Thank You Leslie for your vote of confidence. If you have been working outpatient for awhile then the exam should not be a problem. You need to know the UB04 fields and the information they require. Especially the condition codes and how that affects the payment. There was an entire section on my exam that had very detailed questions about the chargemaster and its role also how coding fits into the whole picture in a facility setting, in otherwords what do the other departments do and how does that affect the UB04. The critical access part I do not recall being an issue. Just remember that the coding is the same, the critical access has to do with the reimbursement. You may need to know how many beds it takes to qualify for critical access, I do recall some questions along that line, so knowing the difference between critical access, rural access, FQHC, and acute care, in terms of how do they qualify for that title. For me the exam was just another day at the office so to speak, all of the questions were compeletly relevant to my job. Since you work in critical access however you may want to study up on APCs (OPPS), That was a big deal on my exam. You need to know all about the outpatient code editor (OCE) and what it does. That is what I remember as the highlights. The medical terminology section is not as easy as you may think, some of the terms they came up with were pretty obscure. However I used my ICD-9 book on a couple and found the term in the alpha and then from the tabular I was able to figure out the body part and ultimately the definition.
From what you have said, if it were me I would go for the CPC-H cert for now, with that then you may be able to pick up some remote coding as it makes you more marketable to have hospital and physician certs. Then I would maybe consider waiting for ICD-10 CM for the auditing portion. This will give you time to start now preparing for ICD-10 CM and be the first one out of the gate with that credential for auditing which will be even more valuable. I do not see the critical access hospital wanting to pay more because you have CPMA, they should however be encouraging the CPC-H and be willing to give a pay increase. I think you should be well rounded as a coder, but with a new code set just around the corner it might be wise to wait for some certifications. I hope this helps in some way, good luck on the exam and let me know if you need anything else.