A person must be certified by the American Academy of Professional Coders and have extensive coding experience to become a Certified Professional Coder® in the medical administration field. Passing an exam and demonstrating the ability to read and understand medical billing codes are required for certification. There are two levels of Certified Professional Coder® certification, each of which certifies a different type of facility — a physician’s office or a hospital.
While a certification isn’t always required to work in a medical facility’s billing department, being a Certified Professional Coder® can help you get a job. Certification can also help you earn more money.
A person must understand the basic application of codes in the medical billing process to become a Certified Professional Coder®. This includes CRT®, HCPS procedure and supply codes, and ICD-9-CM diagnosis codes, among other coding formats used for medical billing to insurance companies. Knowledge of human anatomy, physiology, and medical terminology, in addition to technical coding skills, is required. Prior to training, testing, and seeking a job in the medical billing and coding field, a high school diploma is required, but an associate’s degree is strongly recommended.
There are a variety of medical coding and billing schools and training programs available, both online and on campus, that will teach many of the fundamentals of the profession and prepare students for the national exam. There is a fee associated with the national exam, which consists of 150 questions. Approved manuals are permitted to be used during the testing process by the American Academy of Professional Coders. A complete list of what is permitted can be found on the website. Practice exams, workbooks, and other training tools are recommended to supplement any course work for those preparing for the test.
A person must demonstrate practical ability to properly understand these complex medical codes in addition to passing the exam. A person who passes the exam but does not have any work experience will be given apprentice status. While gaining work experience, apprentices must complete additional continuing education credits. The apprentice designation can be removed in one of two ways. A minimum of 80 hours of coding education and one letter of recommendation from an employer verifying one year of on-the-job experience working with one of the code sets is required, or a minimum of 80 hours of coding education and one letter of recommendation from an employer verifying one year of on-the-job experience working with one of the code sets is required.