For the purposes of this article, we're going to assume you've already moved past career research and you're trying to pick your training and certification path.
Luckily for you, that's our specialty!
Beginner Coding Specialist Certification Options: What Are They?
There are three medical coder certifications that you can earn early in your career:
- Certified Professional Coder (CPC), through the American Academy of Professional Coders (AAPC)
- Certified Billing and Coding Specialist (CBCS), through by the National Healthcareer Association (NHA)
- Certified Coding Associate (CCA), through the American Health Information Management Association (AHIMA)
They all certify your ability to apply the same three medical coding systems to standardize health record information, including diagnoses, services, treatments, and more.
Each medical coding certification is a little bit different, however. It's mostly related to the role each certification best prepares you for outpatient, inpatient, or insurance.
We've explained the difference between inpatient and outpatient coding before, but essentially, coding for an outpatient environment (like a doctor's office or urgent care facility) is much more straightforward than an inpatient facility (like a hospital or a nursing home).
As a result, most medical coders start their careers as outpatient medical coders. This lets you learn the "language" of coding before you try to tackle trickier applications.
The CCA designation has its roots in inpatient coding, so we're going to focus on the other two medical coder certifications: CPC and CBCS.
CBCS vs CPC: Which Do You Choose?
The CPC credential is a versatile coding specialist certification that is especially helpful for new outpatient coders. The exam focuses on medical coding alone, with little to no information on billing.
This works for beginners who want to specialize in coding without doing billing work, as well as experienced billing professionals who want to hone their coding skills.
CBCS certification examines your knowledge in billing and coding. In addition to medical coding guidelines, the CBCS lets you prove your competence to potential employers in other areas: insurance eligibility, payer requirements, billing and reimbursement, revenue cycles, and regulatory compliance. The last two topics are relatively new. According to the NHA, understanding revenue cycles and regulations can empower certified billing and coding specialists to remain flexible in the face of evolving healthcare reform.
As a result of this well-rounded approach and its focus on insurance requirements, the CBCS medical billing and coding certification is attractive to employers in the insurance industry. The knowledge set is also useful for those who want to focus on medical billing.
If you want a widely accepted coder certification and don't need the billing component, you should choose a CPC training program to qualify you for that exam.
If you want to be a medical biller or do billing and coding within the insurance industry, choose CBCS certification instead.
The CBCS Exam: What to Expect
So, you want to focus on medical billing or work for an insurance company – what do you need to know about the certification exam?
Who is eligible for the CBCS Medical Billing and Coding Exam?
There are two ways to qualify for the CBCS exam: training or work experience.
The training path requires completing a medical billing or coding program within the last 5 years. The experience path requires completing at least one year of supervised work experience in the medical billing and coding field within the last 3 years.
In either case, you also need to have either a high school diploma or a High School Equivalency (HSE) test like the GED.
What's the easiest way to qualify for the CBCS exam?
If you're starting from scratch, the training path is definitely the way to go. Certification will make it easier to get a job, and certified candidates also get paid more. Plus, it'll take you half the time to become qualified for the exam.
An online CBCS medical billing and coding course like ours prepares you for CBCS certification from the comfort and convenience of your own home. You can study on your own schedule and at your own pace.
This makes it easy to make CBCS training fit your needs. If you're juggling other responsibilities, you can squeeze studying in when it's convenient. If you're in a hurry and able to study full-time, you can get through the curriculum in as little as three months.
How do you sign up for the Certified Billing and Coding Specialist exam?
First, you'll create a free NHA account online and submit an exam application through the portal. With an online training program like ours, proving your eligibility is as simple as uploading your certificate of completion.
Next, you'll select a date and location for your exam. The CBCS exam fee of $117 is due at this point unless you've finished a training program that offers a free exam voucher, as we do.
How long is the CBCS exam?
The Certified Billing and Coding Specialist exam has 125 multiple-choice questions, including 100 scored items and 25 pretest items.
Pretest items don't count for or against you – they're just a way for the NHA to try out future test questions. However, they'll be mixed in with the scored items, so you won't know which is which. This can give you some peace of mind – if a handful of questions seem ambiguous or tricky, they might be pretest questions that don't count.
You have three hours to complete the test.
What is the passing score for the CBCS exam?
Questions are weighted for difficulty, so your score is more complicated than the percentage of questions answered correctly.
Out of 500 possible points, you need a "scaled score" of at least 390 to pass the exam.
What Does the CBCS Exam Cover?
The 100 scored test questions are divided up between four topics (or "domains"), including:
- 15 questions about The Revenue Cycle and Regulatory Compliance
- 20 questions about Insurance Eligibility and Other Payer Requirements
- 32 questions on Coding and Coding Guidelines
- 33 questions on Billing and Reimbursement
Within each domain, some questions will focus on your knowledge, and some will focus on application. In other words, you'll be tested on certain information in a straightforward way, but you'll also be tested on your ability to use what you know to perform tasks as a Certified Billing and Coding Specialist.
For an example in the cloud software domain, you might get one question about the rules for applying a code set, then another where you're given a health record and asked to code it.
The NHA has a helpful test plan where they list exactly which task and knowledge statements will appear from each domain.
What Are You Waiting For?
And if you're a military spouse, you may be eligible to have the DOD pay for the whole thing.