Medical Coding Certifications

Explanation of AAPC & AHIMA Medical Coding Certificate Offerings

Learn what Medical Coding Certifications are available and who administers the Medical Coding Certificate. All the different types of medical coder certification.

Coding Credentials
Membership for coders in a professional organization provides opportunities for professional development and a way to keep abreast of coding industry issues.

Credentials for a medical billing coder are administered by two different organizations – AAPC (American Academy of Professional Coders) and AHIMA (American Health Information Management Association). Employers seem to have differing preferences when hiring. If you are considering becoming credentialed talk with an experienced medical billing coder field and get their opinion. Look at job listings in your area and see what credential are required. Here’s a summary of their certifications:

AAPC Certifications
AAPC is a national group dedicated to advancing the medical coding profession and currently has over 106,000 members with over 64,000 certified. AAPC was founded in 1988 to raise medical coding standards through training, certification, continuing education, networking, and job opportunities.AAPC provides education and professional certification for physician-based coders.

AAPC credentials are for medical coders working in physician offices, outpatient facilities, surgical centers, and for insurance payers. Being credentialed by AAPC requires members to agree to a Code of Ethics to uphold high standards of integrity, ethical behavior, and professionalism.

The AAPC has the following exam based certification offerings:

  • CPC – Certified Professional Coder for physician and clinic. Exam consists of 150 multiple choice questions and costs $300 – one free re-take allowed. Its an open code book exam and you are allowed 5 hours and 40 minutes to finish the exam. CPC medical coding certificates are help by over 60,000 coding professionals.
  • CPC-H – Certified Professional Coder Apprentice – Hospital Outpatient. The CPC-H medical coding certifications are intended for those who code services, procedures, and diagnoses on medical claims in the outpatient setting. The cost, format, and time allowed are the same as the CPC exam.
  • CPC-P – Certified Coding Specialist – Payer is for coding professionals of third-party and government payer organizations.These medical coding certifications recognize the value of certified coding professionals in the processing and analysis fo medical claims by the insurance payer.
  • CIRCC – Certified Interventional Radiology Cardiovascular Coder. The CIRCC medical coder certification authenticates the additional education, knowledge, and expertise needed by those working in the complex and specialized areas of interventional radiology and cardiovascular coding and reimbursement. Cost of the CIRCC exam is $400, 150 multiple choice questions, open book, and 1 free retake
  • CPMA – Certified Professional Medical Auditor. Certifies proficiency and knowledge of medical documentation, fraud, abuse, and penalties for coding and documentation violations based on governmental guidelines.CPMA’s are also proficient in auditing, coding concepts, statistical methods, and medical records. Exam cost is $325 and similar format for CPC exam.
  • CPCO – Certified Professional Compliance Officer. CPCO medical coding certifications recognizes the need to comply with various government rules, regulations, laws, and guidelines imposed on healthcare providers and facilities. These certified medical coding professionals are helpful to facilities and medical practices to establish and maintain a compliance program. The CPCO demonstrates a knowledge and expertise to develop and assist, implement, and monitor a healthcare compliance program. Exam cost is $325 and similar format for CPC exam.
  • CPC -Specialty. AAPC offers a medical coding certificate for 20 other medical specialties. These are stand-alone certifications with no requirement to hold the CPC certificate. Cost of exam is $245 with the same format as the CPC exam.

For more info on AAPC certification, check out American Academy of Professional Coders.

AHIMA Certifications
AHIMA is dedicated to the effective management of personal health information required to administer healthcare to the public with over 61,000 members. AHIMA was founded in 1928 with the goal of improving the quality of medical records. The organization is committed to advancing the health information management profession by advocacy, certification, and education, The majority of coding students who pursue AHIMA medical coding certifications sit for the Certified Coding Associate (CCA) exam.

The AHIMA offers three exam based medical coding certifications:

  • CCA – Certified Coding Associate. The CCA show a competency in both hospitals and physician practices. The CCA exam costs $299 ($199 for AHIMA members)
  • CCS – Certified Coding Specialist. More proficient coders who are knowledgeable in ICD-9-CM and CPT coding, anatomy, physiology, pharmacology, and patient documentation. Generally for coders in a hospital setting. The CCS medical coder certificate demonstrates a coders proficiency, data quality, integrity skills. Experienced coders for inpatient and outpatient facilities should consider this certification. Exam fee is $299 for AHIMA members, $399 for non-members.
  • CCS-P – Certified Coding Specialist – Physician based. Medical coding certifications intended for coders in physician-based settings such as physician offices, group practices, or multi-specialty clinics. More proficient Physician Based coder with demonstrated competence in multispecialty ICD-9-CM and CPT coding. Exam fee is $299 for AHIMA members, $399 for non-members.
  • CHDA – Certified Health Data Analyst. This certification denotes an expertise in health data management, analysis, interpret, and transform health care information. CHDA shows a broad organizational knowledge balanced with the ability to communicate effectively with groups and individuals from diverse levels. Exam cost is $329 non-member, $259 member.
  • CHPS – Certified In Healthcare Privacy and Security. This medical coder certification demonstrates competency in developing, implementing, and administering privacy and security protection programs for healthcare organizations for the privacy and security of health information. Exam cost is $329 non-member, $259 member.
  • RHIA – Registered Health Information Administrator. RHIA professionals are experts in managing patient health information and records. Knowledgeable on legal and ethical requirements for patient information. May play a critical roll in the decision making and administrative responsibilities of the healthcare organization. Exam cost is $299 non-member, $229 member.
  • RHIT – Registered Health Information Technician. The certified technician ensures the quality, accuracy, and integrity of medical records and information. Uses computer applications to enter and analyze patient information to improve patient care and reduce costs. Additional roll of RHIT’s is cancer registrars to compile and maintain cancer patient data. Exam cost is $299 non-member, $229 member.

For more info on AHIMA certifications, check out American Health Information Management Association.

Advantages of Medical Coding Certifications
Maintaining certification requires continued membership in the association and meeting annual continuing education requirements. Obtaining credentials demonstrates a level of commitment to the profession, ethics, integrity, and a knowledge and competence in a particular area of coding. This is desirable of many employers – especially larger ones. Certified coding professionals typically earn more than non-certified coders – according to AAPC this can be up to 20% more.

Before pursuing the certified medical coder credential from AAPC or AHIMA, consider your career path and the credentials your preferred employer requires. If the type of setting or employer requires CCS credentials, then your goal would be to pass the AHIMA certification exam. If they require CPC credentials, then AAPC is the credentialing and exam authority.

Public Health Online’s Guide to Online Health Administration Degrees provides a helpful guide to getting started in Health Administration. Their site is a great resource for program information and case studies that helps students evaluate pathways into the profession.