# So, just how hard is the CSS exam in comparision to the CPC



## school_email12345@yahoo.com

Hello,

I debate what cert to go for next every other day. I want to get another one. I am considering the CCS.


How hard is it in comparison to the CPC? I hear it's quite a bit more difficult


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## twizzle

school_email12345@yahoo.com said:


> Hello,
> 
> I debate what cert to go for next every other day. I want to get another one. I am considering the CCS.
> 
> 
> How hard is it in comparison to the CPC? I hear it's quite a bit more difficult


You've answered your own question.


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## school_email12345@yahoo.com

wassock said:


> You've answered your own question.



I was hoping someone could give me a more specific answer.


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## Pam Brooks

It's quite difficult, from what I hear. It's different from the CPC in that it deals with inpatient coding: abstracting charts to determine the DRG. In the facility, payment is received based on a number of factors, but most importantly the reporting of diagnosis codes in specific detailed order to calculate the weight of the DRG. Basically, the sicker the patient, the more the facility is paid. Additionally, procedures are coded utilizing ICD-9-PCS, not CPT, so you'd have to learn and understand the coding based on that schematic. From what I understant, it's not like the CPC, in that you can sit with no experience.  I have copied the AHIMA requirements for CCS here:  As you can see, it's much more restrictive as to who can sit. 
http://www.ahima.org/certification/ccs.aspx

*CCS  - Eligibility FAQ Document*
_Candidates must meet one of the following eligibility requirements:_


By Credential:RHIA, RHIT, or CCS/CCS-P; *OR*
By Education:Completion of a coding training program that includes anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding; *OR*
By Experience: Minimum of two (2) years of related coding experience directly applying codes; *OR*
By Credential with Experience: CCA plus one (1) year of coding experience directly applying codes; *OR*
Other Coding credential from other certifying organization plus one (1) year coding experience directly applying codes.
This is an AHIMA certification, so you'd have to join AHIMA (that's fine...some of us are also AHIMA members), and obtain additional CEUs to maintain that second certification.   

But my question is this: Where do you see yourself working? Without a clear plan for your career path, obtaining random certifications will do nothing but take up your time and empty your pockets. I encourage you to figure out what kind of coding or revenue cycle work you really want to do before you consider any additional education. CPC and CCS are so far apart in terms of skill set and responsibility, that they don't necessarily complement one another. If you want to work in the physician world, even in a facility setting as I do, you have no need to obtain a CCS.  I see that currently you're a CPC-A.  If I were you, I'd focus on getting experience and a better understanding of the revenue cycle first before you invest the time and money into a certification that you may never get the opportunity to use. Just something for you to think about.


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## MnTwins29

*It is more difficult than CPC*

The CCS (and for that matter, the CCS-P as well) only has one section that is multiple choice and there are very few coding questions there - that is mostly for coding guidelines and the like.  Part II is the coding and you are given a certain number of encounters, inpatient and outpatient for CCS, and you assign the codes in the manner Pam described.   They must be sequenced correctly so you have to know what qualifies as the principle diagnosis, what is a major complication/comorbidity that will change the DRG and increase the severity of illness, and also need to code ICD-9 procedures as well.     CCS-P is a similar format, but of course for professional services. 

I took CCS-P in 2003 and at the time, it was strongly recommended, but not required, to have three years experience.   I wanted to take one of the AHIMA certs (have been a member for over 15 years) but I waited until I had the experience - and was very glad I did.   The biggest reason is to assign the codes from "scratch" (no mult choice) meant that the candidate needs to know how to read a record and code it.   Not saying that people can't pass these exams fresh out of school - I know many colleagues who did - but I would agree that it's more difficult.   Not putting down the CPC/CPC-H exams in any manner - they are difficult in their own way - but from my own experience, the CCS/CCS-P ones were trickier.  

Interesting topic.


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## twizzle

Pam Brooks said:


> It's quite difficult, from what I hear. It's different from the CPC in that it deals with inpatient coding: abstracting charts to determine the DRG. In the facility, payment is received based on a number of factors, but most importantly the reporting of diagnosis codes in specific detailed order to calculate the weight of the DRG. Basically, the sicker the patient, the more the facility is paid. Additionally, procedures are coded utilizing ICD-9-PCS, not CPT, so you'd have to learn and understand the coding based on that schematic. From what I understant, it's not like the CPC, in that you can sit with no experience.  I have copied the AHIMA requirements for CCS here:  As you can see, it's much more restrictive as to who can sit.
> http://www.ahima.org/certification/ccs.aspx
> 
> *CCS  - Eligibility FAQ Document*
> _Candidates must meet one of the following eligibility requirements:_
> 
> 
> By Credential:RHIA, RHIT, or CCS/CCS-P; *OR*
> By Education:Completion of a coding training program that includes anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding; *OR*
> By Experience: Minimum of two (2) years of related coding experience directly applying codes; *OR*
> By Credential with Experience: CCA plus one (1) year of coding experience directly applying codes; *OR*
> Other Coding credential from other certifying organization plus one (1) year coding experience directly applying codes.
> This is an AHIMA certification, so you'd have to join AHIMA (that's fine...some of us are also AHIMA members), and obtain additional CEUs to maintain that second certification.
> 
> But my question is this: Where do you see yourself working? Without a clear plan for your career path, obtaining random certifications will do nothing but take up your time and empty your pockets. I encourage you to figure out what kind of coding or revenue cycle work you really want to do before you consider any additional education. CPC and CCS are so far apart in terms of skill set and responsibility, that they don't necessarily complement one another. If you want to work in the physician world, even in a facility setting as I do, you have no need to obtain a CCS.  I see that currently you're a CPC-A.  If I were you, I'd focus on getting experience and a better understanding of the revenue cycle first before you invest the time and money into a certification that you may never get the opportunity to use. Just something for you to think about.



Sound advice Pam. I keep contemplating sitting for the CCS but it really is only worth the time and money if you're going to use it. I do know that a lot of employment companies only advertise jobs that require the CCS, and more employers certainly require it, but with experience as well. Because coding offers so many avenues to go down, you really need to carefully choose which one you want to follow and go with it. Set yourself a career path because a lot of employers will ask job seekers "where do you see yourself in 5 years?". Don't answer, as a friend of mine did recently "I hope I'm still alive". They didn't get the job.
The CCS is difficult, it requires a very broad knowledge of all aspects of coding, and it is not all multiple choice. I'd advise getting some coding experience first.
I hope I've given you more information than in my first reply.


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## MnTwins29

*Good post wassock*

I too would say the same thing - don't chase a certification just to have it or because a lot of job ads "require" it.   I don't have a CCS and have spent most of my career either in hospitals or auditing hospital coding outpatient service, so I have not really needed a CCS.   While not directly related, I took the CCS-P with only hospital outpatient experience and it was fine.   Although....my current boss knew about certifications and noticed that I didn't have one specific to HOSPITALS - so I had to obtain one!  Sticking with outpatient, I obtained CPC-H - again, more suited to my current duties and career goals (yes, even old farts like me still have goals!  ) than CCS.  

Moral of the story that all of us are trying to say in different manners - get certified in the areas that match your interests, goals and skills - not to just get something required to answer a job ad.


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## RobinSewell

*CCS Exam*

Hi,
The CCS exam and CPC really cannot be compared in my opinion. If you wish to stay in outpatient or physician billing, the plain CCS is probably not for you. If you would like to try to move into inpatient, the CCS is for you and is the preferred credential in that setting. 

There were two parts to the CCS when I took it and the multiple choice in my opinion was easier than CPC. I think I missed 3 questions in CCS multiple choice. 

The other section was coding medical records with no choices of the codes and if you are not familiar with inpatient coding, it may be difficult. 

There are many outpatient and physician coders that would like to make a transition to inpatient but dont know anything about it. For this reason, I have created a course. I am going to post it under the main forum for people to get an idea of what it is. 

Please let me know if you want more info.

Robin Sewell CCS CPC MCS-P


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