What is Medical Billing and Coding? (2024)

Train for Your Career in Medical Billing and Coding

A new career in medical billing and coding is only months away when you train with AAPC, the world’s leading training and credentialing organization in the business of healthcare — with more than200,000members achieving personal and professional success. Take your first step toward a brighter future and begin reaping the rewards of this career path.

Why choose AAPC for your billing and coding training?

AAPC sets the standards for medical billing and coding — and created the CPB^®and CPC^®certifications, which, with few exceptions, are prerequisites for the profession. We specialize exclusively in healthcare business education, and our top-ranked training programs boast pass rates unmatched by any other medical billing and coding schools in the U.S.

Pass rates of 80% and higher

AAPC leads the healthcare business industry in the national accreditation of medical billers and coders, specialty coders, risk adjustment coders, clinical documentation specialists, medical auditors, healthcare compliance officers, and practice managers.

When you study with the creators of the CPB and CPC certifications, you get training with the same standard of excellence as the credential itself. What’s more, you’re ensured a comprehensive education that covers everything needed to pass the certification exam, earn your credential, and succeed in your career as a medical billing and coding professional.

Why study at an institution that bases its curriculum on AAPC’s when you can train directly with us?

We not only created the Certified Professional Biller (CPB) and Certified Professional Coder (CPC) accreditations, but we’ve been teaching medical billing and coding for more than 30 years. You can see proof of our success in the numbers. Pass rates for AAPC students exceed 80% compared to those who study with third-party programs with an average of 22%.

Flexible study with in-person and online course options

We designed our medical billing and coding programs to fit your lifestyle, whether you’re currently employed or have limited time due to other responsibilities.

You’ll enjoy the greatest flexibility with our online courses, which allow you to train anywhere, at your pace and on your schedule. If you prefer structure but would like the convenience of training from home, you can select an instructor-led online course for medical coding and billing.

Our instructor-led online courses give you the opportunity to participate in the class with your fellow students and include 1.5 hours per week of one-on-one time with your instructor.

But if you learn best in a physical classroom setting, you’ll find medical billing and coding classes located across the country. When yousearch for an AAPC coding or billing course near you, you’ll find all the details, including the name and contact information of the AAPC-certified instructor.

Employment support

We don't just train and certify at AAPC. We provide you with numerous resources to help you gain employment — including a regularly updated nationwide job database, a vast membership network, local AAPC chapters, regional and national conferences, as well as Project Xtern, which could set you up with great experience opportunities and a potential employer.

Career advancement

AAPC stands with you throughout the duration of your career with ongoing support as you work to achieve important milestones. Our career counselors will help you maintain cutting-edge expertise, show you how much you’re worth to negotiate your salary, give you guidance on how to elevate your earning potential, and give you tips and tricks to help you advance in the business of medicine.

Now available: Instructor-led training for the CPC+CPB Preparation Course

What is medical billing and coding?

Medical billing and coding is the process of identifying diagnoses, medical tests, treatments, and procedures found in clinical documentation and then transcribing this patient data into standardized codes to bill government and commercial payers for physician reimbursem*nt.

What do medical billers and coders do?

Medical billers and coders are the healthcare professionals in charge of processing patient data, such as treatment records and related insurance information. Both medical billing and medical coding professions are involved in the medical reimbursem*nt cycle, working together to ensure that healthcare providers are accurately and efficiently paid for the services they perform.

Increasing demands on providers and allied health clinicians with decreasing reimbursem*nt requires medical offices to invest in highly skilled medical billers. An intimate understanding of medical insurance, the claims process, the appeals process, and the impact on revenue gives the medical biller the necessary knowledge to optimize revenue performance. The financial health of a practice depends on the effectiveness and overall performance of the billing office.

Medical coding and billing job descriptions

The primary job of a medical coder is to review clinical documentation to extract and translate billable information into medical codes usingCPT®,ICD-10-CM, andHCPCS Level IIclassification systems. Medical classification, or medical coding, is the process of translating medical reports into codes used within the healthcare industry. The use of medical codes helps summarize medical services and reports. These medical code sets help medical coders document the patient conditions and describe the healthcare procedure(s) performed to treat their conditions.

Medical billingis the process of submitting and following up on claims with health insurance companies to receive payment for services rendered by a healthcare provider. The medical biller needs to understand how to read medical records and, like the medical coder, be familiar with CPT^®, HCPCS Level II, and ICD-10-CM codes. Medical billing translates a healthcare service into a medical billing claim. The responsibility of the medical biller is to follow the claim to ensure the practice receives properreimbursem*nt.

While medical billers’ duties vary based on where they work, they typically fulfill front-end and back-end jobs that include gathering patient information, entering charges, verifying health plan coverage, securing prior authorizations, collecting copays, and “scrubbing” claims to ensure that procedure, diagnosis, and modifier codes are accurate before transmitting claims to payers and posting payments.

Online medical billing and coding training programs

Certified Professional Biller (CPB)

TheCertified Professional Biller(CPB) certification prepares medical billers with the technical knowledge and skills to maintain all aspects of the revenue cycle. Without deep knowledge and expertise inmedical billingand the unique understanding of insurance requirements, provider reimbursem*nt may be denied, delayed, or incomplete.

CPBs have proven knowledge of claim submissions in accordance with government regulations and private payer policies, follow-up on claim statuses, resolution of claim denials, appeals submissions, posting of payments and adjustments, and collections management.

Certified Professional Coder (CPC)

TheCertified Professional Codercertification (CPC) is the established standard formedical codingin physician office settings. Over200,000certified professionals help maintain compliance and profitability within healthcare practices through accurate medical coding and documentation. CPCs have demonstrated mastery of all medical code sets, evaluation and management principles, surgical coding, and adherence to documentation and coding guidelines through rigorous examination and experience.

Online Medical Coding (CPC) and Billing (CPB) Preparation Course

Your career rewards are much greater with a dual medical coding and billing certification. Become a CPC and CPB in less than 12 months with our medical coding and billing program — and start your career as a professional in the business of healthcare with an average entry-level salary of $55K.

This online medical billing and coding program will equip you to effectively perform the duties of a medical coder and biller for physician offices, outpatient facilities, and laboratories.

Designed to be completed in 8 months, you’ll have 12 months to complete your training (from date of purchase) at your pace, from your home. You’ll learn everything you need to prepare for the CPC and CPB certification exams.

WHAT’S INCLUDED:

Supplemental training courses

New to the healthcare industry? These courses teach medical fundamentals and are highly recommended for those preparing for training in medical coding and billing.

• Online Medical Terminology Course

• Online Anatomy Course

• Online Pathophysiology Course

• Online Evaluation and Management Course

• Online personal and career development courses

Discover the professional satisfaction of medical billing and coding

Medical billing and coding program FAQs

Find answers to your questions about a medical billing and coding program at AAPC. Our FAQs section will help you make informed decisions about your education, whether you’re interested in becoming a CBP, a CPC, or both.

What skills will I learn in medical billing and coding training?

You’ll learn the skills needed to correctly use the three medical code sets — ICD-10-CM, CPT^®,and HCPCS Level II — and understand regulatory compliance and insurance requirements, as well as proper claim form preparation, submission, payment processes, and more.

How much do billers and coders make?

In 2022, certified medical coding and billing professionals earned anaverage annual salaryof $58,055 and $56,652, respectively. While CPCs earned slightly more than CPBs, it's worth noting that billing specialists entering the field can expect to move into senior positions within 10 years.

The median salary for dual certification of CPB and CPC increases to $64,712 per year. With AAPC’s best-in-class CPC& CPB course, you can begin a new career and — at the same time — set an upward trajectory for professional satisfaction throughout your career.

Why is medical coding and billing certification necessary?

Medical billing and coding standards become increasingly complex and require extensive knowledge and skills. AAPC certification attests to the highest levels of proficiency and is recognized byemployersas the highest stamp of approval. An AAPC certification also elevates your earning potential by greater than $30,000 above annual salaries for persons without AAPCcertification.

Where can I work as a medical billing and coding specialist?

Medical billing and coding professionals work in a variety of settings: physician offices, clinics, labs, medical billing services, insurance companies, and more.

Can a medical coder and biller work from home?

Many employers hire remote CPBs and CPCs to manage their medical billing and coding online — making working from home an attractive option. In fact, more than one-third of AAPC-certified medical coders and billers work remotely.

How do I become a medical coder and biller?

To earn your CPC or CPB certification, you will need to hold an active membership with AAPC and sit for your proctored certification exam. The medical coding and billing exams are different certification exams and must be taken separately.

Do I need a university diploma to enter the AAPC program?

No specific skills or experience are prerequisite for entry into the AAPC program. A 4-year college degree or an associate degree may influence hiring decisions, but in this industry you don’t need either.

What is the difference between the medical billing (CPB) and medical coding (CPC) courses?

TheCPCPreparation Courseteaches physician office coding, such as how to assign the proper diagnosis and procedure codes from operative reports and patient charts. This course also helps prepare you for the CPC certification exam.

TheCPB Preparation Courseconcentrates on requisite billing skills, only touching on coding, and will prepare you for the CPB certification exam. This course teaches medical billing and reimbursem*nt issues, such as: how to take the codes that have already been assigned by the coder and process a claim form, and how to work with third-party payers to make sure the claim is processed correctly. It’s important that coders understand billing issues, as this knowledge helps decrease claim denials and increase reimbursem*nt. An understanding of billing will also expand a coder’s career opportunities.

How much does it cost to become a certified medical biller and coder?

Online medical coding and billing training packages start at $3,000.

How long does it take to earn medical billing and coding certification?

The training process for combined CPC (Medical Coding) and CPB (Medical Billing) certification takes 12 months or less, depending on your experience and background. To learn more about what training you need, please call our career counselors today at 877-290-0440.

Where can I find medical billing and coding schools near me?

For students who prefer to train in a classroom setting, AAPC medical billing and coding classes are located throughout the U.S. To find a class in your area, you can use ourclassroom directoryor call a career counselor at 877-290-0440.

As an online student, how can I interact with other medical billing and coding students?

Communityis one of AAPC’s greatest benefits. With more than 500 local chapters, three annual conferences, local conferences, roughly50 online forums, and an activeFacebook group, you’ll find ample opportunities to interact with fellow students, as well as those who have successfully graduated from training, passed their certification exams, and have workplace experience. AAPC members are eager to help, quick to provide information and answer questions, and always ready to give advice and encouragement.

What kind of employment resources does AAPC provide to students completing the medical billing and coding program?

One of the best ways to find a new job is networking. Develop relationships with like-minded healthcare professionals. Share your ambitions and plant seeds, should related positions appear with their employer. AAPC membership offers face-to-face networking opportunities atlocal chapter meetings,workshopsandconferencesand online in ourmember forums.

In addition, you can use theAAPC jobs databaseto search thousands of healthcare positions using your desired criteria.. You can search positions based on job title, required skills, medical specialty, keywords, and location.

How do I prepare for my certification exam?

The biggest tip to passing a certification exam is: take the preparationcourses! And that includes themedical terminology,anatomy, andpathophysiologycourses, because this knowledge is essential to your career. Each course is an investment that will profit you many times over.

What are the advantages of training with AAPC?

Schools for medical billing and coding come in all shapes and sizes, but not all are created equal. For more than 30 years, AAPC-trained CPBs and CPCs have established a reputation of excellence. The titles of Certified Professional Biller and Certified Professional Coder comes with high expectation, trust, and respect. AAPC's billing and coding programs will prepare you to earn your credential — and help you to maintain your expertise with resources available exclusively to our members.