- Medical Billing Certification Study Guide
- Medical Billing Basics Study Guide
- Study Guide For Medical Billing Certification
You’ve decided to become a medical coder. You’re in it for the flexible schedule, the good salary, and the ability to work from home. Your first step towards your new career is understanding what it takes to become certified.
Here is your comprehensive guide to medical coding certification. Why Should You Get Certified? While certification is not technically required to be a medical coder, it is crucial to remaining competitive. A recent (AAPC) survey of 18,000 coders found that. Coders without certifications earn than those with certifications. Plus, the more credentials you have, the more you can expect to earn.
The same AAPC survey found that on average, nationwide,. Coders with any single certification earned $46,899 per year. Coders with any two certifications earned 25% more on average than those with single certifications.
Coders with any three or more certifications earned 12% more on average than those with two certifications. In addition to improving your job prospects and earning potential, getting certified as a medical coder has other advantages. Ensures you have a strong foundation in current standards and protocols. Improves your ability to catch and correct coding errors. Connects you, through your certifying organization, to a network of other healthcare professionals.
Use CPC medical coding certification exam study guide from the makers of the CPC test to prepare for the exam. The official CPC certification study guide 2018 with 200+ Test your Knowledge questions with answers and rationales. Become a Certified Billing & Coding Specialist (CBCS). This medical billing and coding certification will help prepare you for a rewarding career. Online Study Package $69 Online Study Guide $48 Online Practice Test $39 Printed Study Package $69 Printed Study Guide $48.
Improves your ability to advance in your career. What Certification Should You Get?
There are a variety of coding certifications out there. This guide focuses primarily on the two most popular certifications: the Certified Professional Coder (CPC) and the Certified Coding Specialist (CCS). They are the two gold-standard certifications that will open up opportunities for you as a medical coder.
Medical Billing Certification Study Guide
There are also a variety of other specialized certifications. How do you know which one is right for you? Though CPCs generally code in a physician’s office and CCSs tend to be more in demand in hospitals, either certification is acceptable for a wide variety of positions. The CPC is the most popular certification option for coders who are interested in working in an outpatient setting. It will prepare you to process and improve the profitability of outpatient data in a doctor’s office or a private medical clinic.
CPCs take on many tasks:. Accurately code physician and medical clinic data. Ensure compliance and quality in all coded data. Identify and report medical records errors. Reconcile patient charges and minimize data-based insurance rejections. Master ICD-10, Current Procedural Terminology (CPT), and Healthcare Common Procedures Coding System (HCPCS) Level II coding systems.
Exam The CPC exam covers:. Surgical procedures performed on all body systems. Evaluation and management.
Anesthesia. Radiology. Laboratory/pathology.
Medicine. Medical terminology. Anatomy. ICD-10 Volumes 1 & 2.
HCPCS Level II Codes. Coding guidelines.
Compliance and regulation The CCS is the certificate to go for if you are more focused on inpatient coding. This will prepare you to classify and process data from hospital medical records. CCSs can:. Help hospitals maintain rigorous standards for accuracy and consistency in data. Monitor compliance and quality measures. Identify and prevent coding errors. Improve hospital profitability.
Master ICD-10-CM and CPT coding systems. Exam The CCS certification exam is extensive and much more difficult than the CPC exam. It contains more complex, situation questions and covers:. Health information documentation. Diagnosis and procedure coding (64%-68% of the test). Guidelines and reporting requirements for inpatient services.
Guidelines and reporting requirements for outpatient services. Data and quality management. Information technologies. Privacy, confidentiality, legal, and ethical issues. Compliance Certified Professional Coder vs. Certified Coding Specialist Here’s a comparison of the two certifications. Certified Professional Coder (CPC) Certified Coding Specialist (CCS) Typical career settings.
Doctor’s offices. Surgery centers. Medical clinics. From your home. Hospitals.
From your home Education or experience requirements Two years professional experience or enrollment in an apprentice program. A diploma or degree from a coding training program, OR. Two years of coding experience, OR. Another coding credential plus one year of coding experience National average salary range, once certified Certifying body (AAPC) (AHIMA) Annual membership dues pursuing a certificate or degree; $150 for individuals who are not. Without an AHIMA certification; annual re-certification costs an additional $10.
Exam difficulty Medium: According to an AAPC representative, first-time test takers that use AAPC prep materials pass 80% of the time, on average. Recertification requirements 36 continuing education units (CEUs) every two years; AAPC applies a broader definition of what counts towards CEUs than AHIMA. 20 continuing education units (CEUs) annually and two coding self-reviews; AHIMA has stricter regulations on CEUs and stresses an annual recertification process. Other certifications You may choose to branch out from the most popular certifications.
The credentials in this section are common secondary certifications, achieved after gaining a CPC or CCS. The Certified Coding Associate credential offered by AHIMA will give novice coders a foot in the door. You only need six months coding experience to sit for the CCA exam. It provides entry-level competency in coding across all medical settings. A relatively new certification, Certified Inpatient Coding (CIC) is the AAPC’s answer to the CCS.
This certification helps you gain proficiency in inpatient coding for hospitals. CIC isn’t as recognized as the CCS, but it’s gaining traction. A physician-based Certified Coding Specialist is AHIMA’s mastery-level certification for those coding in physicians’ offices and other outpatient settings. It offers more in-depth training in physician coding than the AAPC’s CPC.
A Certified Risk Adjustment Coder demonstrates expertise in auditing and coding for different risk adjustment models, such as Hierarchical Conditions Categories (HCC). Building off of foundational medical coding knowledge, this AAPC certification prepares you for more in-depth analysis of the interrelationship between diagnoses and revenue. Certified Outpatient Coding (COC), offered by the AAPC, prepares you for specialized medical coding demands in outpatient settings, such as ambulatory surgery facilities, physical therapy centers, and other clinics in which physicians are connected to a hospital group. It is generally pursued by those who already have CPC certifications. A Certified Professional Coder with a specialty in payers is a unique AAPC certification. While other credentials prepare you to work in a medical environment, the CPC-P credential allows you to work for insurance companies and other health plans.
As a CPC-P, you’ll learn the intricacies of coding from the payer’s perspective. The AAPC also offers 22 specialty coding certifications. These certifications give you in-depth knowledge of and proven expertise in specific medical areas:. Ambulatory surgery centers.
Anesthesia. Cardiology. Cardiovascular and thoracic surgery. Chiropractic. Dermatology. Emergency department.
Evaluation and management. Family practice. Gastroenterology. General surgery.
Hematology and oncology. internal medicine. Interventional radiology and cardiovascular. Obstetrics and gynecology. Orthopaedic surgery. Otolaryngology.
Pediatrics. Plastics and reconstructive Surgery. Rheumatology.
Surgical foot and ankle. Urology. Which path is the best for you? The best credentialing route for you to take depends on your interests and location. Decide what area of medical coding interests you.
Outpatient medical coding generally takes place in a physician’s office or medical clinic outside of a hospital. If you are interested in this kind of coding, the most common route for you is to become a Certified Professional Coder (CPC) through the. Some coders opt to become a physician-based Certified Coding Specialist (CCS-P) through. Inpatient medical coding generally takes place in a hospital. If this is the kind of coding that interests you, you’ll most likely become a Certified Coding Specialist (CCS) through AHIMA. The AAPC recently introduced its certification in inpatient coding as well, Certified Inpatient Coding (CIC).
It is still gaining traction. Most certifications will provide opportunities for you to code from home if you choose. The most sought-after certifications vary region to region. Look beyond national averages.
Which certifications have the most job openings and highest pay in your area. Educational Paths Towards Certification You have a variety of options for where to get certified. Diploma program A diploma program is the quickest path to a medical coding certificate. Medical coders and billers typically enter the profession with a. This means many go directly from their high school diploma to a medical coder diploma program. Educational requirement: High school diploma. Location: Community and junior colleges, technical colleges, medical facilities, traditional 4-year colleges, and online.
Program length: 6 months to 1 year. Cost: Associate degree An Associate degree will give you a more in-depth medical coding education. Often, you will study medical billing, too, and take courses such as medical terminology, anatomy and physiology, and other academic building blocks. Educational requirement: High school diploma. Location: Junior and community colleges, adjunct programs at 4-year universities, and online. Program length: 2 years. Cost: Bachelor’s degree and beyond For an even more in-depth and broad base of knowledge, you can go for a Bachelor’s degree in health information management.
These are four-year programs at accredited universities. There are also Master’s degrees and PhDs in health information management. Keep in mind that. Those in the profession with Bachelor’s degrees earn more than those with Associate degrees, who in turn earn more than those with no degree. Though initial costs are steeper, your higher salary will make it worth the investment!
How to Prepare for Your Certification Exams So, you’ve picked your certification and your program, and you’re ready to start studying for the big exam. Here’s how to tackle the challenges of passing the certification exam. Study, study, study, and then study some more. There are extensive online resources to help you prepare for your certification exam. AHIMA and AAPC sell many resources: AAPC’s CPC Exam Resources. AHIMA’s CCS Exam Resources.
Medical Billing Basics Study Guide
But studying doesn’t always need to be expensive. Be sure to take advantage of a variety of free resources as well. Free Resources Quizzes, Clinical Scenarios, and Study Materials. Just Coding provides. Optimum 360 Coding offers that you can try your hand at. The has an extensive collection of medical coding questions and answers. and offer medical coding flash card decks, quizzes, and notes created by other students on sites.
Apps. PocketPrep’s app lets you study for your CPC on the go. is a great app to help you bone up on your anatomy lessons. (Android) or s (Apple) are great for fleshing out your medical terminology skills. Videos.
YouTube has great introductory videos on medical coding. from the American Gastroenterological Association. from the Centers for Medicare & Medicaid Services (CMS). The Certification Coaching Organization has answering common medical coding questions. Medical Billing and Coding Certification offers.
Practice makes perfect. Take multiple practice exams. They’ll give you a good indicator of what you’ve mastered and where you have room for improvement.
AHIMA’s is chock full of practice exams. The AAPC offers. Don’t attempt to frantically stuff your head full of medical coding guidelines and scenarios a week or two before the tests. Chances are, if you cram, you will fail. Study at a calm pace, with spaced repetitions of materials, for about 8 to 13 weeks before your test date. Study for about 20-50 minutes at a time, taking short breaks in between, for ideal retention. Don’t multitask.
Multitasking kills your brain. If you are logging onto Facebook or watching TV while you’re studying, chances are you aren’t making the most of your study time. It makes you less efficient and impairs your ability to retain knowledge. Tell yourself a story. Having trouble remembering a set of coding guidelines or medical terminology suffixes? Tell yourself a vivid, interesting story with the information.
For example, a popular way to remember the in order is with a story, such as “.” Find a study buddy. Find a partner who can check your progress and motivate you. You can also share study resources.
One of the best ways to know you’ve learned something is to be able to teach it to someone else. Talk out those codes and standards. Before the exam. Be sure to arrive early to your testing location.
Study Guide For Medical Billing Certification
Come with the proper identification. Bring the most recent acceptable coding books. AAPC strongly recommends for their CPC exam. Both the CCS and CPC exams are very long, with limited breaks, so be sure to get plenty to eat beforehand.
During the exam Here are some tips for doing your best during the exam. Do it backwards. Many medical coding hopefuls suggest starting at the back of the test and working towards the front. The more difficult questions tend to be at the front and this will prevent you from being bogged down. Remember that the devil’s in the details. Read all the instructions very closely.
Go over directions twice to make sure you are proceeding correctly. Mind the clock.
When taking the test, be constantly mindful of time. Move through the multiple choice questions at a pace of about one question per minute. For the more substantive case study questions, it’s appropriate to spend 15-18 minutes. Don’t allow yourself to get stuck on any one question. If you move through quickly, you’ll be able to go back and puzzle over any questions you weren’t able to immediately answer. Make educated guesses.
If you’re stuck on a multiple-choice question, eliminate answers that you are sure are incorrect. Pick the best choice from the remaining questions. How to Maintain Your Medical Coding Certifications Congratulations! You’ve passed your exam! You’re now a certified medical coder. Each year, you’ll want to keep up on what’s what in the medical coding world.
The AAPC and AHIMA both require you to take regular continuing education credits (CEU) to make sure your knowledge is fresh and on-point. The requires you to take. requires you to take.
For CCSs, this requirement includes, which are 25-question self-guided exams. For both the AAPC and AHIMA, if you have more certifications, you need more CEUs each recertification cycle.
Each organization has a recertification schedule based on when you obtained your certification. Be mindful of these dates and conscientious of obtaining your required CEUs in time. Here are some example CEUs for medical coders:. Webinars, online courses, and on-demand workshops. In-person conferences, talks, and seminars. Local meetings and events.
You are now ready to enjoy your career as a medical coder. Looking for an exciting new position?.
CPB The Certified Professional Biller (CPB ™) credential prepares medical billers with skills to maintain all aspects of the revenue cycle. Without expertise in and the nuances of payer requirements, healthcare provider reimbursement may be compromised. Validate Your Expertise Through rigorous examination and experience, CPBs have proven knowledge of how to submit claims compliant with government regulations and private payer policies. They follow-up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections.
The CPB medical billing credential is vital to the financial success of the professional healthcare services claims process. CPBs Earn Their Worth According to AAPC's, the average salary for a CPB was $52,037. If you want to see how much earning potential you have with medical billing expertise, to calculate the average CPB salary in your area, based on your job responsibility. Keep in mind that a CPB’s annual salary varies based on the size of the practice you bill for or whether you work in a large facility. Other factors include years of experience, how many credentials held, and your location.
CPBs have demonstrated:. An understanding of various types of insurance plans. Expertise in applying payer policy, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs) for successful claim submissions. Knowledge of CPT ®, ICD-10-CM, and HCPCS Level II coding guidelines. Successful navigation of healthcare industry rules and regulations, including HIPAA, False Claims Act, Fair Debt Collections Act, and Stark Law.
An understanding of the life cycle of a medical billing claim and how to improve the revenue cycle. Expertise in effective claim follow-up, patient follow-up, and denial resolution.
Approved Manuals for Use During Examination Required References:. Books (AMA standard or professional edition ONLY). No other publisher is allowed. Your choice of. Your choice of. Note: Electronic devices with an on/off switch (cell phones, smart phones, tablets, etc.) are not allowed into the examination room.
Failure to comply with this policy may result in disqualification of your exam. Any officially published errata for these manuals may also be used.
No other manuals are allowed. Each code set is updated annually; it is essential that examinees use the current calendar year's coding manuals when taking the certification exam. Questions on the CPB ™ tests do not require the use of any other outside material. Non-Approved Manuals for Use During Examination Due to the advantages of additional information and/or ease of use, the following references cannot be used during the exam:. Any Procedural Coding Expert. Any Procedural Professional.
CPT ® Plus! - PMIC. CPT ® Insider's View - AMA. ICD-10-CM Easy Coder. Study Guides. We recommend having an associate’s degree. Pay examination fee at the time of application submission.
Maintain current membership with the AAPC. New members must submit membership payment with examination application. Renewing members must have a current membership at the time of submission and when exam results are released. Note: Each examination is separate and distinct from one another. To obtain all certifications, each examination must be taken separately and passed. An overall score of 70% or higher is required to pass an exam. For examinees who do not pass, only the areas of study/categories with a score of 65% or less are provided for examinees’ preparation.
The areas of study reported reflect scores based on the number of questions in each category/section of the exam; each of the category/section may vary in the number of questions asked. Continuing Education Unit (CEU) submissions are required for all certifications. For CEU requirements please see our page. ADDITIONAL COURSES. Popular Topics.
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