Credentialing Advice for HIM Professionals

With so many options of credentialing out there, I’d like to offer my advice as to which are most preferred from the experience I’ve accrued in this industry. According to the Bureau of Labor Statistics (BLS Oct. 2017), the number of positions for medical records and health information technicians—including medical coders—is expected to grow 13 percent from 2016 to 2026. Credentials, partnered with experience, are a great way to stand out amongst the rest and show your commitment to this field.

Which credential is right for you?

There are several organizations that offer credentials for HIM professionals, including coders, auditors, CDI professionals, cancer registry, and HIM management. 

Preferences amongst contract companies/high-level organizations include:

Inpatient coders/auditors – AHIMA based credentials (CCS, RHIT, RHIA). Some clients prefer multiple credentials (ex: CCS, RHIA). 

Outpatient facility coders/auditors – AHIMA or AAPC based credentials (CCS, RHIT, RHIA, COC, CPC). Some clients prefer multiple credentials (ex: CCS, CPC). 

Outpatient profee coders – AAPC based credentials (CPC, COC, CPC-I). CPC is most preferred/required. Specialty credentials offered and should be explored. Multiple credentials speak to your interest and investment in this industry.

CDI specialists – ACDIS or AHIMA credentials (CCDS, CCDS-O, CDIP) required. Most hospitals will also prefer an RN degree. 

Cancer tumor registrars – NCRA credential (CTR) required.

HIM management – AHIMA credentials required, RHIT/RHIA usually partnered with the CCS. 

AHIMA – American Health Information Management Association

This organization is the leading preference amongst hospitals nationwide for coders, auditors and HIM management. 

CCS – Certified Coding Specialist

The CCS credential demonstrates a professional’s tested skills in data quality and accuracy as well as mastery of coding proficiency. This credential is achieved by having at least 1 year of experience and usually starts off as the CCA credential. This is the most preferred credential of them all, including both INP and OP coding/auditing. 

RHIT – Registered Health Information Technician

2-year academic program that prepares students for a career in health information. This credential is partnered with a 2-year college degree and is desirable. It does not validate coding experience and the CCS would. 

RHIA – Registered Health Information Administrator

4-year baccalaureate program that prepares students for a career in health information. This is the most desirable credential for management positions. Like the RHIT, it does not validate coding experience and the CCS would. 

CCS-P – Certified Coding Specialist – Physician-Based

Self-study, comprehensive physician’s office coding certification. This credential is a preference with profee coding/auditing roles, like AAPC’s organization. 

CDIP – Certified Documentation Improvement Specialist

Individuals earning the CDIP credential demonstrate expertise in clinical documentation within patient health records. This is a top credential for CDI professionals and highly desirable. 

AAPC – American Academy of Professional Coders

This organization is the leading preference amongst hospitals, physician offices and clinics nationwide for outpatient-based or profee-based coders and auditors.

CPC – Certified Professional Coder

The CPC? certification validates proficiency in the correct application of CPT?, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes used for coding and billing for medical claims in a physician's office. 

COC – Certified Outpatient Coding

The COC? (formerly CPC-H?) certification validates proficiency in the correct application of CPT?, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes used for coding and billing in an outpatient hospital or facility.

CIC – Certified Inpatient Coder

The CIC? certification validates proficiency in the correct application of ICD-10-CM diagnosis codes used for coding and billing for medical claims in an inpatient hospital or facility. This is a newer credential and hospitals haven’t quite accepted it the same way they would accept a CCS credential.  If you are interested in pursuing an inpatient credential, I would recommend the CCS. 

CRC – Certified Risk Adjustment Coder

The CRC certification validates proficiency in the correct application of ICD-10-CM diagnosis codes used in risk adjustment payment models. Highest desired credential for HCC/risk adjustment roles. 

CHONC – Certified Hematology and Oncology Coder

Specialty credential. The Coders with sufficient experience and expertise in hematology and oncology coding are encouraged to site for the Certified Hematology and Oncology Coder (CHONC?) examination, developed by a team of leading hematology and oncology coding professionals. Highest desired credential for oncology/cancer coding/auditing roles. 

CIRCC – Certified Interventional Radiology Cardiovascular Coder

Specialty credential. The CIRCC? credential has been developed by expert interventional radiology physicians, technicians, coders and billers.  Highest desired credential for interventional radiology coding/auditing roles. 

CCC – Certified Cardiology Coder

Specialty credential. The Certified Cardiology Coder exam was developed by a team of leading cardiology coding professionals. Those coders with sufficient experience and expertise in cardiology coding are encouraged to sit for the CCC? exam.

COSC – Certified Orthopedic Surgery Coder

Specialty credential. The Certified Orthopedic Surgery Coder (COSC?) exam was developed by a team of leading orthopedic coding professionals. Coders with sufficient experience and expertise in orthopedic coding are encouraged to sit for the COSC? exam.

AAPC has additional specialty credentials available and should be explored if you meet the experience requirement. These include:

CASCC – Ambulatory Surgical Center

CANPC – Anesthesia and Pain Management

CCVTC – Cardiovascular and Thoracic Surgery

CPCD – Dermatology

CEDC – Emergency Department

CEMC – Evaluation and Management

CFPC – Family Practice

CGIC – Gastroenterology

CGSC – General Surgery

COBGC – Obstetrics Gynecology

COPC – Ophthalmology

CPEDC – Pediatrics

CRHC – Rheumatology

CUC – Urology

ACDIS – Association of Clinical Documentation Integrity Specialists

This organization is the leading preference amongst hospitals for CDI professionals.

CCDS – Certified Clinical Documentation Specialist

The Certified Clinical Documentation Specialist (CCDS) credential provides a mark of distinction for this unique profession. Clinical documentation specialists understand a wide range of specialized disciplines, including education in anatomy and physiology, pathophysiology, and pharmacology; knowledge of official medical coding guidelines, CMS, and private payer regulations related to the Inpatient Prospective Payment System; an ability to analyze and interpret medical record documentation and formulate appropriate physician queries; and an ability to benchmark and analyze clinical documentation program performance.

CCDS-O – Certified Clinical Documentation Specialist – Outpatient

The Certified Clinical Documentation Specialist-Outpatient (CCDS-O) provides a trusted baseline of competency for CDI in the outpatient setting, which includes physician practices, hospital clinics, and the emergency department, among other settings. The CCDS-O credential represents a mark of excellence for CDI professionals operating in outpatient settings and provides employers with a baseline of competency for existing staff or potential hires. Newer credential as hospitals are implementing OP programs.

NCRA – National Cancer Registrars Association

This organization is the leading preference amongst hospitals for cancer registry professionals.

CTR – Certified Tumor Registrar

The Certified Tumor Registrar (CTR?) credential sets the standard for professional excellence in the cancer registry field. It is nationally recognized in the recruitment and retention of registry personnel. NCRA's certification board - the Council on Certification - oversees the CTR exam administration and credential maintenance.