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Medical Billing and Coding Certification: An Introduction

Medical billers and coders record the diagnoses that doctors give to patients by using special alphanumeric codes. These records are used to keep track of patients’ illnesses, treatments, bills and to create invoices for insurance companies. Although there is a fair amount of overlap between careers in medical billing and coding and both jobs are often carried out by a single person, they are actually two distinct specialties.

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If you are interested in this field, you should seek out a basic level of training, like earning an online medical coding certification. Becoming certified as a medical biller and coder greatly increases your chances of finding a job in the field, whether it is in a doctor’s office, a hospital, an insurance company or a nonprofit healthcare agency.

Many job seekers are attracted to this profession because of the possibility of working from home. However, prospective medical billers and coders should be aware that only a fraction of all professionals in the field actually work from home, and most find work in an office.

Earning Your Medical Billing and Coding Certification

One of the first things that you should know when you are considering a career in the medical billing and coding field is the significance of certification. Though it isn’t absolutely necessary to obtain certification to get a job in the field, it will greatly improve your chances of finding employment. Employers prefer applicants who can prove that they have the specific skills and knowledge required to work in this branch of the healthcare industry. In fact, earning your certification may be easier than you think. The majority of skills that medical billers and coders practice on a daily basis are easily learned in non-traditional classrooms, so getting your certification online is a good option.

Most certifications that are preferred by employers are designed to teach medical billing, though the American Medical Billers Association (AMBA) does offer an online medical billing certification. On the whole, billing jobs alone generally require less specialized knowledge than coding jobs, and they also tend to pay less.

It is not necessary to earn a degree prior to taking a medical billing and coding certification exam, but employers do prefer to hire candidates who have associate’s degrees in the field. An associate’s degree in medical billing and coding indicates that the candidate has a broader knowledge of the field as a whole compared to those who have only completed the certification exams.

If you are interested in medical coding training online or in traditional classroom settings, you should look for programs that teach the most up-to-date standards, practices and software. One of the most common coding systems, the International Classification of Diseases (ICD), is updated periodically to incorporate medical advances. The newest version, ICD-10, is scheduled to go into effect on October 1, 2013. If you want to get the best education, you should look for programs that offer training in both ICD-9 and ICD-10. These programs will give you a significant advantage once you enter the job market as a new medical biller and coder.

Finally, the information used in billing and coding directly relates to patient health, treatment and reimbursement, so being consistent and accurate is crucial to being successful on the job. The best medical billers and coders have great concentration and attention to detail. These are also traits that will help you succeed in your accredited online medical coding courses as you prepare for a career in the field.

Coding Organizations and Certifications

The American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA) offer the top medical billing and coding online certification credentials sought by most employers. AAPC and AHIMA are the most reputable national medical coding certification organizations, and both offer online medical billing and coding certification courses, study materials and exams.

The American Medical Billers Association (AMBA) is another respected but less prominent professional credentialing organization. In addition, the American College of Medical Coding Specialists (ACMCS) also offers quality medical coding certification online programs, although they are not as widely recognized as the AAPC and AHIMA courses and credentials.

A selection of AAPC’s main credentials are described below, followed by information about AHIMA’s 3 primary certifications:

Certified Professional Coder (CPC®)
CPC courses teach coding fundamentals and codes used in outpatient clinics and medical offices. The CPC credential examination offered by AAPC tests students’ knowledge of anatomy and medical terminology as well as their ability to utilize relevant coding guidelines and practices.

Certified Professional Coder – Outpatient Hospital (CPC-H®)
The “H” in AAPC’s CPC-H certification stands for hospital, and this certification exam tests students’ knowledge of the coding procedures and guidelines that relate specifically to outpatient hospitals.

Certified Professional Coder – Payer (CPC-P®)
Coders seeking work in insurance reimbursement should consider the CPC-P. This AAPC credential certifies a students’ understanding of claim adjudication and reimbursement methods for inpatient and outpatient services. Examinees must complete 2 years of coding work before taking the exam.

Certified Interventional Radiology Cardiovascular Coder (CIRCC®)
The best certification that AAPC offers for those who want a medical billing and coding job in radiology or cardiology is the CIRCC. CIRCC courses teach students basic and advanced coding related exclusively to radiology and cardiovascular procedures.

Specialty Credentials
In addition to the credentials listed above, AAPC also offers numerous advanced certifications designed to allow experienced coders to demonstrate higher levels of specialization within their respective subfields. These include specialty credentials in fields like dermatology, gastroenterology and anesthesia.

Certified Coding Associate (CCA)
AHIMA’s CCA credential certifies that recipients have a broad understanding of the coding practices used across all types of medical settings. This medical billing online certification qualifies students for an entry-level job assigning codes to the diagnoses and procedures described in patient medical records.

Certified Coding Specialist (CCS)
The CCS credential is AHIMA’s certification for professionals who have mastered the coding skills and systems used in hospitals. In order to qualify to take the certification exam, students must first graduate from a school that is accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM).

Certified Coding Specialist-Physician-based (CCS-P)
Recipients of AHIMA’s CCS-P certification are professionals who have achieved mastery of the coding practices used in physicians’ offices. This credential requires at least 3 years of work experience and expertise in medical office management in addition to earning the medical billing certification online.

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