Medical Billing and Coding Exam

If you’re interested in becoming a medical billing and coding specialist, getting certified can be an important step. There are two primary certifying bodies in the United States: the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC).

AHIMA offers three medical billing and coding certifications: Certified Coding Associate (CCA®), Certified Coding Specialist (CCS®) and Certified Coding Specialist – Physician-based (CCS-P®), while the AAPC offers five: Certified Professional Coder (CPC®), Certified Outpatient Code (COC™), Certified Inpatient Coder (CIC™), Certified Risk Adjustment Coder (CRC™) and Specialty Medical Coding Certification. While some roles may require a specific credential, passing any of these exams can help you demonstrate your knowledge and skills in medical billing and coding to future employers. Below we cover three of the exams for which DeVry offers programs or courses that integrate elements or can help you prep for these exams.

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What is the Certified Professional Coder (CPC) Exam?

What is the CPC Exam? The CPC exam, offered by the AAPC, is a multiple-choice exam that covers 17 different knowledge domains. It lasts five hours and 40 minutes, and a passing score is 70%. The AAPC offers the CPC exam online or in-person at a physical testing center.

You might also be wondering: how hard is the CPC exam? The answer depends largely on your preparation. The exam requires strong background knowledge in anatomy and physiology, as well as medical terminology. You will also need to be familiar with the different types of codes used to submit medical claims. But don’t panic – you won’t need to memorize all the codes as you will be able to reference approved coding books during the exam.

What is the Certified Coding Associate (CCA) Exam?

Offered by AHIMA, the CCA exam is a two-hour computer-based test consisting of 90 to 115 questions across six knowledge domains. Students must score a 300 to pass. You will be able to use approved reference books to look up specific codes.

Passing the CCA exam is largely a matter of preparation. The test uses many different types of questions to test your skills, knowledge and experience. AHIMA recommends that before taking the exam, you either take a prep course, work for at least six months in a coding position or brush up on your knowledge of medical terminology, anatomy, physiology and diagnostic and procedural codes.

What is the Certified Coding Specialist (CCS) Exam?

The CCS exam is AHIMA’s more advanced test, designed for experienced coding professionals. The four-hour computer-based exam consists of 115 to 140 items, divided into two sections: multiple choice and medical scenario. A minimum score of 300 is needed to pass.

AHIMA recommends that those preparing for the exam have either two years of coding experience or another coding credential with one year of experience. You will also need strong foundational knowledge in areas such as anatomy and physiology, pharmacology, pathophysiology and reimbursement methodology.

How Can I Earn a Medical Billing and Coding Certification?

The first step in the certification process is to decide which credential you want. While different employers may have different preferences, both the AAPC and AHIMA are nationally recognized.

You will then need to prepare for your exam. Some people choose to do this on their own, but for many students, a formal certificate program is the best way to help ensure that they have all the knowledge, skills and practice they need to pass their chosen exam.

At DeVry, we offer two different Medical Billing and Coding certificate programs, which include built-in CCA and CCS exam prep. Our two Medical Billing and Coding programs also integrate elements in their curriculum that align with the objectives of the CPC exam. Both programs cover similar material, but which to take depends primarily on the specific skills you want to gain and which certificate you want to earn.

Medical Billing and Coding Certificate

Our Medical Billing and Coding certificate program at DeVry is most appropriate for those who are looking to gain core skills in billing and coding. In just 10 courses and as little as one year of study¹, you will gain a strong understanding of the topics you need to pursue entry level roles in the industry. These include fundamental health courses such as anatomy and physiology, as well as medical terminology, health information processes, ICD coding and other health information technology courses. Exam prep focuses on the CCA exam but also includes content and objectives of the CPC exam.

Medical Billing and Coding – Health Information Coding Certificate

Our Medical Billing and Coding – Health Information Coding certificate program at DeVry covers all the material in our medical billing and coding program, with additional courses in topics such as legal and regulatory issues. With this program, you can help prepare for more advanced entry level billing and coding positions. Exam prep focuses on the CCS exam but also includes content and objectives of the CCA and CPC exams.

Regardless of the path you choose, after passing your certification exam you may need to meet additional requirements to become fully certified, including becoming a member of the AAPC or the AHIMA. Those who pass the CPC exam are considered apprentices until they gain two years of coding experience.

What You'll Find on the CPC Exam

The CPC exam focuses largely on surgical procedures across 10 different areas of the body, such as the digestive, respiratory and nervous systems. There are also questions in the domains of evaluation and management, radiology, anesthesia, path/lab, medical specialties, medical terminology, anatomy, ICD diagnosis, compliance and various coding guidelines and modifiers.

What You'll Find on the CCA Exam

The CCA exam focuses on six different areas. Most questions are in the area of clinical classification systems, including vocabulary and terminology, data interpretation and assigning codes. The next biggest focus is on reimbursement methodologies, including linking diagnoses and codes to payer guidelines and responding to denied claims. Other areas of focus include health records, compliance, information technologies and confidentiality.

What You'll Find on the CCS Exam

Questions on the CCS exam are drawn from four domains. Most questions focus on coding knowledge and skills, including modifiers, sequencing, edits and reimbursement classifications. The next largest area of focus is regulatory compliance, including health record integrity, HIPAA and adherence to ethical standards. Other domains include coding documentation and provider queries.