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.

Becoming a medical biller or coder requires certification. Those who choose a career path that will place them in a hospital environment should become familiar with the American Health Information Management Association (AHIMA). Nitin Chhoda shares how a highly respected organization  such as AHIMA, issues multiple levels of certifications for its members.

The organization recommends that medical biller or coder completes a training program prior to certification testing.

Depending on the desired certification, students may be required to participate in a short-term program or acquire a four-year degree before being eligible to take a specific certification exam.

Benefit of Joining AHIMA

The focus at AHIMA is providing certification for hospital-based medical biller or coder. The group has yearly conventions, issues certifications and conducts training programs.

It offers continuing education options and networking opportunities designed to keep medical biller or coder abreast of issues that affect them in the professional arena.

AHIMA offers online education courses, programs and webinars and exam preparation.

Students can participate in a virtual lab featuring multiple state-of-the-art software applications they will encounter in their professional capacity.

Different Certification Levels

The group only offers entry level credentials and is available to those who already have first-hand knowledge of coding. AHIMA issues certifications for those who plan a career working in hospitals and strives for excellence in medical record integrity.

AHIMA provides three medical biller or coder certifications:

• certified coding associate (CCA)
• correct coding specialist (CCS)
• correct coding specialist-physician based (CCS-P)

All types of medical biller or coder are recognized and accepted by hospitals, physicians and practice management companies.

Correct Coding Associate

To earn a CCA designation, coders must exhibit competency with in-patient and out-patient coding. It’s an overall certification that allows medical biller or coder to work in multiple venues. It demonstrates competency but not mastery.

Certified Coding Specialist

The CCS is AHIMA’s primary certification that shows a coder has a higher level of skill with procedural and diagnosis coding, are experts in CPT and ICD coding, and knowledgeable in anatomy and medical terminology.

Those earning CCS certification must also know about pharmacology and the disease process.

Correct Coding Specialist-Physician

Those receiving a CCS-P certification specialize in working within physician offices, clinics and practices with multiple clinicians.

They’re highly skilled professionals who are adept at billing accurately to obtain the highest level of reimbursement for practitioners.

They assign ICD and CPT codes on patient records and may be responsible for transmitting claims to clearinghouses.

Healthcare Privacy and Security

The organization also offers the only combined privacy and security certification. Those medical biller or coder with healthcare privacy and security (CHPS®) certification must demonstrate competence in the design, implementation and administration of security protection programs for all types of healthcare-related organizations.

AHIMA provides medical biller or coder who wants to follow a career path in hospital medical billing and coding with the information, requirements, education and certification they need. The professional organization is one of the most respected in the industry, offering the multiple certification levels those in the medical billing and coding industry require to take their career from associate to specialist.

Watch out for the part two of this two-part series of articles entitled “Medical Biller or Coder — How Do I Obtain Certification?”