Medicare Compliance & Reimbursement

Question: Our practice wants to hire only certified coders to ensure we are getting candidates well-versed in accurate coding. However, I do not come from a coding background. Can you explain the difference between CPC, CCS, and NRCCS?

Answer:Many coding associations offer their own version of a coding certification. The type of certification depends on the association and the exam content (the skills and knowledge tested) will vary from exam to exam.

You can research the certifications that are commonly required for employment in your region and in your specialty. For example, if you are a physician-based practice there will be different certification your practice should look for than if you are hiring for a hospital or facility coding department. Also, there are specialty-specific coding certifications as well so you may want to look for those types of credentials.

To refer to the three certifications you asked specifically about:

• Certified Professional Coder (CPC) certification is offered by the American Academy of Professional Coders (AAPC). This is one of the well-known coding certifications. The exam tests on supply, procedure and diagnosis coding as well as compliance, reimbursement, and anatomy. See the AAPC website for additional information about the CPC certification: https://www.aapc.com/certification/cpc.aspx.
• Certified Coding Specialist (CCS) certification is offered by the American Health Information Management Association (AHIMA). This is another well-known coding certification. According to the AHIMA website (http://www.ahima.org/certification/CCS), “CCSs are skilled in classifying medical data from patient records, generally in a hospital setting. These coding practitioners: Review patients’ records and assign numeric codes for each diagnosis and procedure; possess expertise in the ICD-9-CM and CPT® coding systems; are knowledgeable about medical terminology, disease processes, and pharmacology.”
• The Nationally Registered Certified Coding Specialist (NRCCS) certification is offered by the National Association for Health Professionals. This credential is not as well-known but shows the candidate has an interest in furthering her coding education and career. See the association’s website for additional information regarding this credential: https://www.nahpusa.com/Content.aspx?page=13.