An Introduction To Medical Coding Certification

A medical coding certification is basically a special examination to test for competency. Upon passing an exam that tests competency in the field of medical coding, a coder or coding student is said to be certified.

Certification is not usually offered by any state run educational organization but rather by professional organizations and various schools.

Often they correspond to or follow courses of study in medical coding, but they also may be taken at any time by somebody already in the field to demonstrate their competency. Anyone with a high school diploma may take these tests, but the chances are that you will need to study fairly deeply in the field before you’re really prepared to take and pass a medical coding certification exam with a decent score.

If you’re considering getting certified in basic medical coding the first thing you need to realize is that there are several types of medical coding certification based on what type of medical coding you’re going to be doing and how comprehensive you want to be.

The following are a few varieties of the basic Certified Professional Coder (CPC) certification listed on the American Academy of Professional Coders website along with some other exams. Keep in mind that other professional organizations and schools may offer differently titled medical coding certifications, but these are some of the most widely accepted ones.

Basic Level Medical Coding Certification: Certified Professional Coder (CPC)

As noted above this is the basic certification and demonstrates a knowledge of basic codes and coding procedures.

Certified Professional Coder – Outpatient Hospital (CPC-H, CPC-P, etc.)

As the name implies this certification shows mastery of techniques and coding procedures used in outpatient situations – hospital, clinics, and so on. Again all the basic coding schemes and techniques are covered but the emphasis is on the way they factor into outpatient billing practices.

Certified Professional Coder – Payer (CPC-P)

This certification deals with the coding procedures and norms that apply after a bill has been submitted to the paying party – i.e. Medicare, Medicaid, a private insurance company, or the patient. Often payers themselves hire coders to check medical bills submitted and adjust claims if necessary. This certification exam tests the knowledge of this whole branch of the coding/billing process.

These coding certifications will be very helpful for you in your search for a well paid and enjoyable coding position.

If you want to go “above and beyond”, there are also more comprehensive medical coding certifications that allow you to branch out a little more. Exams for these are often given after students have completed Associates and Bachelors degree programs.

Professional Level Medical Coding Certification: Registered Health Information Technician (RHIT)

This certification usually follows completion of an associate’s degree program. It demonstrates not only in depth knowledge of medical coding, but related fields such as billing and transcription and the whole field of health information in general.

Advanced Level Medical Coding Certification: Registered Health Information Administrator (RHIA)

Usually follows a Bachelor’s degree program. This covers health administration, of which billing and coding is only a part. With this certification a student is qualified not only to work in a medical office but to run a health care facility or a section of one.

The way to get a medical coding certification is usually simply to take an in class or online course, preferably an accredited one, and then proceed to take (and pass) one of these exams. There are several professional organizations such as the American Health Information Management Association (AHIMA), the American Academy of Professional Coders, the Committee on Accreditation for Health Informatics and Information Management (CAHIIM), and the American Medical Billing Association (AMBA) that either accredit various colleges and online program which offer their own certification exams, or provide their own certifications.

AHIMA offers a basic medical coding certification exam called the Certified Coding Associate (CCA) exam as a beginning level certification and also offers the higher level exams. They or similar certifications may be found at colleges and universities as well. AMBA offers an exam/certification called Certified Medical Reimbursement Specialist (CMRS) that is also widely accepted as a good all around certification. The links to the websites of these organizations are listed at the end of this article.

Getting a medical coding certification is not legally required but it is certainly a good idea. Coders with certifications often find higher paying positions, or simply have an easier time getting hired in general. Certification proves a certain standard mastery level rather than leaving it up to chance or a general impression of your experience level so it’s not difficult to see why employers like to see it on a resume.

So if you’re going to get educated as a medical coder you might as well be thorough about it. Take a certification exam and give prospective employers, or in the case of freelance coders in business for themselves – clients, all the proof they could need of your expertise.

The American Health Information Management Association (AHIMA)

The American Academy of Professional Coders (AAPC)

Commission of Accreditation for Health Informatics and Information Management (CAHIIM)

The American Medical Billing Association (AMBA)

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