Medical Billing & Coding Certification - AHIMA, AAPC

Medical Billing & Coding Certification

After graduating from an accredited medical billing and coding school or training program, the next step to becoming a competitive medical billing and coding professional is getting medical billing and coding certification. Certification for medical billing and coding specialists demonstrates your expertise in the fields of medical billing and medical coding, and shows employers that you are committed to excellence and ongoing education. It can also help you earn a higher medical billing and coding salary.

Several organizations offer medical billing and coding certification, ranging from certification in overall coding for hospitals and for insurance environments, to certification in specific areas of medicine. Some of the most recognized certifications are:

AHIMA Certifications

The American Health Information Management Association (AHIMA) offers several types of medical billing and coding certification. AHIMA certifications focus on general excellence in the medical billing and coding job description for hospital settings, physician’s offices and insurance settings.

RHIA Medical Billing & Coding Certification

  • Overview: The Registered Health Information Administrator (RHIA) medical billing and coding certification is a general credential for medical billers and medical coders in hospital and clinical settings. It also has growth in non-patient settings such as insurance providers, software companies, and consulting services.
  • Requirements: Requirements include graduation from a bachelor’s degree program from an accredited medical billing and coding school.
  • More Information: RHIA Certification

RHIT Medical Billing & Coding Certification

  • Overview: The Registered Health Information Technician (RHIT) certification is similar to the RHIA certification, with the additional aspect that medical billing and coding professionals with this certification may specialize in certain diagnoses, and may also specialize in cancer coding.
  • Requirements: Graduation from an accredited bachelor’s degree-level medical billing and coding training program is a requirement for this certification.
  • More Information: RHIT Certification

CCA Medical Billing & Coding Certification

  • Overview: The Certified Coding Associate (CCA) medical billing and coding certification is a broad certification focused on demonstrating medical billing and coding excellence in both hospital and physician settings. The CCA certification is the only medical billing and coding certification accredited by the National Commission for Certifying Agencies (NCCA).
  • Requirements: A high school diploma is required for this certification, and graduation from an accredited medical billing and coding school, or equivalent work experience, is strongly recommended.
  • More Information: CCA Certification

CCS Medical Billing & Coding Certification

  • Overview: Certified Coding Specialist (CCS) certified professionals are focused on coding medical data from patient records, including conditions and treatments. They work primarily in hospital settings, interacting between the facility and insurance providers.
  • Requirements: Before January 2013, certification requirements include a high school diploma and work experience in inpatient and outpatient medical billing and coding.
    After January 2013, requirements include graduation from an accredited medical billing and coding training program, relevant work experience, an existing AHIMA credential, or a combination of the above.
  • More Information: CCS Certification

CCS-P Medical Billing & Coding Certification

  • Overview: The Certified Coding Specialist – Physician-based (CSS-P) certification is similar to the CSS certification, but focuses on physician settings rather than hospital settings. Certified medical billing and coding specialists with this certification work directly with the CPT coding system, and with ICD-9-CM and HCPCS Level II codes.
  • Requirements: Before January 2013, a high school diploma or equivalent is required for this certification, and completion of an accredited medical billing and coding training program and three years of work experience are strongly recommended.
    After January 2013, requirements consist of a high-school diploma, plus either completion of an accredited medical billing and coding program or six months of relevant work experience.
  • More Information: CCS-P Certification

AAPC Certifications

The American Association of Professional Coders (AAPC) offers several medical billing and coding certifications based on working environments and medical coding specialties. Some of their certifications include:

CPC Medical Billing & Coding Certification

  • Overview: The Certified Professional Coder (CPC) certification from AAPC is a broad medical coding certification that demonstrates expertise in coding for various diagnoses and treatments across a variety of care settings. Medical billing and coding specialists with CPC certification work directly with ICD-9, CPT, and HCPCS Level II codes.
  • Requirements: To receive the CPC certification, medical billers and medical coders must have an associate’s degree from an accredited medical billing and coding school, and have two years of work experience or a medical billing and coding apprenticeship.
  • More Information: CPC Certification

CPC-H Medical Billing & Coding Certification

  • Overview: The Certified Professional Coder-Hospital Outpatient (CPC-H) medical billing and coding certification focuses on medical billing and medical coding for hospital outpatient facilities. Medical billers and coders with this certification are proficient in coding for a range of medical services and coding types.
  • Requirements: An associate’s degree from an accredited medical coding school is recommended for the CPC-H medical billing and coding certification, and at least 2 years of medical coding experience is required.
  • More Information: CPC-H Certification

CPC-P Medical Billing & Coding Certification

  • Overview: Certified Professional Coder-Payer (CPC-P) medical billing and coding certification focuses on medical coding for insurance providers and private health plans. CPC-P certified medical billers and coders work in claims review, auditing, health benefits administration, and other areas related to health insurance.
  • Requirements: The AAPC recommends graduation from an accredited medical coding school and having at least two years of work experience to qualify for the CPC-P medical billing and coding certification.
  • More Information: CPC-P Certification

CIRCC Medical Billing & Coding Certification

  • Overview: The Certified Interventional Radiology Cardiovascular Coder (CIRCC) certification focuses on the use of radiology and other imaging technologies to aid minimally invasive surgical procedures. These specialists work in hospitals and other surgical facilities, and are in one of the highest average earning medical specialties.
  • Requirements: The AAPC recommends an associate’s degree from an accredited medical coding training program, as well as two years of direct experience in coding for interventional radiology to qualify for this certification.
  • More Information: CIRCC Certification

NCRA Certifications

The National Cancer Registrars Association (NCRA) offers CTR certification for medical billing and coding specialists. These specialists summarize the diagnoses, treatments, and medical histories of patients with forms of cancer.

CTR Medical Billing & Coding Certification

  • Overview: The Certified Tumor Registrar (CTR) certification focuses on medical coding for various forms of cancer, including diagnosis, treatment, and disease status. Medical coders with CTR certification may work in hospitals or outpatient cancer facilities.
  • Requirements: To be eligible for this certification, the NCRA requires both associate degree-level training from an accredited medical coding training program, and work experience in the field of cancer registry.
  • More Information: CTR Certification