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Medical Billing & Coding Certifications

Written By: Seph Anderson

Published: 5/9/2022

Have you ever seen a doctor's handwritten medical notes and wondered how that information actually gets translated from doctor-speak to something patients, office and hospital staff, and  insurance companies can read and understand? Moreover, have you ever wondered how health insurance providers know the specific types of medical services to bill for after you’ve been to the doctor? Of course, we all ponder this upon receiving an insurance provider’s explanation of benefits statement in the mail. A defined billing and coding system in place allows these various entities to communicate and assess patient charges accurately. This is where certified medical billing and coding professionals come in.

If you’re considering pursuing a career in medical billing and coding, it’s important to have a thorough understanding of the different specialty areas in which you can earn medical billing and coding certifications and how doing so can impact your career path.

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What Are Medical Billing and Coding Certifications?

An individual with a medical billing and coding certification has gained in-depth knowledge and skills that demonstrate professional expertise in a respective niche. Although medical billing and coding professionals are often tasked with the billing and coding aspects of their job, certifications tend to reflect either one aspect or the other.

Although medical billing and coding professionals are often tasked with the billing and coding aspects of their job, certifications tend to reflect either one aspect or the other.

In short, medical coders are responsible for translating clinicians' medical notes and diagnoses concerning a patient and assigning medical codes that confirm the medical records. Once a patient’s medical codes have been assigned, medical billers create the patient’s bill and file the relevant health insurance claims. Online medical billing and coding programs help prepare you for certification in your desired area.

How To Become a Certified Medical Biller or Coder

The first step to becoming a certified medical biller or coder is to participate in an online or in-person educational program specific to your desired type of certification. Individuals with a high school diploma or GED are eligible to pursue any number of professional coding certifications.

Although certification programs include content that is unique to their respective certifications, a common curriculum taught across programs includes topics such as professional ethics, billing and coding technologies, medical terminology, and patient confidentiality. Common curriculum elements are aimed at educating participants with healthcare industry knowledge, specifically. Some examples include coursework that coversthe Healthcare Common Procedure Coding System (HCPCS) and associated Current Procedural Terminology (CPT) coding and International Classification of Diseases (ICD) coding. Certificate programs may also cover more generalized online courses in areas such as anatomy and physiology.

The final steps to earn a professional certification and begin your coding career involves registering for and successfully passing the respective certification exam. Most participants spend a couple of weeks studying and taking practice exams before sitting for their certification exam.

What Are the Different Types of Medical Billing and Coding Certifications?

Before examining the different medical billing and coding certifications available, it’s important to note that you can pursue a certificate or certification through a college or university medical billing and coding certificate program or a professional association certification program.

A key difference between the two is that a certification program through an industry association leads to an officially recognized “certification,” whereas a college or university program leads to a “certificate.” To determine your best option, you need to understand each in more detail.

A certification program through an industry association leads to an officially recognized “certification,” whereas a college or university program leads to a “certificate.”

College and University Certificate Programs

Holding an associate degree in the field — the only degree level offering a specific medical billing and coding program — can help increase your marketability when applying for jobs. Moreover, a bachelor’s or master’s degree in a related field, such as healthcare informatics or healthcare management, can do the same. Upon earning program certificates, and potentially a degree, many students then choose to participate in an industry-accredited certification program.

What’s unique about online academic programs is that they’re all slightly different, giving you the opportunity to find a program aligned with your specific career goals. 

For example, Albany State University offers a 27 credit-hour Certificate in Medical Coding that also prepares students to take the Certified Coding Associate national credentialing exam. The program’s curriculum covers health record content and structure, pathophysiology, pharmacology, coding, advanced coding, and reimbursement. 

In contrast, Weber State University provides graduates with a Certificate of Proficiency in Healthcare Coding and prepares them to take national coding certification exams. Core courses of the program include medical terminology, integrated anatomy, and pharmacology. Additionally, students learn about the ICD-10-CM, ICD-10-PCS, and CPT coding systems.

Professional Association Certifications

It's important to note that earning a professional medical billing and coding certification — as opposed to a school-issued certificate — doesn’t require a college or university certificate or degree. Instead, the only pre-requisite requirement is holding a high school diploma or GED. If you choose not to go the college or university route, you can register for a certification prep program through the respective association offering certification. 

The two largest certification organizations — the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC) — offer more than 30 medical biller and coder certifications.

Medical Billing and Coding Organizations

As mentioned above, the two most recognized and well-respected professional organizations offering certifications for medical billing and coding are the AAPC and AHIMA. Both organizations use the same coding systems: CPT and HCPCS. In addition to certifications, each organization offers a number of training workshops and continuing education opportunities as well as general career support.

To give you a closer look at the various programs, we’ve outlined some of the most common certifications available through AAPC and AHIMA. The AAPC also offers online training programs to prepare you for the certification exams.

AAPC Medical Coding Certifications

Certified Professional Coder (CPC) certification is among the most popular medical coding credentials, as it proves competencies in physician-based medical coding practices. (Alternatively, the Practice Management Institute offers a Certified Medical Coder (CMC) certification.)

Certified Outpatient Coder (COC) credential is designed for professionals who want to show their competence providing outpatient coding services across a spectrum of healthcare settings, from hospitals to oncology clinics.

Certified Inpatient Coder (CIC) certification illustrates expertise in medical record reviews as well as hospital and facility inpatient coding.

Certified Risk Adjustment Coder (CRC) credential shows an expertise in coding that is specific to chronic conditions and comorbidities attributed to complex diseases.

AAPC Medical Coding Certifications

Certified Coding Associate (CCA) certification is intended for entry-level professionals who want to show that their coding skills span across all healthcare settings.

Certified Coding Specialist (CCS) certification demonstrates coding proficiency and mastery of data quality as well as accuracy.

Certified Coding Specialist- Physician-Based (CCS-P) certification illustrates expertise in coding that takes place in a doctor's office, group practices, and specialty clinics/centers.

Certified Documentation Improvement Practitioner (CDIP) certification focuses on clinical documentation in patient records.

How Much Do Medical Billing and Coding Certifications Cost?

When reviewing the cost of obtaining a particular certification, there are several things you’ll want to include in your calculations, such as the program cost and certification exam fee. The exam fee alone runs anywhere from $200 to $400. If you are acquiring an industry certification through a certification-granting organization, you may also be required to purchase an association membership.

Beyond the minimal requirement of having a high school diploma or GED, there are multiple educational paths you can take in order to sit for your certification exam. The costs vary depending on your approach.

While a degree in higher education isn’t required, some students choose to pursue a certificate or two-year associate degree in medical billing and coding. With in-state residency, the average national tuition of an associate degree is $6,754, while the cost of certificates on our list of the most affordable online colleges offering medical billing & coding certificates range from about $1,000 to $5,000.

While a degree in higher education isn’t required, some students choose to pursue a certificate or two-year associate degree in medical billing and coding.

On the other hand, certification-granting organizations, like the AAPC, offer customized industry certification prep programs that range from $2,500 to $3,500. Since these programs do not require the same time commitment and well-rounded education in healthcare and science topics, they are not considered as prestigious.

Ultimately, you want to choose a program that meets your personal and professional needs and provides a healthy work/life balance. Therefore, it's important to think about the potential indirect costs, financial and otherwise, for each option:

  • What type of time commitment should you expect?
  • If you work full-time, will you be able to continue working at the same pace during your studies?
  • Will a program's curriculum be sufficient to help you pass the certification exam at the end?

Will you need to borrow students loans or apply for financial aid to pay for the program?

What Are the Benefits of Being a Certified Medical Biller or Coder?

Aside from the functional knowledge gained and official recognition of career field expertise, being a certified medical biller, coder, or specialist can make you a more marketable professional in your chosen specialty area. While a well-respected certification is an excellent resume booster at the most basic level, the benefits extend far beyond this new line of ink on your resume. 

Put yourself in the shoes of a hiring manager reviewing your application for a new job. The employer has combed through almost all of the applications, but nothing has really stood out. Most applicants have similar educational backgrounds, relevant work experience, and put together a visually-appealing and grammatically-correct resume. And suddenly, your application comes up in the review queue. 

Similar to two previously-reviewed applicant resumes, yours checks all the boxes: education, experience, and intangibles. However, there’s one thing in particular that clearly differentiates you from the other candidates, which is that you’re a Certified Cardiology Coder (CCC).

A CCC certification shows your commitment to excellence in the medical coding niche, a strong professional drive, and a feeling that you’ll bring actual value to a cardiology clinic.

FAQs About Medical Billing and Coding Certifications

Is a Medical Billing and Coding Certification Worth It?

Becoming a certified coder can serve as a catalyst for career growth. However, it’s always wise to weigh the potential benefits and drawbacks as you consider your options.

How Long Does It Take To Earn a Medical Billing or Coding Certification?

Technically, you can pass a certification exam with no time commitment, though this is rare. Most candidates complete a test preparation program that takes a few months of intensive study, and others choose to earn a one-year certificate or two-year associate degree first.

Which Certification Is Best for Medical Billing and Coding?

There isn't necessarily one certification that's better than all others; it all depends on what type of role you want to perform. Read job posts in your preferred area of expertise, such as inpatient coding or document improvement, to see what employers are looking for. You can also read AAPC and AHIMA salary surveys to find the certifications that tend to lead to higher wages.

Which Medical Coding and Billing Certification Pays the Most?

According to a 2022 survey, the highest paying AAPC certification is the Certified Professional Compliance Officer. AHIMA's most recent salary data is from 2019, at which time their most remunerative certification was the Certified Documentation Improvement Practitioner credential.

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