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Medical Billing and Coding Certification

By Ashley Boyce, an allied health world staff writer

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What is the American Health Information Management Association?

The American Health Information Management Association (AHIMA) is a national organization for medical records and health information technicians that sets the standard for education and accreditation in this field. This organization recognizes those schools whose courses meet the highest standards for educating future medical records and health information techs.  They also certify professionals who have tested and registered with their organization.  The mission of AHIMA is to see to it quality health care is provided through the maintenance of quality medical information.

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What is the importance of AHIMA certification?

Since the medical billing and coding profession doesn’t require state or federal licensure, accreditation through AHIMA is the best way for professionals in this field to distinguish themselves as experienced and knowledgeable.  AHIMA certification is not a requirement to work as a billing and coding specialist, but employers show a strong preference towards applicants with this additional credential because it means the prospective employee has graduated from a recognized school and proven their competency, knowledge, and applied skills.  Being credentialed through AHIMA will typically result in higher pay and better opportunities for career advancement.  AHIMA has published information showing 68% of employers choose credentialed candidates over those without credentials, and  67% of credentialed employees report earning more than their non-credentialed counter-parts.

What’s required to earn AHIMA certification?

To be eligible to take the AHIMA exam and become certified, a recent graduate or employed professional would need to submit an application to AHIMA who verifies that all requirements for accreditation have been met.  Eligibility for the basic level of AHIMA accreditation is based on having received a two-year associate degree from one of the 245 schools recognized by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM).  Higher levels of accreditation require a certain amount of job experience, continuing education, and comprehensive knowledge of classification systems, privacy policies, and regulations.  AHIMA certification is not an option to those who have not received their medical billing and coding training through an AHIMA-recognized program.  When the applicant is approved, they are then issued an Authorization to Test (ATT) letter which allows them to schedule an exam.


What are the various levels of accreditation?

AHIMA and other similar organizations provide various levels of accreditation for health information management (HIM), coding, healthcare privacy and security, and health data analytics.  The different types of accreditation are based on levels of professional experience in the different fields of practice.  This accreditation becomes the title that follows the billing and coding specialist’s name, just as doctors would have M.D. after their name.  Other organizations similar to AHIMA like the American Academy of Professional Coders (AAPC) offer similar titles and certification, but AHIMA sets the standard.  The different titles and levels of competency granted by AHIMA are:
Certified Coding Associate (CCA) is the basic level of accreditation for those starting their career.  It represents completion of an AHIMA-approved program, a full understanding of common classification systems, and six months job experience.  Through AAPC the equivalent title would be Certified Professional Coder (CPC).
Certified Coding Specialist (CCS) represents three years of job experience in coding hospital-based inpatient, ambulatory, and outpatient care.  Through AAPC the equivalent of this title would be Certified Professional Coder- Hospital (CPC-H).
Certified Coding Specialist-Physician-based (CCS-P) is available after three years of experience coding physician services in different settings that would include physician offices, group practices, or specialized medical clinics.  Through AAPC the equivalent title would be Certified Professional Coder-Payer (CPC-P).
Certified Health Data Analyst (CHDA) is a high-level certification for coders who perform analysis for cost reduction and research projects.
Certified in Healthcare Privacy and Security (CHPS) is available to professionals with four years work experience, or two years experience if other AHIMA accreditation has been earned.  This certification represents competency in the design and use of patient privacy protection programs.
Registered Health Information Administrator (RHIA) is reserved for coding and billing specialists in managerial positions who have demonstrated comprehensive knowledge of privacy practices, administrative objectives, and legal requirements.
Registered Health Information Technician (RHIT) certification denotes a level of expertise that qualifies the holder of this title for research work in cancer registry; or for pharmaceutical companies, law firms, or insurance companies. For more information on AHIMA-recognized schools and how to become certified, visit www.ahima.org.

What can I expect from the AHIMA exams?

Exams qualify billing and coding specialist for the different levels of field-specific accreditation mentioned above.  The different levels of accreditation have unique exams, but they are generally two-hours in length and consist of two parts.  Part I is multiple choice and tests knowledge of medical terms human physiology, while Part II demonstrates applied knowledge of job skills and classification systems.  In all cases these exams test for expertise and comprehensive knowledge of the skills required of each level of certification.  Exams are taken through Prometric, a contracted testing agency with test centers located all over the United States.  Sample tests and scoring charts for each type of accreditation are available at www.ahima.org.

Learn more about the medical billing and coding career path.

What is required of continuing education (CE)?

Continuing education is required to maintain an existing level of AHIMA accreditation or to become certified at a higher level.  The amount of Continuing Education Units (CEUs) required to maintain accreditation depends on the level of accreditation currently held.  The CEU requirement also varies for the different levels of accreditation.




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