Medical Coding Certification Guide

Medical Coding Certification

Almost all jobs in coding require certification. Medical coding often deals with high-risk reimbursement and fraud. Individuals who commit fraud, even unintentionally, can face jail time and hefty fines, so employers look for coders who are certified. Being certified means that every year you must complete continuing education to keep your certification and prove that you are up-to-date with the latest rules and regulations. Certified coders also make more money than uncertified coders, and coders who have multiple certifications make even more money than coders with just one certification.

Organizations that certify coders include:

• The American Academy of Professional Coders (AAPC)
• American Health Information Management Association (AHIMA)
• American Medical Billing Association (AMBA)
• National Healthcareer Association (NHA)

AAPC and AHIMA are the most widely-recognized organizations for medical coding certifications. AAPC’s entry level certification is the Certified Professional Coder (CPC). Individuals who pass the certification test are given the certification of a CPC-A, where the A stands for “apprentice”. The A designation is removed after you demonstrate 2 years of experience working in medical coding. 

What's On the Medical Coding Exams

Depending on which certification exam you take, it may cover more than just coding.

The CPC exam is a timed test that covers CPT® procedural codes, ICD-10-CM diagnoses codes, and HCPCS Level II supply codes, along with coding guidelines and compliance knowledge. The passing score is 70% and there are 100 questions. You can take the CPC as a proctored test online or you may choose to take the test in-person. Four hours is given to take the test.

The CCA is a two-hour timed exam that covers CPT procedural codes, ICD-10-CM diagnosis codes, ICD-10-PCS codes, reimbursement, health records, compliance, IT and your knowledge on confidentiality and privacy.  There are between 90 and 115 questions that vary in the number of points they are worth. For this exam, you will be expected to go to a testing center from PearsonVue, so make sure to schedule your exam well in advance of when you want to take it, since seats are often limited.