It is very understandable that an occupational field would concern itself with credentialing. Licensure and certification convey a sense of professionalism that is above and beyond simply doing a job well. It includes a body of highly specific knowledge that has to be absorbed, and a person’s expertise has to be demonstrated by successful completion of an examination.

Medical coding has come a long way from being just a back office administrative job. The need for specialized knowledge is great, and the arrival of ICD–10 codebooks next year will make this need for technical understanding even greater. The American Health Information Management Association (AHIMA) has been in the front ranks of professional development for decades. The AHIMA offers a range of certifications to enable a person to advance professionally; the most popular of which are the Certified Coding Associate (CCA), Certified Coding Specialist (CCS), and Certified Coding Specialist – Physician-based (CCS-P).

Certified Coding Associate (CCA)

The CCA certification enables its holders to perform coding duties in environments that range from a small office of a single physician to the coding and billing departments of major hospitals. A high school degree or equivalency is a core requirement and there is a need to have an understanding of academic disciplines such as anatomy, physiology, pathophysiology, and pharmacology. These are covered in an AHIMA approved certificate program.

Certified Coding Specialist (CCS)

The CCS certification requires an in-depth knowledge of the ICD-9-CM and CPT coding. These professionals are found in hospitals, coding the records of patients and the various procedures. Because of the relationship to the billing of insurance companies, Medicare, and Medicaid, the CCS must show a high level of accuracy. No less than three years of practical experience is needed, as well as demonstrated expertise in the terminology of a number of medical areas.

Certified Coding Specialist – Physician-based (CCS-P)

As the job title suggests, the CCS-P certification works in an environment of a practicing physician’s office. The job requires more than just competency in the various codes, as the CCS-P is also concerned with the accuracy of health information documentation. Moreover, this professional also plays a vital role in the operation of the office, as the accuracy of the coding and data heavily influences any payment received from healthcare insurance or the government. Successful attainment of this certification relies heavily on the knowledge gained in the day-to-day activity of physician services, such as surgery, radiology, and anesthesia. As with the other certifications, proficiency in anatomy, physiology, pathophysiology, and pharmacology is a must.

Summing-Up

All three certifications draw a very clear line between their holders and those who are non-certified. There is a body of knowledge – both medical and technical – that has to be mastered in order to be eligible for these designations. All three require sitting for an examination which is known to be a challenge. It should be obvious that there is a qualitative difference between the CCA and the other two certifications. While all three serve as a legitimate mark of credibility in the profession, the CCS and CSS-P are a step above. These designations belong to the best professionals in the field and are the pinnacles to be reached. Since everyone has to start somewhere, the CCA is an excellent designation to begin a career path that will lead to certification as a CCS or CSS-P.