To the uninitiated, understanding medical coding certification seems a little intimidating. What is important to know is that you do need to become certified to advance in your career.
While you may be able to get an entry-level job while taking classes, you will not be able to move up the career ladder and take on additional responsibility (and an accompanying larger paycheck) without the appropriate certifications.
Getting Started
Certified Coding Associate (CCA) – This is the entry-level certification for new medical coders. In order for you to become eligible to take the CCA exam, you must have, at the minimum, a high school diploma or its equivalent.
The American Health Information Management Association (AHIMA) is one of the top two credentialing associations for medical coders. They recommend that before you sign up for the exam, you should either have six months experience coding or you should complete some type of formal training. Either a community college certificate course, an online degree program, or a certificate program that has been approved by AHIMA would be beneficial at this stage.
Hospital Coding Requirements
The next level of certification offered by the American Health Information Management Association (AHIMA) is a Certified Coding Specialist (CCS). This level of professional certification is designed to recognize skilled professionals who have experience classifying medical data directly from patient records, generally while in the hospital setting.
Their tasks include review patients’ records and assigning numeric codes for each patient’s diagnosis and procedure. To achieve this level of certification, medical coders must excel in proving their thorough knowledge of the ICD-9-CM coding system as well as the CPT coding system, with a particular emphasis on the surgery section.
A Certified Coding Specialist will also be expected to demonstrate his or knowledge of human anatomy and physiology, disease processes, medical terminology, and pharmacology.
Physician Offices Coding Requirements
The next level of certification offered by the American Health Information Management Association (AHIMA) is a Certified Coding Specialist-Physician-based (CCS-P).
Without effective Certified Coding Specialist in the physician’s offices, the doctors couldn’t keep their doors open.
The role of the CCS-P is to take descriptions of diseases, injuries, conditions, and procedures from patient records and codes it so it can be submitted to the government or health insurance companies for reimbursement. A Certified Coding Specialist in a physician based setting will be expected to demonstrate extensive understanding of the CPT coding system and knowledge of both the ICD-9-CM and HCPCS Level II coding systems.
Coders for physician’s office will also have to demonstrate competency in understanding human anatomy and physiology, disease processes, medical terminology, and pharmacology.
Specialty credentials
The American Association of Professional Coders offers specialty certifications in a variety of areas, including:
• Emergency Department
• Otolaryngology
• Obstetrics and Gynecology
• Ambulatory Surgical Center
• Orthopaedics
• Cardiovascular and Thoracic
• Pediatrics
• Gastroenterology
• Plastic and Reconstructive
• Evaluation and Management Auditor
• Family Practice
• General Surgery Rheumatology
• Urology
• Dermatology
• Anesthesia
• Cardiology
• Internal Medicine
Angie Boss is an award-winning health industry writer and author or co-author of several books, including Before Your Time: Living Well with Premature Menopause (Simon and Schuster, 2010). She received a Bachelor's of Arts degree in Sociology and Journalism from Virginia Wesleyan College and a Masters of Pastoral Counseling from Union Theological Seminary.
