The Certified Professional Coder (CPC) credential, offered by the American Academy of Professional Coders (AAPC), stands as a respected benchmark in the medical coding industry. For individuals aiming to excel in medical billing and coding roles, understanding the CPC certification is a crucial career step. This guide breaks down what you need to know about achieving this certification and navigating your career path in medical coding.
What is CPC Certification and Why is it Important?
The AAPC, or American Academy of Professional Coders, plays a vital role in setting professional standards and fostering career development within medical coding. Through AAPC certifications, professionals gain documented proof of their expertise in various areas, including Medical Billing, Medical Auditing, and Medical Compliance.
Earning an AAPC certification, particularly the CPC, signifies to potential employers that you possess a strong educational foundation and a commitment to excellence in the field. It’s a recognized mark of competence and dedication.
There are several core AAPC certifications available, including:
- CPC (Certified Professional Coder): The foundational certification for medical office coding, covering essential aspects like coding guidelines, medical terminology, and diagnostic codes. It’s the most widely recognized and a great starting point.
- CPC-H (Certified Professional Coder-Hospital Outpatient): Specialized for outpatient hospital department coders.
- CPC-P (Certified Professional Coder-Payer): Designed for those working with insurance providers, Medicare, or Medicaid.
- CIRCC (Certified Interventional Radiology Cardiovascular Coder): For professionals handling billing for cardiac and interventional radiology procedures.
Beyond these, AAPC also offers certifications in specialized areas like Medical Auditing, Medical Compliance, and Practice Management, allowing for further career specialization. Specialty certifications are also available in specific medical fields like surgery, cardiology, and family practice, enabling coders to deepen their expertise.
AAPC vs. AHIMA: Understanding the Certification Landscape
It’s important to distinguish between AAPC and AHIMA (American Health Information Management Association) certifications. AHIMA certifications, such as Certified Coding Specialist (CCS), primarily focus on inpatient and outpatient coding mastery within hospital settings.
AAPC certifications, particularly the CPC, are geared towards professional coders across various healthcare settings, with a strong emphasis on physician-based coding and outpatient services.
While both are respected, employers may sometimes express a preference. When seeking medical coding positions, always check job descriptions for specific certification requirements.
Decoding the CPC Exam: Your Gateway to Certification
The CPC exam is widely recognized as the gold-standard for medical billing and coding certification. Passing this exam demonstrates a robust understanding of coding medical services and procedures. It’s a comprehensive 150-question multiple-choice exam assessing knowledge across 17 key areas, including CPT, HCPCS, and ICD-10-CM codes.
Further Reading: CPC or CCA: Which Medical Billing Certification is Right for You?
Is the CPC Exam Difficult?
Yes, the CPC exam is challenging and requires thorough preparation. However, with dedicated study, it is certainly achievable. A passing score is 70% or higher. Effective preparation, including consistent study habits, practice exams, and a solid grasp of coding materials, is crucial.
If you don’t pass on your first attempt, the exam fee includes a second try, providing another opportunity to succeed.
Exam Modalities: Online and In-Person Options
You have the flexibility to take the CPC exam online or at a testing center. Online exams require a remote proctor and a suitable environment: a quiet space, reliable internet, a computer, and an external webcam to monitor you during the exam.
Open Book Policy: Utilizing Your Coding Resources
The CPC exam is open book, allowing you to reference specific coding manuals: CPT®, ICD-10-CM, and HCPCS Level II code books. You are permitted to bring one copy of each, current or previous year editions. While you can highlight, tab, and write notes in your code books, you cannot attach or glue any additional materials.
Prerequisites: Schooling vs. Self-Study
While technically you can take the CPC exam without formal schooling, it is strongly discouraged. The exam covers complex material and specific coding procedures. A structured educational program significantly increases your chances of passing. Programs like the CareerStep Medical Coding and Billing Professional Program are designed to provide the necessary knowledge and skills.
Explore Programs: How a Skills-focused CPC Program Can Help You Prepare for the CPC Exam and a Job as a Medical Coder
Career and Compensation: What to Expect with CPC Certification
While the Certified Professional Compliance Officer (CPCO®) certification currently reports the highest average salary in the AAPC salary survey at $81,495, the CPC certification is a critical stepping stone for many roles and offers strong earning potential. Salaries vary based on experience, location, and employer type.
Salary Insights: AAPC Medical Coding Salary Survey
CPC certification is valid for two years and requires 36 continuing education units (CEUs) every two years for maintenance, ensuring ongoing professional development.
Preparing for Exam Success: Study Strategies and Resources
Effective study habits are key to CPC exam success. Allocate ample study time and avoid last-minute cramming.
Study Tips:
- Review your learning materials: Revisit areas of weakness, such as those identified in your CareerStep final exam or practicum reports.
- Utilize available resources: Leverage forums and support teams for exam tips and guidance.
- Practice with exam simulations: AAPC offers practice exams and study guides that many find helpful.
CPC Exam Specifics: Format and Logistics
- Exam Duration: 4 hours
- Number of Questions: 150 multiple-choice questions
- Passing Score: 70% (allowing for a maximum of 45 incorrect answers)
- Exam Cost: $499 (AAPC membership required, additional cost)
- Registration: Through the AAPC website, “Certifications” section, “Schedule Your Exam.”
- Testing Locations: Online with remote proctoring or in-person at designated testing centers.
Content Areas: Mastering the CPC Exam Syllabus
Approximately 70% of the CPC exam questions are coding scenarios, with the remaining covering areas like medical terminology and anatomy. The exam assesses 17 subject areas, each with up to ten questions.
Key Content Areas:
- Surgical procedures across all body systems (Integumentary, Musculoskeletal, Digestive, Respiratory, Cardiovascular, etc.)
- Evaluation and Management (E/M) coding (inpatient, outpatient, nursing facilities, etc.)
- Anesthesia
- Radiology and Laboratory Pathology
- Medicine and Medical Terminology
- Anatomy
- Coding Guidelines, Compliance, and Reporting for ICD-10-CM, HCPCS, and CPT®
Apprentice Status: Initial Certification Stage
If you lack two years of prior work experience, passing the CPC exam initially grants you CPC-A status (“A” for apprentice). Upon submitting proof of two years of coding work experience, the “A” designation is removed.
Nationwide Recognition and Recertification
The CPC certification is nationally recognized across all 50 states. Recertification is required every two years through CEU completion, not by retaking the exam, ensuring your credentials remain current.
Conclusion: Your Career Step to CPC Certification
Pursuing CPC certification is a significant career step for aspiring medical coding professionals. It demonstrates expertise, enhances job prospects, and opens doors to career advancement. By understanding the certification process, preparing thoroughly for the exam, and continuously developing your skills, you can build a successful and rewarding career in medical coding. Exploring structured educational programs, like CareerStep’s Medical Coding and Billing Professional Program, can provide a strong foundation and targeted syllabus to help you confidently embark on this career path and achieve CPC certification.
