Medical Billing and Coding Certification – Training, Requirements and Benefits

March 3, 2017

Medical Billing and Coding Certification – Training, Requirements and Benefits

March 3, 2017

If you want to work in the medical billing and coding field, career training and certification can help distinguish you as a qualified candidate. Employers often seek applicants with a medical billing and coding certification or Certified Professional Coder (CPC) credential from the American Association of Professional Coders (AAPC).

Training for Medical Billing and Coding Certification

Many healthcare facilities – like physicians offices, insurance companies, nursing care facilities and more – depend on medical billers and coders to make sure patients’ records and insurance forms include the right codes for diagnoses and procedures. Career training and certification can help candidates in this field stand out as job applicants.

Things you’ll need to learn to prepare for certification include:

  • Current Procedural Terminology (CPT) codes – These help identify procedures like office visits, physical examinations, flu shots and more.
  • ICD-10 codes from the International Statistical Classification of Diseases and Related Health Problems – These indicate diagnoses like diseases of the digestive or nervous systems, pregnancy complications, injuries and more.
  • Healthcare Common Procedure Coding System (HCPCS) Level II codes — These represent devices and supplies like prosthetics and durable medical equipment, as well as non-physician services like ambulance transportation.

These codes determine the amount of reimbursement a healthcare provider receives from insurance companies for services provided to patients, which is why the process is so important. Through medical billing and coding training and CPC certification, medical billers and coders become familiar with CPT, ICD-10 and HCPCS Level II codes.

Medical billing and coding career training also prepares students to learn how to process healthcare claims, accurately code medical procedures and use the right medical terminology. These qualifications can assist applicants when competing for coding jobs.

Benefits of AAPC Certification

Employers usually prefer to hire candidates with certification for medical billing and coding positions. The CPC credential from the AAPC is generally respected by healthcare providers, medical societies and government organizations nationwide. CPC certification signifies that a candidate should be able to:

  • Review patient records and assign the right medical codes for treatment, diagnoses and services.
  • Be familiar with healthcare services like surgery, radiology, anesthesia, pathology and more.
  • Apply knowledge of medical coding rules, procedures, compliance and reimbursement.
  • Manage issues like claims denials, medically necessary procedures and bundling.
  • Understand key medical terminology, anatomy and physiology.

The CPC Examination

The CPC certification exam consists of 150 multiple-choice questions. It is designed to evaluate the candidate’s knowledge of anatomy, medical terminology, laboratory and clinical procedures, practice management, coding guidelines and others. It also evaluates the candidate’s ability to apply the right procedure, supply and diagnosis codes.

People who sit for the exam are allowed to use approved manuals for reference, and may take up to five hours and 40 minutes to complete it.

Medical Billing and Coding Certification Requirements

The AACP recommends that certification candidates hold an associate’s degree. While full CPC certification requires two years of relevant work experience, the AACP will grant apprentice status (CPC-A) to individuals who pass the exam but do not yet have the necessary work experience.

CPC-A holders may apply to have the apprentice designation removed by either submitting two letters of recommendation confirming two years of experience, or submitting proof of 80 hours of coding education plus one letter verifying one year of on-the-job experience.

To maintain CPC certification, medical billing and coding professionals must be current AAPC members. This requires annual renewal of AAPC memberships and completion of 36 continuing education units every two years.

Medical Billing and Coding Jobs are In-Demand

Medical billing and coding is detailed work, and healthcare providers depend on the skill, knowledge and accuracy of medical billers and coders.

If you’re detail-oriented, comfortable with computers and interested in the opportunities presented by today’s healthcare industry, consider enrolling in a medical billing and coding training program.

Ultimate Medical Academy (UMA) offers the Associate of Science degree in Medical Billing and Coding, which helps prepare students for a career in medical billing and coding while also preparing them to sit for the CPC certification exam. At 63-66 semester credits (depending on state of residence), UMA’s online Medical Billing and Coding associate degree program can be completed in as few as 17 months (results vary based on individual student).

When you complete your UMA training and earn the CPC credential, you’ll join the ranks of healthcare employees with AAPC certification and help yourself stand out as a candidate to employers.

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About the Author

is an award-winning writer and journalist with years of experience within the healthcare and education space. She has contributed to dozens of periodicals, publications and blogs, and she specializes in providing well-researched and thought-provoking content.

The views expressed herein are those of the author and do not necessarily reflect those of Ultimate Medical Academy.

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