Medical Billing and Coding Certification

Medical billing and coding combines financial knowledge with an understanding of medical terminology in order to bill patients, build accurate patient health records and create insurance claims. Employers on the hunt for medical billers and coders may have several things in mind during their search, including medical billing and coding certifications. These professional certifications signal to hospitals, private practices and clinics that you have taken the time to study the complexities of the medical billing and coding world.

There are many different types of medical billing and coding certifications available that are administered by several major and respected institutions. Each certification has its own purpose and application, making them specific  to certain areas within  the medical billing and coding field.

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

According to the 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.

The Certified Coding Specialist certification is offered by the American Health Information Management Association (AHIMA), a professional association with more than 103,000 members. The CCS certification demonstrates that you can accurately classify medical data as well as test your proficiency and measure data quality.

According to AHIMA, CSSs:

• Review patient 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 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 you take a medical billing and coding certification exam, you should complete courses that cover the following topics in order to prepare for each examination:

Explore medical terminology by learning the foundation of words used to describe anatomy and conditions in patients, terminology for medical procedures, names of frequently prescribed medications and common abbreviations.

Learn about current issues in the United States healthcare delivery system and explore the history of those issues and the system itself, as well as investigate the relationship between system operators and care providers.

Discover how codes, categories, calculations, tabulations and audits are compiled and completed and learn how to verify data and information.

Learn how to transcribe, input and store patient information in written and electronic forms.

Explore patient reimbursement and payment methods, and learn about the relevant forms, practices and processes used by health information professionals in the U.S. healthcare system.

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

• CPC exam: 70%
• CCS exam: 300 points
  
• CCA exam: 300 points

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

• CCA exam: $299 ($199 for AHIMA members)
• CCS exam: $399 ($299 for AHIMA members)
• CPC exam: $399

Two respected healthcare organizations administer the major medical billing and coding certifications. The CCS and CCA are offered by AHIMA, and the CPC certification is offered through the AAPC.

To help prepare students not only for certification exams but also for a career in medical billing and coding, we offer an undergraduate Medical Billing and Coding program online that provides an extensive set of coursework. 

Both the Health Information Coding certificate path and the core Medical Billing and Coding curriculum can help you develop 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