The HFMA Certified Inpatient Coding Auditor (CICA) certification validates and acknowledges the expertise of the inpatient coding auditor professional. Certified inpatient coding auditors can help your organization ensure coding accuracy, increase reimbursements, and improve overall revenue cycle performance. The CICA certification is the only certification currently available to inpatient coding auditors and it tests across all coding auditor responsibilities, including:

  • Documentation and coding accuracy and specificity
  • DRG assignment, case mix index, quality initiatives, MAC's, RAC's
  • The impact of accurate documentation and coding on overall revenue cycle
  • Compliance

Organizational Perspective

Why should we employ certified coding auditors?
  • Gain confidence in the expertise of your coding auditors
  • Keep money on the front end with improved revenue capture and reduction of claim denials
  • Lose less money on the back end with better performance on external audits
  • Improve regulatory compliance
  • Reduce in improper payments

Coding Professional Perspective

Why should I obtain a CICA certification?
  • Justify your career advancement
  • Gain confidence and validate your expertise through key industry standards
  • Make the case for increased in professional responsibility and earning potential
  • Gain advantage in a competitive hiring situation
  • Demonstrate your expertise by showcasing the CICA credential next to your name in your signature

Course Information

Pricing: $300 Member/Non-Member

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The assessment: The certification assessment will be hosted via the HFMA online learning portal and will be accessible for one year following purchase. It is comprised of 150 multiple-choice questions and must be completed within 3 hours. If necessary, participants may retake the assessment following a 30-day wait period. A certificate suitable for framing may be downloaded upon successful completion of the assessment. Recertification is required every two years (a minimal fee is charged).

Prerequisites: None

Advance preparation: Coursework to prepare for the CICA assessment is available through Career Step LLC

Recommended experience: The certification assessment is intended for coding professionals with at least 3 years of acute care inpatient coding experience. Participants should have a working knowledge of DRG assignment, case mix index, quality initiatives, MAC’s, RAC’s, and the importance of accurate clinical documentation.

CPEs: Not available

More details can be found in the CICA FAQs.


The Role & Value of Inpatient Coding Auditors in Today's Healthcare Climate

According to the American Hospital Associations (AHA) RACTrac Initiative survey from Q3 2016, incorrect MS-DRG or other coding errors account for a majority of complex Recovery Audit Contractor (RAC) denials. These errors have the greatest overall dollar impact than any other type of denial. Organizations are increasingly employing inpatient coding auditors to ensure coding accuracy and increase reimbursements. Drivers that highlight the need for coding auditors include:  

  • Changes in reimbursement models
  • Increases in regulatory audits
  • Continuous DRG downgrading
  • Increased regulatory reporting requirements

Watch the webinar recording below to learn more about the new certification, the role of an inpatient auditor, and how to built your patient audit team.