Medical Billing and Coding Certifications

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Specialty certifications in medical billing and coding let workers specialize in a healthcare subfield, such as anesthesia or cardiology. Check out our guide on the various certifications available.

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Accredited Medical Billing and Coding Professional Certficates

Medical billing and coding certification helps professionals enter the healthcare field quickly. Certification for medical coding and billing can take 4-15 months. Learners need two years to earn a medical billing and coding degree. With medical coding and billing certification, professionals can work in hospitals, doctors' offices, or other healthcare settings.

Some professionals work as medical records and health information specialists. These workers help ensure that healthcare providers bill patients accurately. They earn a median annual salary of $45,240, according to the Bureau of Labor Statistics (BLS). These specialists can increase their salary by earning a medical billing and coding degree.

The following sections answer common questions about medical billing and coding. Read on to learn about important skill sets and certification options. This information includes data as of Jan. 2022. Please use the embedded links for the most current fee schedules.

Questions About Medical Billing and Coding

What Do Medical Billers and Coders Do?

These professionals analyze patient records, organize databases, and apply correct classification codes. They also verify test results and medical histories. Some workers choose a specialization, such as cancer registrar. Medical billers and coders ensure pathology reports contain all required information.

How Much Do Medical Billing and Coding Professionals Earn?

Certified medical billing and coding specialists earn an average annual salary of $44,160, according to Jan. 2022 Payscale data. This surpasses the annual median salary of $41,950 for all occupations, according to the BLS.

Medical billing and coding professionals working for the federal government, professional services companies, and hospitals earn the highest salaries. Geographic location also impacts pay. Professionals in Maryland, Washington, D.C., and New York earn the highest salaries.

What is the Difference Between Medical Coding and Billing?

Medical coders use specialized software to digitize patients' medical records. This requires mastering one or more coding systems. Many coders work at hospitals or other healthcare centers. Medical billers use coders' work to process insurance claims. They also help patients with the appeals process. Many billers work for insurance companies.

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Governing Bodies That Grant Certification

The American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA) award professional certifications to workers with a medical billing and coding certificate. Certification programs also accept learners without an academic background in billing or coding.

  • AAPC

    This organization offers many medical billing and coding certifications. Options include certified professional biller (CPB), certified professional coder (CPC), and a dual-certification program. Many employers do not consider applicants without a CPB or CPC. Some students earn a certification in just eight months. More than 80% of learners pass the certification exam on the first try.

    Students can complete certification classes fully online at their own pace. Career advisors help students find a job that matches their skills.

  • AHIMA

    AHIMA's classes appeal to new and experienced medical billers and coders. Classes cover topics such as medical coding and health information management. Some classes award a microcredential and cost less than certification classes. Learners can work at their pace during some classes. AHIMA members receive tuition and exam discounts.

    Students can transfer microcredentials from AHIMA to a college degree or certificate program. AHIMA partners with Purdue University Global, Pierpont Community and Technical College, and the University of Saint Mary.

Medical Billing and Coding Certifications

Learners can explore several medical billing and coding certifications. Each certification helps workers learn new skills and grow their careers.

  • CCA

    AHIMA's certified coding associate (CCA) costs $299 for nonmembers and appeals to workers with at least six months of experience. Candidates must complete at least one AHIMA program and outside coursework. The two-hour computer test includes 90-115 questions. Test-takers need a minimum 300 score to pass. This top industry certification shows professional competencies and commitment to the field.

  • CCS

    The certified coding specialist (CCS) costs $399 for AHIMA nonmembers and $299 for members. Candidates need two years of work experience, or the CCA certification plus one year of experience. Other requirements include completion of anatomy, medical terminology, and coding courses. The test contains 115-140 questions.

  • CCS-P

    CCAs with at least two years of experience can pursue the certified coding specialist - physician-based (CCS-P). The CCS and CCS-P use the same eligibility requirements and pricing. They differ in that the CCS-P exam focuses on healthcare business operations. Many of the 97-121 exam questions focus on diagnostic coding, research, and procedure coding.

  • CIC

    Certified inpatient coders (CICs) work at hospitals processing new patients' personal and medical data. They work in four coding systems, including ICD-10-CM and ICD-10-PCS. AAPC prefers candidates with membership and an associate degree. The exam includes multiple-choice and fill-in-the-blank questions. Workers renew their certification by earning 36 continuing education units (CEUs) every two years.

  • COC

    AAPC's certified outpatient coder (COC) appeals to workers in many healthcare settings, such as hospitals, clinics, and dialysis centers. The exam costs $350 and includes 100 multiple-choice questions. The test covers medical terminology, coding guidelines, and compliance. COCs must earn the same number of CEUs as CICs to renew their certification.

  • CPC

    Coders who completed AAPC training can pursue the certified professional coder (CPC) credential. The exam contains 100 multiple-choice questions. Candidates complete the test at a testing center or with an online proctor. The test covers medical terminology and surgical procedures. Most test-takers pay $399 for the exam. AAPC offers a discount to student members. CPCs' accuracy leads to improved patient outcomes.

  • CRC

    Certified risk adjustment coders (CRCs) help insurance companies insure high-risk patients. CRCs do so by creating a risk score for each patient. Eligibility requirements include AAPC membership. The four-hour, 100-question test covers compliance and documentation improvement. The exam costs $350. Test-takers receive one free retake if they fail on their first try.

Specialty Certifications in Medical Billing and Coding

Specialty certifications in medical billing and coding let workers specialize in a healthcare subfield, such as anesthesia or cardiology. They appeal to experienced professionals.

  • CASCC

    The certified ASC coder (CASCC) attracts candidates working in ambulatory surgery care. The 100-question certification exam covers different surgeries and reimbursement rules. Test-takers pay $299 for one attempt or $399 for two. AAPC contracts with outside companies to provide CASCCs with CEU opportunities.

  • CANPC

    The certified anesthesia and pain management coder (CANPC) exam assesses test-takers' knowledge of appropriate codes and Medicare billing regulations. AAPC recommends but does not require two years of experience. Test-takers pay the same exam fee as those earning the CASCC. They can schedule the exam at least four weeks in advance and need a minimum score of 70% to pass.

  • CCC

    Certified cardiology coders (CCCs) specialize in coding and medical terminology related to heart medicine. The 100-question, four-hour exam covers cardiology basics and related surgical procedures. Test-takers can buy AAPC study guides to prepare for the exam. Professionals review exam results on their My AAPC account.

  • CCVTC

    Certified cardiovascular and thoracic surgery coders (CCVTCs) use many of the same skills as CCCs. However, CCVTCs further specialize in thoracic conditions and treatments. AAPC recommends that CCCs pursue the CCVTC after gaining professional experience. Test-takers may use approved reference materials during the exam. Those who do not pass their first try receive a breakdown of improvement areas.

  • CDIP

    Healthcare providers hire certified documentation improvement practitioners (CDIPs) to develop and maintain accurate patient records. Eligibility requirements include holding an associate degree or at least one AHIMA certification. Candidates also need two years of work experience. AHIMA members pay a $259 exam fee. The computerized test contains 130-150 questions on topics such as clinical coding practice and leadership.

  • CEDC

    Healthcare centers with emergency rooms hire certified emergency department coders (CEDCs). These coders specialize in codes for emergency procedures, such as fracture care. The 100-question test takes four hours to complete. Test-takers can use approved references during the test.

  • CEMC

    The certified evaluation and management coder (CEMC) certification appeals to AAPC members with two years of relevant experience. Test-takers may use references during the multiple-choice exam. Test questions cover decision-making coding and time-based coding.

  • CFPC

    Coders working in a family practice healthcare setting can earn the certified family practice coder (CFPC) certification. The test focuses on Medicare billing fundamentals, including consultations and shared visits. Other questions assess medical terminology and time-based coding skills. The exam costs $299 for the first attempt. Test-takers must pay $399 for two attempts.

10 Skill Sets From a Medical Billing and Coding Certification

Students who pursue medical billing and coding certification develop many in-demand skills. They can continue improving these skills on the job.

  1. 1

    Knowledge of Medical Terminology

    Coders and billers must know common medical terms relating to body systems, injury, and disease. This knowledge helps them match terms with the right software codes. It also helps them communicate with patients, peers, and medical professionals. Many programs require a medical terminology class in the first module or semester.

  2. 2

    Computer Literacy

    Medical coders and billers spend much of their day on computers. They must keep up with industry software and the latest best practices. Computer skills help workers troubleshoot problems and recognize incomplete data. Students learn these skills in coding basics classes.

  3. 3

    Bookkeeping

    Medical billers apply their bookkeeping skills daily. Bookkeeping involves processing financial information, such as patients' bills and payments. Workers also use bookkeeping to determine insurance obligations and payouts. Experienced bookkeepers recognize errors affecting their employer or patients. Mastering bookkeeping skills involves paying close attention to facts and figures.

  4. 4

    Accuracy

    Mistakes in medical billing or coding may lead to treatment delays or incorrect patient charges. Workers can maintain accuracy by double-checking their work and not rushing through required tasks. Certificate- and degree-seekers learn other accuracy best practices while performing coding and billing exercises.

  5. 5

    Strong Communication Skills

    Medical billers and coders need strong communication skills. These skills allow them to help patients and collaborate with healthcare professionals. Answering questions, resolving issues, and completing tasks all involve communication. Effective communication also reduces mistakes, as workers can ask for help when necessary.

  6. 6

    Teamwork

    Advanced communication and interpersonal skills make medical billers and coders effective team members. They use these skills to collaborate with peers, patients, and healthcare providers. Teamwork leads to positive outcomes, including accurate patient records and billing statements. Top medical billing and coding certifications promote teamwork skills through group projects.

  7. 7

    Adaptability

    Medical billers and coders should be able to adapt quickly to changes. These changes may include sudden problems, increased workloads, or longer hours. Medical billers and coders with this flexibility do not make careless mistakes when under stress. They can also apply this skill in other professions.

  8. 8

    Reading and Listening

    Medical coders use their medical terminology expertise to input medical reports into databases. Performing this task well requires them to read documents closely. Medical transcriptionists use listening skills to turn healthcare professionals' recordings into text. Medical billing and coding degrees train learners in these skills with classes in coding, healthcare, and insurance.

  9. 9

    Attention to Detail

    Detail-oriented workers make fewer mistakes. This means better patient outcomes and correct billing statements. Medical billing and coding classes offer learners specialized feedback. This helps professionals become more attentive workers. Professionals can further develop this skill by double-checking their work.

  10. 10

    Strong Organization Skills

    Many medical billers and coders work from home. This setting requires strong organization skills. Professionals should create a dedicated workspace and create a digital filing system to keep documents organized.

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