How To Get Certified As A Medical Coder

The path to becoming a certified medical coder involves education, training, and passing a rigorous certification exam. Gaining certification demonstrates competence and can significantly improve your career prospects and earning potential in the healthcare industry. This guide will walk you through the necessary steps, explore different certification options, and provide expert advice to help you succeed.

Step-by-Step Guide to Medical Coding Certification

Here’s a detailed breakdown of the steps involved in becoming a certified medical coder:

1. Education and Training

A strong foundation in medical terminology, anatomy, and physiology is crucial. While a bachelor’s degree isn’t always mandatory, it can provide a competitive edge.

• Formal Education: Consider an associate’s or bachelor’s degree in health information management, medical coding, or a related field. These programs typically cover all the necessary subjects, including:
  • ICD (International Classification of Diseases) coding
  • CPT (Current Procedural Terminology) coding
  • HCPCS (Healthcare Common Procedure Coding System) coding
  • Medical billing principles
  • Healthcare regulations (HIPAA, etc.)
• Coding Certificate Programs: If you already have a degree in another field, a focused coding certificate program can be a faster route. These programs are offered by vocational schools, community colleges, and online institutions.
• Self-Study: While possible, self-study is extremely challenging and not generally recommended for beginners. The complexity of coding requires structured learning and expert guidance. If you choose this route, be prepared for a longer study time and potentially higher exam retake fees.

2. Choose a Certification Body and Exam

Several organizations offer recognized medical coding certifications. The most widely accepted are:

• AAPC (American Academy of Professional Coders): AAPC offers several certifications, including:
  • CPC (Certified Professional Coder): The most popular certification, covering physician-based coding.
  • COC (Certified Outpatient Coder): Focuses on outpatient coding.
  • CIC (Certified Inpatient Coder): Specializes in inpatient hospital coding.
  • CRC (Certified Risk Adjustment Coder): Covers risk adjustment coding, often used in Medicare Advantage.
• AHIMA (American Health Information Management Association): AHIMA offers certifications such as:
  • CCA (Certified Coding Associate): An entry-level certification suitable for those with limited experience.
  • CCS (Certified Coding Specialist): A more advanced certification for inpatient coding.
  • CCS-P (Certified Coding Specialist – Physician-based): A more advanced certification for physician-based coding.

Choosing the right certification depends on your career goals. The CPC is the most generally recognized and versatile certification. If you are interested in inpatient coding, the CIC or CCS would be more appropriate. Research the job market and identify the certifications most sought after by employers in your area.

3. Gain Practical Experience (Recommended)

While not always mandatory, practical experience significantly improves your chances of passing the certification exam and securing a job.

• Entry-Level Coding Positions: Look for entry-level coding positions, even if they’re not directly related to your desired specialty. Any experience with medical records and billing systems is valuable.
• Internships: Many coding programs offer internships that provide hands-on experience in a real-world setting.
• Volunteer Opportunities: Consider volunteering at a hospital or clinic to gain exposure to medical documentation.

4. Thorough Exam Preparation

The certification exams are challenging and require extensive preparation.

• Study Materials: Purchase official study guides and practice exams from the certification body.
• Coding Manuals: Invest in the latest editions of ICD, CPT, and HCPCS coding manuals.
• Practice Exams: Take numerous practice exams under timed conditions to simulate the actual exam environment.
• Coding Workshops: Attend coding workshops or review courses offered by AAPC, AHIMA, or other reputable organizations.
• Online Forums and Study Groups: Join online forums and study groups to connect with other coding students and professionals. Share tips, ask questions, and stay motivated.

5. Register for and Pass the Certification Exam

Once you feel adequately prepared, register for the certification exam through the chosen certification body’s website.

• Application Process: Carefully review the application requirements and deadlines.
• Exam Fees: Be prepared to pay the exam fee, which can vary depending on the certification.
• Exam Format: Understand the exam format, including the number of questions, time limit, and question types.
• Testing Centers: Locate a testing center near you and schedule your exam date.
• During the Exam: Manage your time effectively, read each question carefully, and eliminate incorrect answers.
• Retake Policy: Familiarize yourself with the retake policy in case you don’t pass the first time.

6. Maintain Your Certification

Medical coding certifications typically require continuing education units (CEUs) to maintain your credentials.

• CEU Requirements: Understand the CEU requirements for your specific certification.
• Approved CEU Providers: Obtain CEUs from approved providers, such as AAPC, AHIMA, and other accredited organizations.
• Renewal Fees: Pay the annual renewal fees to keep your certification active.
• Stay Updated: Stay up-to-date on coding changes and industry regulations through continuing education and professional development.

Cost Breakdown for Medical Coding Certification

This table illustrates the approximate costs associated with becoming a certified medical coder. These are estimates and can vary.

Checklist for Aspiring Medical Coders

• Research different medical coding certifications (CPC, COC, CIC, CRC, CCA, CCS, CCS-P).
• Choose a certification that aligns with your career goals.
• Enroll in a reputable medical coding program or pursue relevant coursework.
• Obtain the latest editions of ICD, CPT, and HCPCS coding manuals.
• Create a study schedule and stick to it.
• Take practice exams regularly to assess your knowledge and identify areas for improvement.
• Join online forums or study groups to connect with other coding students.
• Register for the certification exam.
• Pass the certification exam.
• Obtain practical experience through entry-level coding positions, internships, or volunteer opportunities.
• Maintain your certification by earning required CEUs and paying annual renewal fees.
• Stay up-to-date on coding changes and industry regulations.

Pro Tips for Success

• Network with Professionals: Attend industry events and connect with experienced medical coders. Networking can provide valuable insights, mentorship opportunities, and job leads.
• Stay Persistent: The path to certification can be challenging, but don’t give up. Persistence and dedication are key to success.
• Continuous Learning: Medical coding is a constantly evolving field. Stay committed to continuous learning to maintain your skills and knowledge.
• Don’t Rush: Take your time to truly understand the coding guidelines and principles. Rushing through the material can lead to errors and a lower chance of passing the exam.
• Understand Insurance: Familiarize yourself with the different types of health insurance plans (PPO, HMO, etc.) and their billing requirements.

By following these steps and tips, you can increase your chances of becoming a certified medical coder and building a successful career in this growing field. Good luck!

Frequently Asked Questions

How much does it cost to get certified as a medical coder?

The cost varies, from $2,679 to $8,649+, depending on the chosen education path (certificate program vs. self-study), exam fees, study materials, and membership fees. Certificate programs range from $1,000-$5,000.

How long does it take to become a certified medical coder?

It can take anywhere from a few months to two years, depending on the educational path chosen. A certificate program may take several months, while an associate’s or bachelor’s degree will take longer.

Which medical coding certification is the easiest to obtain?

The CCA (Certified Coding Associate) from AHIMA is generally considered an entry-level certification and may be easier to obtain than more specialized certifications like the CPC or CCS. It requires less experience.

Is medical coding a difficult career to get into?

Medical coding requires a strong understanding of medical terminology, anatomy, and coding guidelines. The exams are challenging, but with dedication and proper preparation, it’s a very achievable career path.