Medical Coding Certification

Certified Professional Coder (CPC®)

The AAPC's gold standard CPC^® credential demonstrates a broad encompassing knowledge and expertise in reviewing and assigning the correct coding of physician services, procedures and diagnosis for medical claims. It rigorously validates an individual's ability to assign codes based on national coding guidelines and operative reports, comprehend medical terminology and human anatomy and apply billing reimbursement guidelines. The CPC^® examination consists of questions regarding the correct application of CPT®, HCPCS Level II procedure and supply codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies and CMS.

Take the CPC^® exam if you code in the following places or situations:

• Physician office or group
• Hospital-associated physician office or group
• Health system-associated physician office or group
• Home health agency
• Physician group at a university and or in a teaching setting
• Compliance auditor or forensic auditor of physician claims
• Physician billing service
• Ambulatory Surgery Center (ASC)
• Outpatient hospital services not reimbursed by Ambulatory Patient Category (APCs) groups
• If you are a consultant, educator, legal counsel, physician or other care-giver seeking a credential to demonstrate your command of outpatient medical coding for physician services

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Certified Professional Coder – Outpatient Hospital (CPC-H®)

The CPC-H^® credential validates proficiency in accurately coding outpatient facility/hospital services. The examination consists of questions regarding the correct application of CPT®, HCPCS Level II procedure and supply codes and ICD-9-CM diagnosis codes used for coding and billing outpatient facility services to insurance companies.

Take the CPC-H^® exam if you code in the following places or situations:

• Billing Ambulatory Patient Category groups (APCs) for facility outpatient services
• Working in a hospital outpatient billing and coding department
• Auditing facility outpatient service billing and coding
• Ambulatory Surgical Center
• Performing utilization review for outpatient services
• If you are a consultant, educator, legal counsel, physician or other care-giver seeking a credential to demonstrate your command of outpatient medical coding in a facility/hospital environment

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Certified Professional Coder – Payer (CPC-P®)

The CPC-P^® credential concentrates on coding and billing after it’s been submitted to the payer. The CPC-P^® certification exam will test the examinee’s basic knowledge of coding-related payer functions with emphasis on how those functions differ from provider coding. The relationship between coding and payment functions will be explored in depth. Those who pass this exam validate their aptitude, proficiency and knowledge within the payer environment.

Take the CPC-P^® exam if you code in the following places or situations:

• Claims manager for a payer (private insurance, Medicare, Medicaid, etc.)
• Auditor for a payer
• Utilization review
• Post-billing auditor for a physician group or facility
• Billing service
• If you are a consultant, educator, legal counsel, physician or other care-giver seeking a credential to demonstrate your command of medical coding in a payer environment

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Certified Interventional Radiology Cardiovascular Coder (CIRCC®)

The CIRCC^® (Certified Interventional Radiology Cardiovascular Coder) credential was created for individuals who are working in the complex and specialized areas of interventional radiology and cardiovascular coding and charging. The exam covers diagnostic angiography, non-vascular interventions, percutaneous vascular interventions, diagnostic cardiac catheterization and basic coronary arterial interventions as well as ICD-9-CM, basic coding (E&M, modifiers, etc.), anatomy and medical terminology. Those who pass this exam validate the additional level of education, knowledge and expertise required in this complex and specialized arena.

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Certified Professional Medical Auditor (CPMA™)

The CPMA™ credential validates expertise in medical record auditing skills, ensuring medical necessity, correct coding and compliance with regulatory issues. A CPMA™-certified coder has the knowledge and skills to maintain the efficiency of a practice by minimizing the risk of costly errors— a valuable asset to any physician’s office.

The scope of the exam includes:

• Compliance and regulatory guideline knowledge
• Coding concepts
• Scope and statistical sampling methodologies
• Abstraction ability
• Quality assurance and risk analysis
• Communication of results and findings
• The medical record

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Specialty Credentials

The AAPC has developed specialty credentials to enable working coders to demonstrate superior levels of expertise in selected specialty disciplines. Whether a coder wishes to show expertise in a specialty they currently work in or wishes to move to another specialty, these credentials are designed to prove superior knowledge and skills. Exams aptly measure preparedness for “real world” coding by being operative/patient-note based. Those who pass this exam demonstrate their coding expertise in a specialty with unique coding, reimbursement and compliance challenges.

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