Certification for Medical Coding and Billing: Requirements to Become Certified

Understand how to get certification for medical coding and billing and become a certified specialist.
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Medical Billing Career Facts

Specialties & Certification for Medical Coding and Billing

A medical billing and coding certification can add a huge boost to your career, especially if you choose an area to specialize in which is in high demand in your region of the country. Employers are always much more likely to hire an individual who carries a recognized certification in a particular area of medical billing and coding.

If you’re wondering how to become a certified medical biller and coder, it’s really just a matter of taking all the steps necessary to prepare yourself to take the tests offered by one of several agencies, for instance the American Academy of Professional Coders (AAPC), or the American Health Information Management Association (AHIMA).

Certifications Recognized by the AAPC

The first certification you can earn from the AAPC is that of Certified Professional Coder (CPC), and the examination for this certification will cover specific areas. In addition, you must have completed a minimum of two years of professional coding, after which you would be required to maintain annual renewals so your skills can be kept updated.

The Certified Professional Coder-Hospital (CPC-H) will involve an examination on procedures specific to hospitals, and to billing insurance companies for medical claims. You must also have the two years of experience in the field before you can acquire the certification.

Certification as a Certified Professional Coder-Payer (CPC-P) requires that you have the skills necessary for adjudication of provider claims. Acquiring this certification will show everyone that you have demonstrated the skills and knowledge in the payer’s environment to successfully manage claims on behalf of your employer. Your coding work could potentially be reviewed by a number of different professionals for accuracy, including benefits staff, customer support team, and utilization management staff personnel.

Again, you must have two full years of coding experience, which consists of working experience with CPT®, HCPCS, or ICD-10-CM code sets.

Medical Billing Specialties

The following medical billing and coding specialty credentials come provided in specific areas by the AAPC:

AnesthesiaCardiovascular & Thoracic
UrologyGynecology  & Obstetrics
DermatologyEmergency Department
GastroenterologyInternal Medicine
OrthopedicsPlastic/Reconstructive Surgery
Ambulatory Surgery Centers (ASC)Family Practice
General SurgeryEvaluation & Management

Certifications Recognized by AHIMA

The first certification authorized by AHIMA is the Certified Coding Associate (CCA), and it is often the first choice for how to become a medical biller and coder. This certification is often the very first way that novice coders can demonstrate proficiency in the coding field, and also to gain some distinction from their peers.

The person who holds a Certified Coding Specialist (CCS) certification will have shown that he/she has specialty skills in the classification of patient records data, usually in a hospital environment. You must have the knowledge to assign specific numeric codes to each one of the procedures performed by medical personnel. That means you need to be proficient in using the ICD-10-CM coding system, as well as applying it to your work processes.

The individual who earns a Certified Coding Specialist-Physician-based (CCS-P) certification will be proficient in applying learned skills to a physician’s office setting. To achieve this certification, you must have a considerable knowledge of all the numeric codes used in medical billing, and how they relate to specific procedures which are performed.

This requires a deep knowledge of and proficiency using the HCPCS Level II and ICD-10-CM coding systems. A successful candidate for this certification must also be adept at documenting health information, as well as maintaining data integrity.

If you want to become a certified medical coding and billing professional then click the blue find schools button to compare medical coding schools.


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