AAPC vs AHIMA: Which Certification is Best?
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If you’re considering a career in health information management or medical coding, you have probably heard of the AAPC and the AHIMA. Both organizations offer multiple certification opportunities for healthcare professionals, specifically medical billing and coding.
Here, we’ll look at these two organizations and some entry-level certifications they offer to help you decide which organization and certification may be proper for you.
What Are AAPC and AHIMA?
AAPC
The AAPC was founded in 1988 as the American Academy of Professional Coders. At that time, its goal was to provide education and certification to medical coders working in outpatient areas, like group practices and other non-hospital settings. Over the years, their services expanded beyond these areas, so the organization dropped its official name and started going by its initials, AAPC.
Today, the AAPC is the country's most extensive education and credentialing organization for medical billers, coders, auditors, documentation specialists, practice managers, revenue cycle managers, and compliance officers. Its members are held to a code of ethics to ensure integrity and professionalism within the industry.
For an annual fee of $ 210, membership to the AAPC provides a range of benefits. These include access to four free annual webinars, discounts on all AAPC products, and the opportunity to network with over 250,000 professionals in the field.
AHIMA
The American Health Information Management Association, or AHIMA, was established in 1928 as the Association of Record Librarians of North America. Its founding mission was to elevate the clinical record standards in hospitals and other healthcare institutions. Over the years, the organization's focus has shifted to reflect the growing influence of clinical data on the continuum of care, leading to a name change in 1991 to AHIMA.
The AHIMA offers multiple membership levels, ranging from a student membership at $49 a year to a professional premier membership at $209 a year. The highest tier offers complimentary CEUs, free recertification on certification renewals, and VIP conference perks.
The most significant difference between the AAPC and AHIMA is that AAPC certifications are generally associated with outpatient coders, while AHIMA certifications focus more on inpatient coders. The certification employers prefer will depend on what type of career you’re interested in. If you’re interested in working in a hospital setting, employers are more likely to prefer an AHIMA certification; for outpatient settings, like doctor’s offices or health clinics, employers are more likely to prefer a certification from the AAPC.
Entry-Level AAPC Certifications: CPC and CPB
The AAPA offers two entry-level certifications: certified professional coder (CPC) and certified professional biller (CPB).
CPC
The CPC certification, often regarded as the gold standard for outpatient coders, is a testament to a coder's ability to specialize in coding for services performed by doctors, nurse practitioners, and physicians in an office setting. Those with this certification have demonstrated proficiency in documentation review, compliance and regulatory requirements for physician services, abstract professional provider encounters, and coding proficiency with CPT, HCPCS Level II, and ICD-10-CM.
The exam consists of 100 multiple-choice questions that must be completed in a single four-hour sitting. Coding professionals can take it online with a live remote proctor or on a computer in a testing center. One exam attempt costs $399, and two are available for $499.
To train for the certified professional coder exam, professional coders must have significant experience in anatomy, pathophysiology, and medical terminology. Coders without an extensive knowledge of these subjects can take prerequisites to prepare.
Once a professional passes the exam and receives the CPC credential, they must maintain it by maintaining an AAPC membership yearly and earning 36 continuing education credits (CEUs) every two years.
CPB
The CPB credential is a comprehensive certification that demonstrates skills related to patient and payer billings, collections, and other aspects of the revenue cycle, ensuring that provider reimbursement isn’t compromised. This certification shows that medical billers understand how to submit claims that comply with private-payer policies and government regulations. They submit appeals, resolve claim denials, manage collections, and post payments and adjustments.
The exam consists of 135 multiple-choice questions in a single four-hour sitting. Like the CPC exam, this exam can also be taken online at home with a live remote proctor or in person at a computer testing center.
To be qualified to take the exam, professionals must demonstrate a high level of knowledge about anatomy, pathophysiology, and medical terminology and understand the proper application of payer policies, healthcare regulations, compliance rules, ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS Level II procedure and supply codes. Prerequisite courses are also available to help test-takers prepare.
To maintain this certification, medical billing professionals must maintain an AAPC annual membership and earn 36 CEUs every two years. This certification exam costs $399 for one attempt or $499 for two attempts. About 80% of test takers pass on their first try.
Other certifications
The AAPA offers other entry-level certifications, too, including a dual CPC and CPB credential that demonstrates competency in both roles. This certification is two separate exams; one covers 100 CPC-related questions, and the other 135 CPB-related questions, all multiple-choice, taken online with a live remote proctor or in a computer testing center. Each test is four hours long. This certification requires an annual AAPC membership and 40 CEUs every two years. The cost for a single attempt at both tests is $798; for two attempts at each test, it’s $998.
The AAPC offers a wide range of 24 certifications, catering to various levels of expertise and career paths. These certifications range from entry-level exams to advanced certifications like Certified Interventional Radiology Cardiovascular Coder (CIRCC) and Certified Hematology and Oncology Coder (CHONC), providing a flexible and comprehensive certification program.
Entry-Level AHIMA Certification: CCS
The Certified Coding Specialist (CCS) certification is the AHIMA’s entry-level certification. It demonstrates proficiency in coding proficiency and data quality and accuracy. To be prepared to take the exam for a CCS credential, professional medical coders must be familiar with reviewing patient records and assigning codes for diagnoses and procedures and have expertise in the ICD-10-PCS, ICD-10-CM, and CPT coding systems. They must also know disease processes, medical terminology, and pharmacological concepts.
The AHIMA recommends that professionals have the following to be prepared for the CCS exam:
- Completion of courses in anatomy and physiology, pharmacology, pathophysiology, pharmacology, reimbursement methodology, medical terminology, and procedural coding and medical services (CPT/HCPCS) and one year of coding experience
OR
- Two years of coding experience
OR
- A certified coding associate (CCA) credential plus one year of coding experience
OR
- A coding credential from another certifying organization a one year of coding experience
OR
AHIMA also offers an online course to help prepare for the certified coding specialist exam. This flexible course comprises six lessons that can be accessed at any time.
This four-hour computer-based exam includes 107 questions, 10 of which are pretest questions. It consists of two sections: a multiple-choice section and a medical scenario section with multiple-choice and multiple-response items.
Members of the AHIMA pay $299 for each exa
m attempt; for non-members, it’s $399.
Other AHIMA credentials include Certified Coding Associate (CCA), Certified in Healthcare Privacy and Security (CHPS), Certified Health Data Analyst (CHDA), and those mentioned above.
CPB vs CPC vs CCS: Which One Is Best for You?
Here are some things to consider when determining which certification is best for you.
Each of these organizations provides memberships, certifications, and CEUs for those who want to advance their careers in the billing and coding niche in the healthcare industry. There are many perks to joining either of these organizations and getting a certification.
The most significant difference between the two is the patient populations they serve: the AAPC is generally associated with outpatient settings, while the AHIMA is usually associated with inpatient facilities. Most people will settle on one organization over the other depending on their career goals, while others may get certifications from both organizations to maximize their marketability.