Getting on the Path to Medical Billing and Coding Certification

By Karen Smiley

The two primary certification organizations for medical coding are the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA). Formerly, AAPC credentials were held by physician coders, and AHIMA credentials were inpatient coders. That is no longer the case. AAPC now offers an inpatient coding certification, and AHIMA offers a physician coder certification. The AAPC also offers other specialty certifications including practice management and biller.

Getting certified by AAPC or AHIMA

Some coding professionals are certified by both AAPC and AHIMA. But remember: The more certifications you have, the more you must maintain, and keeping up with continuing education units (CEUs) can be a challenge when you’re trying to manage several credentials.

It is also important to remember that a certificate and a certification aren’t the same thing. Some training programs offer a certificate upon completion of a program, but that is not a certification. Most billing companies and hospitals require coders to be certified by either AAPC or AHIMA. Most physician offices also prefer certification.

Choosing a study program for medical billing and coding certification

When looking for a study program, keep your career objective in mind. If you’ve always wanted to work in a hospital, take the AHIMA path and find a program that offers AHIMA-based training.

Inpatient hospital claims are billed using ICD codes, not CPT codes, so you’ll want to be familiar with that process.

On the other hand, if you want to work in a doctor’s office or ambulatory surgery center or even a billing company, the AAPC certification may be your best choice. You can choose from a gamut of programs. Many community colleges offer training as well as technical school programs.

There is a difference between a certificate that represents completion of a program and a certification obtained through one of the aforementioned professional organizations. Regardless of whether a program is recommended by either organization, the only way to obtain certification credentials is by taking the appropriate tests that are administered through AHIMA or AAPC. A school that offers training will not be able to issue credentials.

Taking the AAPC or AHIMA exams

After you’ve completed the curriculum, you’re ready to sign up for the certification exam. The AAPC allows you to sign up for a specific date on their website. AHIMA has a request process that can be found on its website.

Prior to the test date, you should review what items are needed and/or allowed. Both organizations require two forms of ID and specify which books you may use. Neither allows cellphones, computers, drinks, food, or calculators in the test area. So make sure you are on time (late arrivals are not admitted into testing areas) and have the necessary supplies.

Steering clear of faulty certification programs

Currently, the coding industry is in transition, waiting for ICD-10 implementation. Beware of any program that offers ICD-10 certification. There is no such thing. Both AAPC and AHIMA offer ICD-10 competency training in preparation. Currently credentialed coders will be required to demonstrate ICD-10 competency when the transition is complete.

Unfortunately, plenty of online diploma mills will take your money but not fully prepare you for the real world. It may seem like you’re getting qualified training, but remember: You can only obtain true certification from AAPC or AHIMA.

Continuing your medical coding education

After you’re certified, you will need to earn continuing education units (CEUs) order to maintain your credentials. Numerous vendors offer CEUs; some are free, and others are costly. From online quizzes to boot camps, you have ample opportunity to continue your learning.

You may be tempted to think of CEUs as something that you are just required to do, but they’re there for a reason. They serve to keep you current in evolving technology as well as changes in regulations and code updates.