The American Academy of Professional Coders (AAPC) is one of the most respected and reputable medical billers / coders organizations in existence. The group is the primary certification, education and information resource for those entering the field of billing/coding. Nitin Chhoda explains more about the organization in this second part of two-part series of becoming a certified medical biller / coder.
Medical billers or coders are knowledgeable in a variety of disciplines, from anatomy and medical terminology to specialized software systems and CPT and ICD codes.
Depending upon the level of certification desired, prerequisites can include completion of specific courses or a four-year degree before being sufficiently qualified to take a certification exam.
The AAPC provides education and professional certification for medical billers or coders employed within a practitioner’s office and hospital. It promotes the highest standard of coding through adherence to accepted standards.
NOTE: The organization maintains strict eligibility requirements for full certification.
AAPC training programs are offered throughout the U.S. for those who will work in private practices and hospitals.
It offers continuing education opportunities, awards certifications, maintains a job database, and conducts regional and national conventions. Individuals have access to resources and materials essential to the profession, and learn about auditing, compliance and practice management.
Certified Professional Coder – the Entry Level
The AAPC offers entry level and apprentice level of medical billers or coders certifications. The basic certification is CPC (certified professional coder) and indicates the individual is proficient with procedural and supply codes, can extract correct diagnosis codes and read a medical chart.
Those with a CPC designation typically work in outpatient environments and will have a working knowledge of medical terminology and anatomy.
Certified Professional Coder-Hospital
A certified professional coder-hospital (CPC-H) demonstrates that the medical billers or coders understands compliance and can complete billing forms used for facility claims.
This level shows that the biller can accurately assign diagnosis, procedural and service codes in an outpatient environment, and use appropriate modifiers when necessary.
Certified Professional Coder-Payer Designation
The medical billers or coders holding a certified professional coder-payer designation (CPC-P) has exhibited a good working knowledge of the payer process. It demonstrates the individual is cognizant of the relationship between coding and payment, understands the adjudication process, and knows the coding-related payer process.
Those medical billers or coders who have completed two years or more of prior experience before taking and passing the exam will be fully certified. Individuals sitting for first time exams and those with no prior experience will receive apprentice status as CPC-A, CPC-H-A or CPC-P-A.
Test takers of medical billing and coding certifications must prove through a letter from their employer that they have prior experience and what their duties encompassed.
They must also provide documentation showing they’ve completed at least 80 hours of coding education and completed a year of on-the-job training using CPT, ICD and HCPCS codes.
Anyone can claim to be medical billers or coders, but credentialing provides proof from a respected and reputable professional organization that these medical billers or coders have achieved a superior level of accomplishment, and have attained the required level of knowledge and proficiency.
Certified medical billers or coders command a higher rate of pay and certification opens multiple career path opportunities. You can also check the first part of this two-part series on how to be certified medical biller or coder by clicking here.