Medical Billing and Coding Certification

Medical billing and coding involves using both financial acumen and medical knowledge to bill patients, send insurance claims and create accurate patient health records. When looking for medical billers and coders, employers seek out candidates with medical billing and coding certifications to ensure that they’re qualified and experienced. These certifications signal to hospitals, private practices and clinics that medical billers and coders have taken the time to study the complex world of billing and coding.

There are many different types of medical billing and coding certifications available from several major and respected institutions.

Offered by AAPC, a professional association with more than 175,000 members, a CPC certification indicates that holders have proven mastery of all code sets, evaluation and management (E/M) principles, adherence to documentation and coding guidelines and more.

According to AAPC, CPCs:

• Understand how to integrate medical coding and payment policy changes into reimbursement processes
• Possess expertise in reviewing and assigning accurate medical codes
• Are knowledgeable in anatomy, physiology and medical terminology

This exam consists of 150 multiple choice questions, and students are allowed 5.5 hours to answer.

Offered by the American Health Information Management Association (AHIMA), a professional association with more than 103,000 members, a CSS certification indicates that holders can classify medical data from patient records.

According to AHIMA, CSSs:

• Review patients’ records and assign codes for each diagnosis and treatment
• Can use ICD-10-CM and CPT coding systems
• Are knowledgeable in medical terminology, pharmacology and disease processes

This exam consists of 97 multiple choice questions and eight medical scenarios, and students are allowed four hours to answer.

Also offered by AHIMA, a CCA certification http://www.ahima.org/certification/CCA indicates that holders have demonstrated a certain level of commitment and coding expertise across all settings.

According to AHIMA, CCAs:

• Are committed to the coding profession
• Exhibit dedication, competency and professional capacity

This exam consists of 100 multiple choice questions, and students are allowed two hours to answer.

Before taking a medical billing and coding certification exam, students should prepare for the exam by taking courses courses that cover:

Learn medical terminology, including the foundations of words used to describe the human body and its conditions, terminology for medical procedures, the names of commonly prescribed medications and common abbreviations.

Explore the history and organization of, and current issues in, the United States healthcare delivery system, including interrelationships among system operators and care providers.

Compile codes, categories, calculations, tabulations and audits, or verify information or data.

Enter, transcribe, store or maintain information in written or electronic form.

Explore reimbursement and payment methodologies applicable to healthcare provided in various U.S. settings as it relates to relevant forms, processes, practices and the roles of health information professionals.

In order to pass a medical billing and coding certification exam, you must obtain:

• CPC exam: 70%
• CCS exam: 300 points out of 400 (75%)
• CCA exam: 300 points out of 400 (75%)

To take a medical billing and coding certification exam, students must also pay for admittance to the exam. The exams cost:

• CPC exam: $260 for AAPC members and $300 for non-members
• CCS exam: $299 for AHIMA members and $399 for non-members
• CCA exam: $199 for AHIMA members and $299 for non-members

The three major medical billing and coding certifications—CPC, CCS, and CCA—are offered through AAPC and AHIMA.

To prepare students not only for certification exams but also for a career in medical billing and coding, DeVry offers undergraduate medical billing and coding programs that offer an extensive set of coursework. Through our health information coding and medical billing and coding programs, students gain a deep understanding of:

• Medical terminology
• Health services and information systems
• International classification of diseases coding
• Health insurance and reimbursement
• Information processing
• Information documentation and recording
• Procedural terminology
• Medical data classification