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Medical Coding Certification


Which credential is right for me?

The AAPC currently provides medical coding certification examinations for coders in physician practices, the outpatient/facility environment and is the first organization to offer a medical coding certification exam that recognizes medical coders in the payer community.

AAPC's CPC® certification credential for physician and outpatient coding, and AHIMA's CCS for inpatient coding are currently the only medical coding credentials recognized by employers, payers and government agencies, including the Department of Labor (Occupational Handbook (www.stats.bls.gov/oco/ocos103.htm)).

In short, AAPC's medical coding certifications are nationally recognized by employers seeking ethical, accurate, experienced, and professional medical coders.

Which Test Should I Take?

Puzzled by which medical coding certification exam you should take? Here’s some help!

  • Specialty
  • CPC-P®
  • CPC-H®
  • CPC®

Specialty Credentials

AAPC has developed specialty credentials to enable CPC®s, CPC-H®s, CPC-P®s, CCSs, CCS-Ps, RHIT and MDs to demonstrate superior levels of expertise in selected specialty disciplines. Whether a coder wishes to show expertise in a specialty they currently work in or wish to move to another specialty these credentials are designed to prove superior knowledge and skills.

AAPC’s specialty credential study guides are designed to prepare a coder for each examination; test writers and study guide authors have worked together to ensure their "fit."

Certified Professional Coder – Payer (CPC-P®)

Take the CPC-P® exam, which concentrates on coding and billing after it’s been submitted to the payer, if you are in the following situations:

  • Claims manager for a payer (private insurance, Medicare, Medicade, etc.)
  • Auditor for a payer
  • Utilization review
  • Post-billing auditor for a physician group or facility
  • Billing service
  • If you are a consultant, educator, legal counsel, physician or other care-giver seeking credential to demonstrate your command of medical coding

Certified Professional Coder – Hospital (CPC-H®)

Take the CPC-H® exam, which concentrates on outpatient facility services, if you are fulfilling the following roles in relationship to facilities medical coding.

  • Billing Ambulatory Patient Category groups (APCs) for facility outpatient services.
  • Working in hospital outpatient billing and coding department
  • Auditing facility outpatient service billing and coding
  • Ambulatory Surgical Center
  • Performing utilization review for outpatient services
  • If you are a consultant, educator, legal counsel, physician or other care-giver seeking credential to demonstrate your command of medical coding

For credentials addressing inpatient medical coding and billing, contact the American Health Information Management Association (AHIMA) for their certification.

Certified Professional Coder (CPC®)

Take this test, which addresses billing and coding for physician services, if you code in the following places or situations:

  • Physician office or group
  • Hospital-associated physician office or group
  • Health system-associated physician office or group
  • Home health agency
  • Physician group at University and or in teaching setting
  • Compliance auditor or forensic auditor of physician claims
  • Physician Billing service
  • Ambulatory surgery center (ASC)
  • Outpatient hospital services not reimbursed by Ambulatory Patient Category (APCs) groups
  • If you are a consultant, educator, legal counsel, physician or other care-giver seeking credential to demonstrate your command of physician based medical coding

Medical Coding Certification Requirements

In order to earn CPC®, CPC-H®, or CPC-P® credentials:

  1. We recommend having an associate’s degree.
  2. Pay examination fee at the time of application submission.
  3. Maintain current membership with the AAPC.
    a. New members must submit membership payment with examination application.
    b. Renewing members must be current at the time of application submission as well as when results are sent.
    c. See “Fees for Membership and Examination” section for details.
  4. Achieve a passing score in each section of the examination. If a passing score in each section is not achieved each time the examination is taken, the entire examination must be retaken.

Requirments for removal of Apprentice designation:

At least two recommmendation letters verifying 2 years of on the job experience using the CPT®, ICD-9, or HCPCS code sets. At least one letter must be from a supervisor outlining your coding experience and amount of time in that capacity.

OR

A minimum 80 hour coding course AND one letter verifying one year of on the job coding experience from a supervisor. Proof of education may be sent in the form of a letter from the instructor stating the amount of contact hours or a certificate of completion stating the amount of contact hours.

Note:
Each examination is separate and distinct from one another. To obtain all certifications, each examination must be taken separately and passed. 36 CEUs are required every two years for single certification, 48 CEUs for dual certification, and 60 CEUs to maintain all three certifications.


Take Your Medical Coding Certification to the Next Level
Demonstrate superior levels of expertise with specialty credentials.
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