The Certified Professional Coder (CPC) credential, offered by the American Academy of Professional Coders (AAPC), stands as a highly respected benchmark in the medical coding industry. For those seeking to excel in medical billing and coding careers, particularly after completing programs like the Career Step medical billing and coding practicum, understanding the CPC exam is a crucial career step. This guide provides comprehensive answers and insights to help you navigate your path to CPC certification and confidently tackle inpatient coding scenarios you might encounter in your practicum and beyond.
Understanding the AAPC and CPC Certification
The American Academy of Professional Coders (AAPC) is the leading organization for medical coding professionals. It establishes industry standards and offers certifications in various areas, including medical billing, auditing, compliance, and, most notably, medical coding.
AAPC certification, specifically the CPC, demonstrates to potential employers that you possess a strong foundation in medical coding principles and practices. Earning your CPC is a testament to your competence and dedication to the field, setting you apart in a competitive job market.
There are several core AAPC certifications, each tailored to specific coding environments:
- CPC (Certified Professional Coder): This foundational certification is designed for coders working in physician offices and covers a broad spectrum of coding knowledge, including CPT, HCPCS Level II, ICD-10-CM coding, medical terminology, and anatomy. It’s the most widely recognized and a solid starting point for a medical coding career.
- CPC-H (Certified Professional Coder – Hospital Outpatient): This certification specializes in hospital outpatient coding, focusing on the unique coding guidelines and procedures in hospital-based outpatient departments.
- CPC-P (Certified Professional Coder – Payer): This certification targets coders working for insurance companies, Medicare, or Medicaid, emphasizing payer-specific coding and billing regulations.
- CIRCC (Certified Interventional Radiology Cardiovascular Coder): This advanced certification is for experienced coders specializing in interventional radiology and cardiovascular coding.
Beyond these primary certifications, AAPC also offers specialty credentials in areas like auditing, compliance, and practice management, allowing for further career specialization. Additionally, coders can pursue specialty-specific certifications focusing on particular medical fields like surgery, cardiology, or family practice to deepen their expertise.
AAPC vs. AHIMA: Key Differences
While both the AAPC and the American Health Information Management Association (AHIMA) offer respected certifications in health information management, they cater to slightly different career paths within the field.
AHIMA certifications, such as the Certified Coding Specialist (CCS) and Certified Coding Specialist-Physician-based (CCS-P), are generally considered more focused on hospital-based coding, encompassing both inpatient and outpatient settings. They emphasize a broader range of health information management skills.
AAPC certifications, particularly the CPC, are primarily centered on physician-based coding and are often favored in physician offices and outpatient clinics. The CPC is highly specialized in the intricacies of CPT, HCPCS, and ICD-10-CM coding systems.
The preferred certification can vary depending on the employer. Some physician practices or clinics may specifically seek CPC-certified coders, while hospitals might favor CCS or CPC-H. When job searching, always check employer preferences regarding certifications.
Decoding the CPC Exam
The CPC exam is widely recognized as the gold standard for medical billing and coding certification. Passing this rigorous exam validates your expertise in accurately coding medical services and procedures for proper reimbursement. The exam assesses proficiency across 17 key knowledge domains, encompassing CPT, HCPCS Level II, and ICD-10-CM coding systems.
Medical coding books are essential resources for CPC exam preparation, covering CPT, HCPCS, and ICD-10-CM coding guidelines.
Further Reading: CPC or CCA: Which Medical Billing Certification is Right for You?
Is the CPC Exam Difficult?
The CPC exam is undeniably challenging, requiring thorough preparation and a strong grasp of medical coding principles. However, with dedicated study and the right resources, passing is achievable. A minimum score of 70% is required to pass. Effective study strategies, practice exams, and consistent review of coding materials are crucial for success.
If you don’t pass on your first attempt, don’t be discouraged. The exam fee includes a free retake, providing a second opportunity to demonstrate your knowledge.
Online CPC Exam Option
Yes, the CPC exam can be taken online, offering flexibility and convenience. Online exams are proctored remotely to maintain exam integrity. To take the exam online, you’ll need a quiet, private space, a reliable high-speed internet connection, a computer, and an external webcam that can clearly show your face, hands, keyboard, and surrounding workspace.
Open Book Exam Policies
The CPC exam permits the use of specific coding books as references. Currently, the approved books are:
- CPT® (Current Procedural Terminology)
- ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification)
- HCPCS Level II (Healthcare Common Procedure Coding System)
You are allowed one copy of each book. Make sure to use current or previous year editions. While you can highlight, tab, and add handwritten notes, you cannot have any loose papers or materials attached to the books.
Allowed Materials During the Exam
On exam day, you are limited to bringing only your three approved code books (CPT, ICD-10-CM, and HCPCS Level II). These must be from the current or previous year. Remember, no additional notes, loose papers, or reference materials are permitted beyond what is directly written in your code books.
CPC Exam Without Formal Schooling
While technically you can sit for the CPC exam without formal medical coding school, it is strongly discouraged. The exam covers complex medical coding procedures and intricate coding systems. Without structured education in medical coding, including hands-on practicum experience like that offered by Career Step, passing the exam becomes significantly more challenging. A comprehensive training program provides the necessary foundational knowledge and practical skills to succeed on the CPC exam and in a medical coding career.
Further Reading: How a Skills-focused CPC Program Can Help You Prepare for the CPC Exam and a Job as a Medical Coder
Highest Paying Medical Coding Certifications
The Certified Professional Compliance Officer (CPCO®) certification often tops salary surveys as the highest-paying medical coding certification, with an average salary around $81,495 [Source: AAPC Salary Survey]. However, salary is influenced by factors such as experience, employer type, location, and specialization. While CPCO may offer higher earning potential, the CPC remains a highly valuable and versatile certification for a wide range of medical coding roles.
CPC Certification Validity and Renewal
CPC certification is valid for two years. To maintain your active certification, you must earn 36 Continuing Education Units (CEUs) every two years. CEUs ensure that CPC-certified professionals stay updated with the latest coding changes, guidelines, and industry best practices.
CPC Exam Study Duration
The ideal study time for the CPC exam varies depending on your background knowledge and learning style. However, adequate preparation is essential. Avoid cramming. Dedicate sufficient time for thorough study, practice exams, and in-depth review of coding guidelines and resources. A structured study plan spread over several weeks or months is generally recommended.
Passing Score on the CPC Exam
To pass the CPC exam, you need to achieve a minimum score of 70%. This means you must answer at least 105 out of the 150 multiple-choice questions correctly.
CPC Exam Costs
To take the CPC exam, AAPC membership is required. The exam fee is $499, and AAPC membership is $210. Student membership is available at a reduced rate of $145 for eligible students. Consider these costs when budgeting for your CPC certification journey.
CPC Exam Registration
To register for the CPC exam, visit the AAPC website. Navigate to the “Certifications” page and click on “Schedule Your Exam.” Follow the step-by-step instructions to schedule your exam, including purchasing the exam or redeeming a voucher and selecting a testing location (if taking the exam in person).
Exam Locations
You can take the CPC exam online from home or in person at a designated testing center. The AAPC website provides a tool to locate nearby testing centers if you prefer to take the exam in person.
Number of Questions on the CPC Exam
The CPC exam consists of 150 multiple-choice questions.
Multiple-Choice Format
Yes, all 150 questions on the CPC exam are in a multiple-choice format. While some may find this format advantageous, be aware that answer choices can be very similar, requiring careful reading and a thorough understanding of coding nuances.
CPC Exam Time Limit
Test-takers are allotted 4 hours to complete the CPC exam, whether taken in person or online with a remote proctor. Effective time management during the exam is crucial.
Number of Missed Questions Allowed
To achieve the passing score of 70%, you can miss a maximum of 45 questions out of the 150 on the CPC exam.
Retaking the CPC Exam
You can retake the CPC exam as many times as needed to pass. Each exam fee payment includes two attempts. If you fail both attempts, you will need to pay the exam fee again for subsequent attempts. Investing in thorough preparation is financially wise, minimizing the need for multiple retakes.
Types of Questions on the CPC Exam
Approximately 70% of the CPC exam questions are coding scenarios, requiring you to apply your coding knowledge to real-world situations. The remaining 30% cover essential topics such as medical terminology, anatomy, coding guidelines, and regulatory compliance.
The exam content is categorized into 17 subject areas, with up to ten questions in each:
- Surgical procedures (Integumentary, Musculoskeletal, Digestive, Respiratory, Cardiovascular, Hemic and Lymphatic, Mediastinum and Diaphragm, Urinary, Reproductive, Maternity and Delivery, Endocrine, Nervous Systems)
- Evaluation and Management (Inpatient, Outpatient, Nursing Facility, etc.)
- Anesthesia
- Radiology
- Pathology and Laboratory
- Medicine
- Medical Terminology
- Anatomy
- ICD-10-CM, CPT, and HCPCS Coding Guidelines, Compliance, and Reporting
Apprentice Status (CPC-A)
If you pass the CPC exam but lack two years of medical coding work experience, you will initially receive the CPC-A credential. The “A” designates “apprentice” status. Once you accumulate and provide proof of two years of coding experience, the apprentice designation will be removed, and you will hold the full CPC credential.
Recertification and Relocation
The CPC certification is nationally recognized across all 50 states. Once certified, you do not need to retake the exam itself as long as you maintain your certification by earning 36 CEUs every two years. Relocation within the US does not necessitate recertification.
Effective CPC Exam Preparation Strategies
Effective study habits are key to CPC exam success. Consider these strategies:
- Review Career Step Practicum Materials: Revisit reports and information from your Career Step medical billing and coding practicum. Pay particular attention to areas where you may have needed improvement on your Career Step final exam. Utilize available retakes for extra practice.
- Utilize Career Step Resources: Leverage Career Step forums and the support team for valuable tips and insights on CPC exam preparation.
- AAPC Practice Exams and Study Guides: AAPC offers practice exams and prep books specifically designed for the CPC exam. Many students find these resources beneficial for targeted preparation.
Medical coding training programs, like Career Step, provide essential knowledge and skills, including inpatient coding practicum experience, to prepare for the CPC exam.
Launch Your Medical Coding Career with Career Step
If you’re passionate about a medical coding career, Career Step’s online Medical Coding and Billing Professional Program provides comprehensive healthcare and coding skills. This program equips you with the foundational knowledge necessary not only to excel on the CPC exam but also to thrive in your new career. To explore the program further, call 1-800-411-7073 and take your first step towards a rewarding future in medical coding.
