different medical coding classes, required training, and exam components. Additionally, candidates must satisfy different processes for recertification, depending on their certification and certifying agency.

Medical Billing and Coding Certifications

Professionals who want to explore medical billing and coding certification opportunities can review medical coder training and medical coder courses within the American Association of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA). These organizations offer certifications across disciplines and levels.

AAPC Medical Coding and Billing Certifications

Providing education and professional certification to physician-based medical coders since 1988, AAPC elevates the standards of medical coding by providing networking, training, and certification opportunities. The association boasts nearly 200,000 members internationally and offers 28 certifications in professional service coding, professional billing, medical compliance, and more.

The certified professional coder (CPC) exam allows professionals to demonstrate high-level competencies in physician-based medical coding. After candidates complete AAPC training to become medical coders, they can register for the CPC exam. Earning this credential can increase earning potential by $20,000 or more. The exam comprises 150 multiple-choice questions and assesses 17 areas of knowledge.

Professionals who earn certification through AAPC must maintain their credentials by completing continuing education requirements. These requirements focus on interventional radiology, cardiovascular coding, auditing, compliance, and practice management.

Certified Professional Coder: Widely considered as the most esteemed certification for medical coders, the CPC credential requires candidates to pass a 150-question, multiple-choice exam to test their medical coding proficiency.

Certified Outpatient Coder: This certification prepares professionals for outpatient ambulatory coder jobs, equipping them with specialized payment knowledge and coding skills. Candidates must pass an exam to obtain certification.

Certified Inpatient Coder: As one of the most prestigious certifications for medical coding, this credential relates exclusively to inpatient hospital and facility coding. This certification validates expert-level experience and knowledge.

Certified Risk Adjustment Coder: The CRC credential prepares candidates to read medical charts and assign the correct diagnosis codes for clinical cases and services for risk adjustment models. Each candidate must pass a certification exam to earn the credential.

Certified Professional Coder-Payer: Candidates pursuing this credential validate their skills and knowledge of medical coding. These individuals demonstrate their ability to decide provider claims appropriately while using basic knowledge of coding-related payer functions.

Specialized AAPC Certifications

Professionals can move beyond the previous options into more specialized certifications. These professionals enhance their knowledge and skills in a more advanced discipline of medical billing and coding. Specialized certifications prepare professionals to pursue more career opportunities with higher salaries. Experienced coders who demonstrate high levels of expertise in their specialty area of the field pursue these certifications.

Certified Ambulatory Surgery Center Coder: This certification requires candidates to pass an exam that tests their ability to read and interpret operative notes to apply the correct codes. These candidates should demonstrate a solid understanding of medical terminology, anatomy, and physiology.

Certified Cardiology Coder: Candidates who want to pursue this credential must pass a certification exam. AAPC also offers a certification study guide to better prepare candidates for certification.

Certified Family Practice Coder: Professionals can earn this credential by passing a certification exam that tests them on their ability to read and interpret procedure and physician office notes to apply the appropriate medical codes.

AHIMA Medical Coding and Billing Certifications

AHIMA, a global nonprofit association of health information dedicated to improving health record quality, promotes leadership roles to enhance health information management.

Professionals can maintain AHIMA certifications through the association's recertification process. Recertification requires each individual to earn a specific amount of continuing education units within the two-year certification cycle. These units can include participation in formal education programs of study, independent study activities, and involvement and oversight of direct clinical practice.

AHIMA and AAPC offer different certification types. AHIMA primarily provides certification for inpatient and outpatient coding, while AAPC certifies prospective coders in outpatient coding and CPC credentials.

Certified Coding Associate: The CCA credential requires candidates to pass an exam based on job analysis standards and created using state-of-the-art testing principles.

Certified Coding Specialist: The certification exam for the CCS credential tests candidates on their ability to review patient records and assign the correct numeric codes for each procedure and diagnosis.

Certified Coding Specialist - Physician-Based: This credential prepares professionals to work in physician-based settings, including group practice, physicians' offices, multi-specialty clinics, and specialty centers. These professionals also focus on health information documentation.

Specialized AHIMA Certifications

Individuals with medical billing and coding training who want to focus on the most advanced career opportunities can consider the following specialty certifications. These opportunities prepare professionals for more career opportunities.

Certified Health Data Analyst: Earning the CHDA credential prepares professionals to demonstrate broad organizational knowledge and validate specialized competencies. These professionals display a commitment and level of professionalism in their discipline.

Certified in Healthcare Privacy and Security: Candidates interested in this credential should hold an associate, bachelor's, or master's degree, along with 2-6 years of professional experience in healthcare privacy or security management, depending on their degree level.

Certified Documentation Improvement Practitioner: This certification allows candidates to demonstrate their competencies in high-quality clinical documentation with patient health records. The credential prepares professionals to become leaders in health informatics and information management.