™ ™

CIC - COC - CCS

COMPARISON
Medical coding is a challenging career. The role of the coder greatly impacts the
compliance and reimbursement success of a facility. Most employers require a coding
certification to validate the skills of potential candidates and to access the expertise of
current employees.

It is important for employers to understand the different coding credentials including

the competencies tested and format of the exam.

AAPC created a stand-alone inpatient credential (CIC™) and a stand-alone outpatient

credential (COC™) to thoroughly validate the skill set and job competencies that are
extremely different for these two roles. Based on feedback from HIM Directors, when

CICCOCCCS COMPARISON
recruiting for facility coding positions, they specifically look for either inpatient or
outpatient coding expertise depending on the position they have available. AAPC felt
it was crucial to develop two separate tests as opposed to one test to validate the
unique competencies required for two distinct job roles.

Key differences between inpatient facility coding and outpatient facility coding:
1. Procedure coding: Inpatient coders use ICD-9-CM Volume 3 through dates of
service 9/30/15 and ICD-10-PCS effective dates of service 10/1/15 for procedure
coding. Outpatient coders use CPT® and HCPCS Level II codes for procedure and
services coding. The code sets are unique and have different coding guidelines for
proper reporting.

2. Diagnosis coding: Inpatient coders review the entire medical record for the length
of stay and select the principal diagnoses and secondary diagnoses for all the
patient’s coexisting conditions. Outpatient coders focus on a particular date of
service and select the first listed diagnosis code and secondary diagnoses to
support the services rendered.

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CIC-COC-CCS COMPARISON
3. Payment methodology: CMS inpatient reimbursement is based on IPPS which is
determined by MS-DRGs. CMS outpatient reimbursement is based on OPPS and
APCs.

AAPC believes test candidates should prepare for the exam that measures the
competencies for the job they are currently performing or aspire to perform. It is
important that examinees not be required to study and apply code sets that they
will not apply in a coding job. For example, an inpatient coder does not typically
code using CPT® codes. AAPC does not want inpatient coders learning CPT® coding
to prepare for an exam.

Comparison of Facility Coding Credentials

CIC Certified COC Certified CCS Certified

Inpatient Coder Outpatient Coder Coding Specialist

Certifying AAPC AAPC AHIMA

Association

Type of Coding Inpatient facility Outpatient Inpatient and

coding facility/ASC coding Outpatient Facility
Coding

Format of the • 60 multiple choice 150 multiple choice • 97 multiple choice

exam questions questions questions (79
• 10 fill-in-the-blank scored)
acute inpatient • 8 coding scenarios
hospital cases (up (6 scored)
to 25 answers for *candidates choose
each case) codes provided
from list

Exam length 5 hours 40 minutes 5 hours 40 minutes 4 hours

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CIC-COC-CCS COMPARISON
Comparison of Facility Coding Credentials (Continued)

CIC Certified COC Certified CCS Certified

Inpatient Coder Outpatient Coder Coding Specialist

Exam Cost • $325 US • $325 US • $299 US Member

• $500 International • $500 International • $399 US
*Includes two *Includes two Non-member
attempts attempts • $349 International
Member
• $449 International
Non-member
*Includes one
attempt

Membership Cost • $70 Student • $125 • $175 Active

• $125 Member Member
• $70 Emeritus • $60 Emeritus
*Additional $10 fee
for recertification

CEU 36 CEUs every two 36 CEUs every two 20 CEUs including

Requirements years years two mandatory
annual coding
self-reviews every
two years

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CIC-COC-CCS COMPARISON
Certification Exam Domains

Domain CIC Certified COC Certified CCS Certified

Inpatient Coder Outpatient Coder Coding Specialist

Medical Record and 5% Tested with in 13-21%

Healthcare coding questions
Documentation
Guidelines

Medical Terminology, 3% 7% Prerequisite

Anatomy and Also tested
Pathophysiology within coding
cases

Inpatient Coding 6% 0% *64-68% (includes

(multiple choice) both inpatient
and outpatient)

Inpatient Payment 13% 5% 6-8%

Methodologies and
Regulatory
Requirements

Outpatient Coding 0% 70% *64-68% (includes

(multiple choice) both inpatient
and outpatient
coding)

Outpatient Payment 3% 5% 6-8%

Methodologies and
Regulatory
Requirements

Compliance 5% 3% 2-4%

Coding Cases (fill in the 65% 0% 0%

blank)

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CIC-COC-CCS COMPARISON
Key differences :

1. Percentage of coding covered on each exam:

CIC: 71% inpatient coding

COC: 70% outpatient coding

CCS: 64-68% which includes inpatient and outpatient. Split between

percentages that is inpatient versus percentage that is outpatient is
not published.

2. Format of inpatient coding questions:

CIC includes 10 acute care facility cases that are fill-in-the-blank to

access the examinees ability to code cases without prompts. The CCS
exam includes eight coding scenarios (six are scored) which includes
both inpatient and outpatient cases. The examinee selects the
correct answer from a list of possible codes provided.

Professional Coding Credentials

CPC Certified Professional CCS-P Certified Coding

Coder Specialist-Physician-based

Certifying Association AAPC AHIMA

Type of Coding Professional (physician and Professional (physician and

non-physician practitioner) non-physician practitioner)
coding coding

Format of the exam 150 multiple choice 88 multiple choice

questions questions (70 scored)
8 multiple select (6 scored)
13 medical record cases

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CIC-COC-CCS COMPARISON
Professional Coding Credentials (Continued)

CPC Certified Professional CCS-P Certified Coding

Coder Specialist-Physician-based

Exam length 5 hours 40 minutes 4 hours

Exam Cost • $325 US • $299 US Member

• $500 International
Includes two attempts
• $399 US Non-member
• $349 International Member
• $449 International
Non-member Includes one
attempt

Membership Cost • $70 Student • $175 Active Member

• $125 Member • $60 Emeritus
• $70 Emeritus *Additional $10 fee for
recertification

CEU Requirements 36 CEUs every two years 20 CEUs including two

mandatory annual coding
self-reviews every two years

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