Medical Billing & Coding Certification

American Academy of Professional Coders

The American Academy of Professional Coders (AAPC) offers several types of certification for medical coders.

Certified Professional Coder (CPC)
A Certified Professional Coder (CPC) must pass a coding certification examination sponsored by the American Academy of Professional Coders. The examination consists of questions regarding the correct application of CPT®, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies. A CPC must have at least two years coding experience and maintain yearly renewal and CEU requirements.

Certified Professional Coder-Hospital (CPC-H)
A Certified Professional Coder-Hospital (CPC-H) must pass a coding certification examination sponsored by the American Academy of Professional Coders. The examination consists of questions regarding the correct application of CPT®, ICD-9-CM diagnoses and procedure codes used for billing facility services to insurance companies. A CPC-H must have at least two years coding experience and maintain yearly renewal and CEU requirements.

Certified Professional Coder-Payer (CPC-P)
The Certified Professional Coder-Payer (CPC-P) credential certifies that the successful candidate has knowledge and skills to adjudicate provider claims effectively. The CPC-P demonstrates the payer coder’s aptitude, proficiency and knowledge within the payer environment. Their coding is viewed by claims reviewers, utilization management staff, benefits staff, provider relations and customer service staff. A CPC-P must have at least 2 years coding work experience that includes working with CPT®, ICD-9-CM, or HCPCS code sets and must maintain the required amount of yearly CEUs.

Specialty Credentials

Specialty credentials are also offered through the AAPC for evaluation and management, general surgery, obstetrics and gynecology. Orthopedics, emergency medicine, cardiology, gastroenterology, psychiatry, and cardiovascular and thoracic surgery will be available in the near future.

The American Academy of Professional Coders
2480 South 3850 West, Suite B
Salt Lake City, Utah 84120

http://www.aapc.com/

American Health Information Management Association

The American Health Information Management Association (AHIMA) offers the following credentials.

Certified Coding Associate (CCA)
New coders who earn the CCA will immediately demonstrate their competency in the field, even if they don't have much job experience. Earning a CCA demonstrates a commitment to coding even for those who are new in the field. CCA holders will also distinguish themselves from non-credentialed coders and those who hold credentials from other organizations that do not require the higher level of expertise necessary to earn AHIMA certification.

Certified Coding Specialist (CCS)
Certified Coding Specialists are professionals skilled in classifying medical data from patient records, generally in the hospital setting. These coding practitioners review patients' records and assign numeric codes for each diagnosis and procedure. To perform this task, they must possess expertise in the ICD-9-CM coding system and the surgery section within the CPT coding system. In addition, the CCS is knowledgeable of medical terminology, disease processes and pharmacology.

Certified Coding Specialist-Physician-based (CCS-P)
The CCS-P is a coding practitioner with expertise in physician-based settings such as physician offices, group practices, multispecialty clinics or specialty centers. This coding practitioner reviews patients' records and assigns numeric codes for each diagnosis and procedure. To perform this task, the individual must possess in-depth knowledge of the CPT coding system and familiarity with the ICD-9-CM and HCPCS Level II coding systems. The CCS-P is also expert in health information documentation, data integrity and quality. Because patients' coded data is submitted to insurance companies or the government for expense reimbursement, the CCS-P plays a critical role in the health provider's business operation.

The American Health Information Management Association
233 N. Michigan Avenue, Suite 2150
Chicago, IL 60601-5800

http://www.ahima.org/certification